Toolbox: Psychotropic use in pregnancy and lactation

• DOI: 10.9740/mhc.n164620
• Publication Date: 2014-12-23T22:11:27Z
• Authors: Kathryn N. Freeland; Kayce M. Shealy
• Keywords: Toolbox

When designing treatment regimens for patients with psychiatric illness, recommendations of pregnant or breastfeeding women can be particularly complicated. Safe and appropriate medication use in this patient population may vary based on the patient's stage pregnancy whether not she plans to breastfeed. The pharmacist is often asked help guide these decisions recommend medications that will minimize toxicity fetus newborn child while also ensuring efficacy control symptoms. appendices following pages were designed quickly review FDA's categories as well current data regarding a patient. include:The FDA first implemented 1979 required all marketed drugs assigned one 5 categories, A, B, C, D X depending risk reproductive developmental adverse effects.1 In 1997, held public hearing obtain feedback practicality utility categories. Due concerns raised at forum about effectiveness decided revise labeling lactation more accurately convey actual risks associated exposure. new format include clinical management statement, assessment summary, discussion available data. While proposed changes announced 2008, they have yet fully implemented.Briggs' Pregnancy Lactation reference, currently its 9th edition, no longer cites letter Beginning 7th printed 2005, authors began assigning each drug included reference addition felt insufficient defining potential poorly written. For instance, category C particular same those labeled X, but benefit certain situations. However, written, might conclude incorrectly proportionately increases from A given share risks. Thus, both Briggs are table further explain where truly lies face existing