Treating with medication during pregnancy is a difficult task as there are no true absolute data studies in the realm of psychiatric medications. There are many risk factors associated with pregnancy and medications. There are risks associated pre pregnancy, during and even post pregnancy effects of some medications. As noted in the text, these risks are teratogenesis on the fetus, behavioral teratogenesis, effects on developing fetus and labor and delivery, neonatal drug effects, pregnancy induced changes in drug actions, and effects on a breast fed infant.
During the first trimester of pregnancy, when organ development is taking, there is heavy concern for teratogenesis. When I was pregnant with my daughter I was given a list of safe
There is increasing awareness of perinatal mental health as a public health issue. The Government is keen for midwives to further develop their role in public health. Midwives need to be adequately prepared to take on a more developed role in perinatal mental health if practice improvements are to be made. I am aware that death from psychiatric causes has been the leading cause of maternal death for the last few years. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer a leading cause, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children’s subsequent
Stimulants are considered as a drug and are commonly used today. The question is will use of stimulants while pregnant affect the infant. A pregnant woman can be prescribed stimulants (Antidepressants) because of them being depressed and stressed out about everything that is occurring in their life while pregnant, but what many people do not see is it going to affect the infant long-term. Most mothers want what is best for their child and they want to make sure that their child is going to have a healthy life as much as possible. Is it safe to take the antidepressants while pregnant and will there be any risk factors? There is mainly a biological and environmental that reflect a child’s senses and development.
A second suggested activity during pregnancy could be for the pregnant woman to take care of herself psychologically and emotionally, to ensure that she is not too stressed or experiencing anxiety. Regular relaxation could be advised by taking up yoga and meditation. Too much prenatal stress can have negative developmental implications for the child later in life. Research has indicated that when mothers-to-be have high levels of pregnancy-specific anxiety, their offspring were significantly more likely to show lower inhibitory control among girls, and lower visuospatial working memory performance among girls and boys (Buss et al., 2011).
There are many expecting mothers who suffer from serious mental illnesses like schizophrenia, bipolar disorder, or borderline personality disorder that requires they must take antipsychotic drugs to remain stable. There are different types of antipsychotics like typical and atypical. Typical antipsychotics are classified as the first generation of antipyschotics. The atypical antipsychotics, the second generation, are reported to be safer than the typical antipsychotics because they are the newer form of antipsychotic medication. Even though they are reported to be safer, they still have severe side effects on the individual consuming it, like tardive dyskinesia, which are uncontrollable movements of the mouth (McCauley et al., 2009). Some drugs can affect the fetus by transferring to the blood-brain barrier. The blood-brain barrier is a permeable barrier that allows some chemicals to pass through. It separates the circulating blood from the brain extracellular fluid in the central nervous system. The blood-brain barrier also transports molecules to the brain that are essential to function properly, like glucose and amino acids. Since capillary endothelial cells, which line the whole circulatory system, form the blood-brain barrier the medication could be transported to the fetus. From
With an increase in articles discussing external effects that can be avoided to help protect the fetus will help several mothers increase the chance of having a healthier child. Websites such as the CDC in collaboration with other websites can lead to mothers that are properly informed of possible defects that can occur with their child. For a drug to receive pregnancy category research is required. However to find subjects willing to risk their child having a defect to help categories a drug is limited. There are instances where some women may not even be aware that they are pregnant. They may be on an opioid regimen and be total unaware of the damage it could cause their unborn fetus. Once realized by the physician, the mother should be tapered off and place on a pregnancy appropriate therapy of either Methadone or Buprenorphine. There are some mothers that may be addicted to the opioid therapy prior to pregnancy. These mothers require a switch of therapy and behavioral therapy to ensure safety of both the mother and child. Some mothers might be opioid naïve till pregnancy. They may need opioid therapy due them needing surgical procedure (car accident, emergency surgeries), infection, injuries or chronic diseases (such as nephropathy).
There are several different antidepressants. Different antidepressants can affect the body in different ways. There are a few antidepressants that have been deemed safe for breastfeeding women. Some of those antidepressants include Paxil and Zoloft. Studies have shown that those antidepressants are not detectable
The current methods of treatment for postpartum depression include antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants, and/or psychotherapy. However, there is a certain amount of risk when taken during pregnancy and lactation. These medications are a pregnancy category C and SSRIs, have been shown to have a slight risk of heart and lung birth defects (Reefhuis, Devine, Friedman, Louik, & Honein, 2015). In breastfeeding mothers, all psychiatric medications are secreted in breastmilk, and some
Results showed that the drugs most frequently used were the SSRIs escitalopram, sertraline, and paroxetine, along with the SNRI venlafaxine and the anticonvulsant sodium valproate, along with twenty-one other drugs. The most common diagnoses were major depressive disorder, followed by anxiety disorders, bipolar disorder, schizophrenia, epilepsy with a psychiatric diagnosis, and others. 81% of those studied were exposed to drugs during their first trimester, with 11% continuing use of drugs through all three trimesters. Interestingly, the rates of elective abortion were higher in the exposed group. This disparity may reflect the perception of psychotropic drug use during pregnancy as being unsafe for the fetus. Two pregnancies in the drug exposure group resulted in major congenital defects, compared to three in the control cohort. No significant differences were found between groups in regards to birth defects, rates of miscarriage, or preterm births.
The efficacy and safety of the drug in patients under the age of 18 years is not established. With renal / hepatic insufficiency and long-term treatment, control over the picture of peripheral blood and liver enzymes is necessary. Patients who did not take previously psychoactive drugs respond to the drug at lower doses compared to patients taking antidepressants, anxiolytics or alcohol. With endogenous depression, alprazolam can be used in combination with antidepressants. With the use of alprazolam, patients with depression have seen cases of hypomanic and manic development. Like other benzodiazepines, alprazolam has the ability to induce drug dependence in long-term admission in large doses (more than 4 mg / day). With a sudden discontinuation of alprazolam, there may be comeback syndromes, such as depression, irritability, insomnia, increased sweating, especially with prolonged admission (more than 8-12 weeks). When patients develop such unusual reactions as increased aggressiveness, acute excitations, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficult sleep, superficial sleep, treatment should be discontinued. During pregnancy Xanax is very dangerous due to its toxic effect on the fetus and increases the risk of congenital malformations when applied in the first trimester of pregnancy. Admission of therapeutic doses in later periods
• If you suspect you are pregnant while on the drug, stop the medication and notify the doctor with immediate effect. If the medicine is used during pregnancy it can result in a miscarriage or cause birth defects to the fetus.
The common fever is one thing that has also been associated with teratogenesis. According to dictionary.com a fever is “an abnormal condition of the body, characterized by undue rise in temperature, quickening of the pulse, and disturbance of various body functions.” Fevers are a normal part of life, and they cannot be prevented. The uncontrolled elevation of body temperature or fever has a potential negative effect on the developing fetus. The raising temperature on the body is an inflammatory or infectious process that has been known to cause stillbirths and miscarriages (Andersen, Vastrup, Wohlfahrt, Olsen, et al 2002). “The process where an embryo develops into a fetus is considered the most vulnerable period” (Andersen et al
Why it is important in our society to know what teratogen is, and some ways to prevent this birth defect in our society. Teratogen is a agent that disturbs the development of an embryo. Well, what exactly causes these disturbances in the embryo? By taking medicine during pregnancy, medicine prescribe to new mothers can cause abnormality in pregnancy. Although many women take medications during pregnancy, the medicine prescribe can be harmful. A example may be a woman during pregnancy comes across morning sickness; therefore, she may ask her doctor to prescribe medicine to treat her morning sickness. A common medicine to take during the 60's was thalidomide. However, over the years researchers found that thalidomide caused partial absence
Most women are unaware of the risks associated with taking prescription medications while pregnant. Usually the fear
Teratogens can harm an embryo. Most will not kill an embryo. However, any large quantity of teratogens like nicotine will
Teratogens can have a huge effect on an infant development during the critical period for the brain which takes places during the proliferation,migration, and the differentiation stages because the fetus is having to develop so rapidly. During these three stages all of the fetus major body systems are developing. If a woman exposes herself to teratogens while she is pregnant she increases that baby chances of having some form of impairment whether it be a physical impairment or some form of brain impairment. Even after a woman has her baby and the baby doesn't displays any signs of side effects because of the teratogens that the mother used during her pregnancy does not me that the child won't suffer later in his/her