Psychiatric Disorders

Question 1

what effect do benzos have on the foetus?

Answer 1

Cleft palet

withdrawl

Question 2

What effects do Bipolar drugs have

Answer 2

Lithium-ebstiens anomily

Valproate- NTD, craniofacial defects, CV abnormality, IUGR, reduced IQ, cleft, genitourinary anomalies

Carbamazepine- facial dysmorphism, cardiac anomalies, fingernail hypoplasia, NTD

Valproate and Carbamezipine often substituted in first trimester

Lamotrigine cleft- Steven Johnson syndrome to baby if breast fed

Question 3

what is the advice regarding lithium

Answer 3

can cause ebstien’s anomally

try and remove gradually

contrindicated with breastfeeding

Question 4

what’s the advice regarding schizophrenic drugs?

Answer 4

Antipsychotics considered safe in pregnancy

Clozapine considered contraindicated during breast-feeding because of its liability of inducing potential life-threatening events in the infant

Olanzapine associated with an increased risk of inducing extrapyramidal reactions in the breast-fed babies

Anticholinergic drugs (used for extrapyramidal side effects ) not to be used in pregnancy

Question 5

what is the advice regarding depression drugs

Answer 5

fluoxetine is the only SSRI licensed for pregancy

TCA’s fine

Venlafaxine: hypertension

Paroxetine: cardiac abnormalities

Citalopram and fluoxetine (SSRI) high levels in breast milk

SSRI breastfeeding- sertraline ok