perinatal psych Flashcards
if mental illness is left untreated during pregnancy what are the risks to the mother
increased risk suicide, substance misuse, poor compliance, poor lifestyle and self care
if mental illness is left untreated during pregnancy what are the risks to the infant
LBW, pre term, poor attachment
when would you get withdrawal syndrome in baby
if drugs are used in 3rd trimester
when are malformations most likely (which trimester) due to drugs
1st
bipolar medication
maintain on medication if severe and high risk relapse. avoid valproate- neural tube defects. can use lithium but teratogenic- cardiac malformations
schizophrenia in pregnancy medication
take antispychotics at every stage. olanzapine
depression treatment pregnancy
delay until 2nd and 3rd trimester. amitryptilline, nortryptilline, fluoxetine
what are the baby blues
brief period low mood, tearful, emotional lability. 2-3 days after, and lasts 2-3 days. 75% new mums
what is post natal depression
significant depressive episode within 6 months of delivery. 10-15% new mums
what is postpartum psychosis
rapidly evolving abrupt onset. confusion and disorientation with psychotic features. high risk suicide and infanticide. 2-4 weeks after birth
management post partum depression
psychotherapy
management post partum psychoses
antipsychotics. ECT can be used
antidepressants
use TCAs, sertraline if SSRI.
what antidepressants are present in breast milk at low levels
imipramine, nortryptyline, amitriptyline.
mood stabilisers
don’t use in breastfeeding
