Use of psychotropic drugs during pregnancy and breast-feeding.
OBJECTIVE
To write clinical guidelines for the use of psychotropic drugs during pregnancy and breast-feeding for daily practice in psychiatry, obstetrics and paediatrics.


METHODS
As we wanted a guideline with a high degree of consensus among health professionals treating pregnant women with a psychiatric disease, we asked the Danish Psychiatric Society, the Danish Society of Obstetrics and Gynecology, the Danish Paediatric Society and the Danish Society of Clinical Pharmacology to appoint members for the working group. A comprehensive review of the literature was hereafter conducted.


RESULTS
Sertraline and citalopram are first-line treatment among selective serotonin reuptake inhibitor for depression. It is recommended to use lithium for bipolar disorders if an overall assessment finds an indication for mood-stabilizing treatment during pregnancy. Lamotrigine can be used. Valproate and carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia.


CONCLUSIONS
It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how it has to be administered.
Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark.
E R
ER
Larsen
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
P
P
Damkier
Department of Clinical Medicine - Gynecological/Obstetric Ward Y, Aarhus University Hospital, Skejby, Denmark.
L H
LH
Pedersen
Neonatal Ward, Sygehus Lillebaelt, Kolding, Denmark.
J
J
Fenger-Gron
Psychiatry in the Capital Region of Denmark, Psychiatric Centre Copenhagen, Section 6211, Rigshospitalet, Copenhagen, Denmark.
R L
RL
Mikkelsen
Psychiatry, Aalborg University Hospital, Aalborg, Denmark.
R E
RE
Nielsen
Psychiatry in the Capital Region of Denmark, Psychiatric Centre Copenhagen, Affective Ward 6203, Rigshospitalet, Copenhagen, Denmark.
V J
VJ
Linde
District Psychiatry Center, Psychiatric Center, Hvidovre, Denmark.
H E D
HE
Knudsen
Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark.
L
L
Skaarup
Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark.
P
P
Videbech
D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000188:drug therapy / Q000523:psychology*; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000009:adverse effects*
D011619:Psychotropic Drugs
breast-feeding; clinical guidelines; pregnancy; psychotropic drugs; recommendations