SM_114b: Psychopharmacology of Pregnancy

Question 1

Peripartum depression, anxiety, and OCD are ____

Answer 1

Peripartum depression, anxiety, and OCD are common

(10-15% have peripartum depression)

Question 2

____ is the category of antidepressants most commonly prescribed for pregnant women

Answer 2

SSRIs is the category of antidepressants most commonly prescribed for pregnant women

Question 3

Antidepressants ____ associated with increased risk of cardiac malformations

Answer 3

Antidepressants are NOT associated with increased risk of cardiac malformations

Question 4

____ is most commonly prescribed SSRI in pregnancy

Answer 4

Sertraline is most commonly prescribed SSRI in pregnancy

Question 5

Concerns for antidepressants in pregnant women are ____

Answer 5

Concerns for antidepressants in pregnant women are unclear

Question 6

Antidepresants may cause _____, consisting of an uncomfortable infant who is fussy, jittery, stiff, tremulous, and with feeding and breathing concerns

Answer 6

Antidepresants may cause neonatal adaptation syndrome, consisting of an uncomfortable infant who is fussy, jittery, stiff, tremulous, and with feeding and breathing concerns

Question 7

Benzodiazepine use in pregnancy is associated with risks of ____, ____, ____, ____, and ____

Answer 7

Benzodiazepine use in pregnancy is associated with risks of cleft lip and/or palate, neonatal adaptation syndrome, withdrawal syndrome, impairment in long-term behavior and development, and breastfeeding

Question 8

Antipsychotics are prescribed in pregnancy for ____, ____, ____, and ____

Answer 8

Antipsychotics are prescribed in pregnancy for bipolar, psychotic disorders, depression, and off label for sleep and anxiety

• Haloperidol is most common typical/first generation antipsychotic
• Atypicals associated with weight gain and metabolic changes

Question 9

____ is an atypical antipsychotic associated with malformations, including cardiac malformations

Answer 9

Risperidone is an atypical antipsychotic associated with malformations, including cardiac malformations

Question 10

Atypical antipsychotics may cause ____

Answer 10

Atypical antipsychotics may cause neonatal adaptation syndrome

(neuromotor development seems to catch up by 2 years old)

Question 11

Mood stabilizers are used for ____, ____, and ____ in pregnant women

Answer 11

Mood stabilizers are used for bipolar, refractory depression, and aggression in pregnant women

Question 12

Lithium in pregnancy causes ____ or ____ defects

Answer 12

Lithium in pregnancy causes Ebstein’s anomaly or right ventricular outflow tract obstruction defects

Question 13

____ is contraindicated in pregnancy due to risk of NTDs and autism spectrum disorders

Answer 13

Valproic acid is contraindicated in pregnancy due to risk of NTDs and autism spectrum disorders

Question 14

____ is an antiepileptic with increased dose in breast milk

Answer 14

Lamotrigine is an antiepileptic with increased dose in breast milk

(metabolism fluctuates greatly during pregnancy so may need to increase dose)

Question 15

Psychotropics ___ to breast milk in pregnant women, but the dose to infants is low

Answer 15

Psychotropics transfer to breast milk in pregnant women, but the dose to infants is low

(monitor for weight concerns / agitation / sleep issues, does not tend to impact maternal milk supply)

Question 16

Untreated psychiatric illness during pregnancy and postpartum is associated with ____, ____, and ____

Answer 16

Untreated psychiatric illness during pregnancy and postpartum is associated with low birth weight, preterm birth, and impact on attachment and development