Lechenie psikhicheskikh zabolevaniy v period beremennosti


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The article considers the different aspects of mental disorders during pregnancy. General principles of treatment of mental disorders in pregnant women are presented. Questions of safety of psychotropic drugs for mother and child (fetus) are discussed. It is emphasized that decision making about administration of psychotropic drugs during pregnancy should be individual in each case. Planning for pregnancy, discussion of potential risks and therapeutic opportunities is extremely important for women with mental disorders. In some cases, withdrawal of psychotropic drugs for the entire period of pregnancy, or in some critical periods is feasible. In case of need for psychopharmacotherapy, careful selection of drugs in view of the course of disease and its negative effects on the fetus and the health of the pregnant woman is necessary. Monotherapy is preferred if possible. In all cases, careful monitoring of the woman and fetus throughout the pregnancy is required.

Full Text

Restricted Access

About the authors

A. V Ushkalova

E. A Ushkalova

Email: eushk@yandex.ru

References

  1. Fisher J, Cabral de Mello M, Patel V, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139G-149G.
  2. Clinical Management Guidelines for Obstetrician-Gynecologists Use of Psychiatric Medications During Pregnancy and Lactation. ACOG Practice Bulletin Focus 2009;7:385-400.
  3. Altshuler LL, Cohen L, Szuba MP, et al. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry 1996;153:592-606.
  4. Sacker A, Done DJ, Crow TJ. Obstetric complications in children born to parents with schizophrenia: a meta-analysis of case-control studies. Psychol Med 1996; 26(2):279-87.
  5. Webb R, Abel K, Pickles A, Appleby L. Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis. Am J Psychiat 2005;162:1045-56.
  6. Gentile S, de' Tirreni C. Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review Schizophr Bull 2010;36(3):518-44.
  7. Watkins ML, Rasmussen SA, Honein MA, et al. Maternal obesity and risk for birth defects. Pediatrics 2003;111:1152-58.
  8. Birdsall KM, Vyas S, Khazaezadeh N. Maternal obesity: a review of interventions. Clin Pract 2009;63:494-507.
  9. Fraser A, Tilling K, Macdonald-Wallis C. Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr 2011;93:1285-92.
  10. Yaeger D, Smith HG, Altshuler LL. Atypical antipsychotics in the treatment of schizophrenia during pregnancy and the postpartum. Am J Psychiat 2006;163(12):2064-70.
  11. Coppola D, Russo LJ, Kwarta RF Jr, et al. Evaluating the postmarketing experience of risperidone use during pregnancy: pregnancy and neonatal outcomes. Drug Saf 2007;30(3):247-64.
  12. Praprotnik S, Agmon-Levin N, Porat-Katz BS, et al. Prolactin's role in the pathogenesis of the antiphospholipid syndrome. Lupus 2010;19(13):1515-19.
  13. Jara LJ, Medina G, Saavedra MA, et al. Prolactin and autoimmunity. Clin Rev Allergy Immunol 2011;40(1):50-9.
  14. Peitl MV, Petric D, Peitl V. Ziprasidone as a possible cause of cleft palate in a newborn. Psychiatr Danub 2010;22(1):117-19.
  15. Petersen I, Gilbert R, Evans S, Nazareth I. Selective serotonin reuptake inhibitors and risk for major congenital anomalies. Obstet Gynecol 2012;119(1):182-83.
  16. Malm H, Artama M, Gissler M, Ritvanen A. Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies.Obstet Gynecol 2011;118(1):111-20.
  17. Alwan S, Reefhuis J, Rasmussen SA, et al. Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 2007;356(26):2684-92.
  18. Bellantuono C, Migliarese G, Gentile S. Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review. Hum Psychopharmacol 2007;22(3):121-28.
  19. Rahimi R, Nikfar S, Abdollahi M. Pregnancy outcomes following exposure to serotonin reuptake inhibitors: a meta-analysis of clinical trials. Reprod Toxicol 2006;225(4):571-75.
  20. Einarson TR, Einarson A. Newer antidepressants in pregnancy and rates of major malformations: A meta-analysis of prospective comparative studies. Pharmacoepidemiol Drug Saf 2005;14:823-27.
  21. Yonkers KA, Norwitz ER, Smith MV, et al. Depression and Serotonin Reuptake Inhibitor Treatment as Risk Factors for Preterm Birth. Epidemiology. 2012 May 23 [Epub ahead of print].
  22. Nakhai-Pour HR, Broy P, Berard A. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 2010;182(10): 1031-37.
  23. Hemels ME, Einarson A, Koren G, et al. Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother 2005; 39(5):803-09.
  24. Ellfolk M, Malm H. Risks associated with in utero and lactation exposure to selective serotonin reuptake inhibitors (SSRIs). Reprod Toxicol 2010;30(2):249-60.
  25. Toh S, Mitchell AA, Louik C, et al. Selective serotonin reuptake inhibitor use and risk of gestational hypertension. Am J Psychiatry 2009;166(3):320-28.
  26. De Vera MA, Berard A. Antidepressant Use During Pregnancy and the Risk of Pregnancy Induced Hypertension. Br J Clin Pharmacol 2012 Mar 21. doi: 10.1111/j.1365-2125. 2012.04196.x. [Epub ahead of print].
  27. Koren G, Nordeng H. Antidepressant use during pregnancy: the benefit-risk ratio. Am J Obstet Gynecol 2012 Feb 21. [Epub ahead of print].
  28. Jong GW, Einarson T, Koren G, Einarson A. Antidepressant use in pregnancy and persistent pulmonary hypertension of the newborn (PPHN): A systematic review. Reprod Toxicol 2012 May 5. [Epub ahead of print].
  29. Pedersen LH, Henriksen TB, Olsen J. Fetal exposure to antidepressants and normal milestone development at 6 and 19 months of age. Pediatrics 2010;125(3):e600-08.
  30. Brummelte S, Galea LA, Devlin AM, Oberlander TF. Antidepressant use during pregnancy and serotonin transporter genotype (SLC6A4) affect newborn serum reelin levels. Dev Psychobiol 2012 Jun 12. doi: 10.1002/dev.21056. [Epub ahead of print]].
  31. Cohen LS, Wang B, Nonacs R, et al. Treatment of mood disorders during pregnancy and postpartum. Psychiatr Clin North Am 2010; 33(2):273-93.
  32. Lusskin S, Misri S. Use of psychotropic medications in breastfeeding women Uptodate, January, 2011.
  33. Einarson A, Choi J, Einarson TR, Koren G. Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. JOGC 2009;31:452-56.
  34. American Academy of Pediatrics. Use of Psychoactive Medication During Pregnancy and Possible Effects on the Fetus and Newborn (RE9866). Arch Pediatr Adolesc Med 2002;156:1129-32.
  35. Malm H, Klaukka T, Neuvonen PJ. Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 2005;106:1289.
  36. Einarsen, A, Bumn, F, Sarkar, M, et al. Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. American Journal of Psychiatry 2001;158:1728-30.
  37. Ramos E, St-Andre M, Berard A. Association between antidepressant use during pregnancy and infants born small for gestational age. Can J Psychiat 2010;55(10):643-52.
  38. Nakhai-Pour HR, Broy P, Berard A. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 201013;182(10):1031-37.
  39. Boucher N, Koren G, Beaulac-Baillargeon L. Maternal use of venlafaxine near term: correlation between neonatal effects and plasma concentrations. Ther Drug Monit 2009;31:404-09.
  40. Biswas PN, Wilton LV, Shakir SA. The pharmaco-vigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England. J Psychopharmacol 2003;17:121.
  41. Djulus J, Koren G, Einarson TR, et al. Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes. J Clin Psychiat 2006;67:1280-84.
  42. Einarson A. The Safety of Psychotropic Drug Use During Pregnancy: A Review. Medscape General Medicine 2005;7:3.
  43. Jacobson SJ, Jones K, Johnson K, et al. Prospective multicentre study of pregnancy outcome after lithium exposure during first trimester. Lancet 1992;339:530-33.
  44. McKnight RF, Adida M, Budge K, et al. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-28.
  45. Yatham LN, Kennedy SH, Schaffer A, et al. Canadian Network for Mood and Anxiety Treatments [CANMAT] guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord 2005;7(3):5-69.
  46. Iqbal MM, Sobhan T, Ryals T. Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatr Serv 2002;53:39-49.
  47. Galbally M, Roberts M, Buist A; Perinatal Psychotropic Review Group. Mood stabilizers in pregnancy: a systematic review. Aust N Z J Psychiat 2010;44(11):967-77.
  48. Meador K, Reynolds MW, Crean S, et al. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res 2008;81:1-13.
  49. Hill DS, Wlodarczyk BJ, Palacios AM, Finnell RH. Teratogenic effects of antiepileptic drugs. Expert Rev Neurother 2010;10:943-59.
  50. De Santis M, De Luca C, Mappa I, et al. Antiepileptic drugs during pregnancy: pharmacokinetics and transplacental transfer. Curr Pharm Biotechnol 2011;12:781-88.
  51. Meador KJ, Penovich P, Baker GA, et al. Antiepileptic drug use in women of childbearing age. Epilepsy Behav 2009;15(3):339-43.
  52. Morrow J, Russell A, Guthrie E, et al. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiat 2006;77:193-98.
  53. Samren EB, van Duijn CM, Koch S, et al. Maternal use of antiepileptic drugs and the risk of major congenital malformations: a joint European prospective study of human teratogenesis associated with maternal epilepsy. Epilepsia 1997;38:981-90.
  54. Ward S, Wisner L. Collaborative Management of Women with Bipolar Disorder During Pregnancy and Postpartum: Pharmacologic Considerations. J Midwifery Womens Health 2007;52(1):3-13.
  55. Cunnington M, Ferber S, Quartey G, et al. International Lamotrigine Pregnancy Registry Scientific Advisory C. Effect of dose on the frequency of major birth defects following fetal exposure to lamotrigine monotherapy in an international observational study. Epilepsia 2007;48:1207-10.
  56. Harden CL, Meador KJ, Pennell PB, et al. Management issues for women with epilepsy -focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia 2009; 50:1237-46.
  57. Hunt SJ, Craig JJ, Morrow JI. Increased frequency of isolated cleft palate in infants exposed to lamotrigine during pregnancy. Neurology 2009;72:1108.
  58. Hunt S, Russell A, Smithson WH, et al. Topiramate in pregnancy: preliminary experience from the UK epilepsy and pregnancy registry. Neurology 2008;71:272-76.
  59. Molgaard-Nielsen D, Hviid A. Newer-generation antiepileptic drugs and the risk of major birth defects. JAMA 2011;305:1996-2002.
  60. Holmes LB, Mittendorf R, Shen A, et al. Fetal Effects of Anticonvulsant Polytherapies: Different Risks From Different Drug Combinations. Arch Neurol 2011;68:1275-81.
  61. De-Regil LM, Fernandez-Gaxiola AC, Dowswell T, Pena-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev 2010 Oct 6[10]:CD007950.
  62. Briggs G, Freeman R, YaffeS. Drugs in Pregnancy and Lactation. Philadelphia, Lippincott Williams & Wilkins, 2002.
  63. McVearry KM, Gaillard WD, VanMeter J, Meador KJ. A prospective study of cognitive fluency and originality in children exposed in utero to carbamazepine, lamotrigine, or valproate monotherapy. Epilepsy Behav 2009;16:609.
  64. Bromley RL, Mawer G, Love J, et al. Early cognitive development in children born to women with epilepsy: a prospective report. Epilepsia 2010;51:2058.
  65. Nadebaum C, Anderson VA, Vajda F, et al. Language skills of school-aged children prenatally exposed to antiepileptic drugs. Neurology 2011;76:719-26.
  66. Meador KJ, Baker GA, Browning N, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med 2009;360:1597.
  67. Dolovich LR, Addis A, Vaillancourt JM, Power JD, Koren G, Einarson TR. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. Br Med J Clin Res Ed 1998;317:839-43.
  68. Calderon-Margalit R, Qiu C, Ornoy A, Siscovick DS, Williams MA. Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy. Am J Obstet Gynecol 2009;201:579.e1-8.
  69. Laegreid L, Hagberg G, Lundberg A. Neurodevelopment in late infancy after prenatal exposure to benzodiazepines-- a prospective study. Neuropediatrics 1992;23:60-7.
  70. Wikner BN, Stiller CO, Bergman U, Asker C, Kallen B. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf. 2007;16:1203-10.
  71. Wikner BN, Kallen B. Are hypnotic benzodiazepine receptor agonists teratogenic in humans? J Clin Psychopharmacol 2011;31:356-59.
  72. Diav-Citrin O, Okotore B, Lucarelli K, Koren G. Zopiclone use during pregnancy. Can Fam Physician 2000;46:63-4.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies