Pregnancy and psychotropic drugs: how to adjust with therapy and what are the risks for the child?

I am 25 years old and I am pregnant. I take Fluoxetine, quetiapine and lamotrigine. Can I continue pregnancy safely? They are important drugs for my health and I would not want to go back to feeling bad.

Respond Giancarlo CerveriDirector of Mental Health and Dependencies Department, Asst of Lodi (Go to the forum)

It is a choice that must always be shared with the attending physician and must be founded on a careful cost-benefit ratio. If the costs of therapy are the possible risks for the fetusthe benefits are represented by the possibility of perform their role as a mother adequatelywithout acute disease phases. Any suspension of the treatment also has specific benefits (which in this case are the reduction of the potential risk of damage to the fetus) and specific risks (a serious regulation of psychic pathology in pregnancy or in the phase post-partum). The theme that she places is also relevant from an epidemiological point of view: depressive disorders generally arise in fertile age. It is estimated that, in pregnancy, the prevalence of depressive disorders equal to 8-10% and that about 13% of women suffer from these disorders in the year following the birth.

Continue the treatments

The management of depressive pathology in pregnancy is complex and, sometimes, involves risks to the health of the mother and child. The untreated depression increases the risk of abuse of alcoholsuicidal ideation and is associated with a greater incidence of premature birth, low birth weight and neuro-behavioral disorders. For this reason, in many cases it is necessary to continue the treatments. The use of antidepressants belonging to the SSRI class (like fluoxetine), in pregnancy, it is sufficiently safe, both on the psychomotor and cognitive development of the child, even if the data available are limited to observational studies. The communications provided by entities such as the Italian drug agency, which underlines how in many cases The continuation of the treatments with antidepressants must be considered the most suitable choice.

Limited risk of malformations

In his case there is the contextual use of lamotrigine and quetiapine, probably due to a complex psychopathological picture. As far as we know, both drugs present a very limited (or null) risk of malformationseven if the quetiapine increases the probability of diabetes in pregnancy. The most appropriate choice for treatment should agree with his trusted doctor, bearing in mind that the drugs he assumes do not show a recognized connection with serious malformations. At the same time it must inform his gynecologist, in order to carry out all the assessments to monitor his son’s health, as well as histhroughout the course of pregnancy.