OUTLINE

INTRODUCTION

DEFINITIONS OF SOME TERMS

ANTEPARTUM PSYCHIATRIC DISORDERS

RISKS FACTORS

MDD,PSYCHOSIS,BORDERLINE PERSONALITY DISODER

DILEMMAS

PSYCHOTROPICS IN PREGNANCY AND BREAST FEEDING

NAVIGATING THE DILEMMAS

RECOMMENDATIONS

CONCLUSION

REFERENCES

INTRODUCTION

AS ESTIMATED 500,000 PREGNANCIES IN THE UNITED STATES EACH YEAR INVOLVE WOMEN WHO HAVE OR WHO WILL DEVELOP PSYCHIATRIC ILLNESS DURING THE PREGNANCY.•ESTIMATES SUGGEST THAT PSYCHIATRIC MORBIDITY, INCLUDING DEPRESSION AND ANXIETY, AFFECTS BETWEEN 12.5  AND OVER 50%  OF PREGNANT WOMEN IN NIGERIA.

THE USE OF PSYCHOTROPIC MEDICATIONS IN THESE WOMEN IS A CONCERN BECAUSE OF RISKS OF ADVERSE PERINATAL AND POSTNATAL OUTCOMES.

ADVISING THE WOMEN TO DISCONTINUE MEDICATION PRESENTS NEW RISKS ASSOCIATED WITH UNTREATED OR INADEQUATELY TREATED ILLNESS, SUCH AS POOR ADHERENCE TO PRENATAL CARE, INADEQUATE NUTRITION , AND INCREASEDD ALCOHOL AND TOBACCO USE.

THE INDUCTION OF PHARMACOLOGICAL TREATMENTS DURING PREGNANCY MAY POSE SIGNIFICANT RISKS TO THE DEVELOPING FETUS.

ANTIPSYCHOTICS ARE TYPICALLY INTRODUCED WHEN NON –  PHARMACOLOGICAL APPROACHES FAIL TO PRODUCE DESIRED EFFECTS OR WHEN THE RISKS OUTWEIGH THE BENEFITS FROM CONTINUING WITHOUT TREATMENT OR THE RISKS FROM EXPOSING THE FETUS TO MEDICATION.

POTENTIAL RISKS ASSOCIATED WITH PSYCHOTROPIC USE IN PREGNANT WOMEN INCLUDES:

CONGENITAL ABNORMALITIES, PRETERM BIRTH, AND METABOLIC DISTURBANCE, WHICH COULD POTENTIALLY LEAD TO ABNORMAL FETAL GROWTH.