title: Psychopharmacotherapy in Pregnancy and Breastfeeding.
abstract: OBJECTIVE
  Fifteen percent to 20% of pregnant women suffer from mental disorders, and 86% of them are not treated due to potential teratogenic risks for the fetus. Several drugs seem to be safe during pregnancy but knowledge regarding risks of antenatal exposure to drugs is still limited.
  
  
  OBJECTIVE
  The aim of this article is to provide a review of literature, data, and a clinical guideline concerning the treatment and management of mental disorders during pregnancy and lactation.
  
  
  METHODS
  Bibliographical research was carried out using Medline and Pubmed (from 2005 until 2015) and articles, books and Websites were consulted.
  
  
  RESULTS
  Regarding antidepressants, only paroxetine seems to lead to an increased risk of malformations, whereas fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram and venlafaxine do not appear to increase this risk. The use of duloxetine is associated with an increased risk of miscarriage during pregnancy but not with an increased risk of adverse events, such as birth defects. There is no clear evidence of malformation risk associated with the use of antipsychotics, whereas a risk associated with pregnancy and newborn outcome has been detected. All mood stabilizers are associated with risks of birth defects and perinatal complications.
  
  
  CONCLUSIONS
  Taking psychoactive drugs is possible during pregnancy, but it is important to consider various effects of the drugs. Future research should focus on prospective and longitudinal studies with an adequate evaluation of confounding variables. This should be followed by long-term studies to obtain accurate measures of child development.
authors.affiliation: Resident, Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina.
authors.forename: Salvatore Giovanni
authors.initials: SG
authors.lastname: Vitale
authors.affiliation: Resident, Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina.
authors.forename: Antonio Simone
authors.initials: AS
authors.lastname: Laganà
authors.affiliation: Associate Professor, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina.
authors.forename: Maria Rosaria Anna
authors.initials: MR
authors.lastname: Muscatello
authors.affiliation: Psychologist, Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy.
authors.forename: Valentina Lucia
authors.initials: VL
authors.lastname: La Rosa
authors.affiliation: Resident.
authors.forename: Veronica
authors.initials: V
authors.lastname: Currò
authors.affiliation: Researcher.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pandolfo
authors.affiliation: Head, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Rocco Antonio
authors.initials: RA
authors.lastname: Zoccali
authors.affiliation: Researcher.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bruno
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control; D001942:Breast Feeding / Q000379:methods*; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D011619:Psychotropic Drugs / Q000494:pharmacology*; D018570:Risk Assessment
chemical_list: D011619:Psychotropic Drugs