Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.
Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making.
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA. Katharine.Dalke@uphs.upenn.edu.|Pennsylvania Hospital, 801 Spruce St, 6th Floor, Philadelphia, PA, 19107, USA. Katharine.Dalke@uphs.upenn.edu.
Katharine Baratz
KB
Dalke
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA.
Amy
A
Wenzel
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA.
Deborah R
DR
Kim
D001007:Anxiety / Q000628:therapy*; D001008:Anxiety Disorders / Q000628:therapy; D003657:Decision Making; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology* / Q000628:therapy*; D018570:Risk Assessment
Anxiety; Decision-making; Depression; Informed consent; Pharmacotherapy; Pregnancy