The last time TCPR covered the topic of psychotropics in pregnancy was less than two years ago, in February of 2009. Since then, however, some new treatment guidelines have been published, and they appear to be useful to clinicians.
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As a pharmacist specializing in psychopharmacology, I am commonly consulted by psychiatrists to provide updated information on the safety of medications in pregnancy and breastfeeding.
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These new guidelines were issued jointly by our APA and by the American College of Obstetricians and Gynecologists. In addition to providing a nice summary of the neonatal risks of antidepressant exposure, the paper offers clear, concise, and easy to follow algorithms for the management of depression in three scenarios doctors are likely to encounter.
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SSRIs theoretically work by inhibiting the reuptake of serotonin, presumably by blocking the serotonin transporter pump whose job is to clean up excess serotonin in the synapses between neurons.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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