Teratogenicity and Developmental Abnormalities

Question 1

How is sodium valproate a teratogenic risk?

Answer 1

1. Neural tube defects
2. Facial dysmorphism
3. Limb defects
4. Cardiac anomalies
5. Neurodevelopmental impact: ↓ IQ, ↑ risk of autism and ADHD
   ….
   (always use folic acid 5 mg/day for women on mood stabilisers)

Question 2

How is lithium a teratogenic risk?

Answer 2

Cardiac malformations: especially Ebstein’s anomaly (1st trimester exposure)
….
(always use folic acid 5 mg/day for women on mood stabilisers)

Question 3

How are SSRIs a teratogenic risk?

Answer 3

Paroxetine: Slight ↑ risk of congenital heart defects (especially in 1st trimester)