Special Populations

Question 1

What are the risks to the mental health of the mother either during pregnancy or postpartum?

Answer 1

depression, mania, or psychosis

Question 2

T or F: The benefits usually outweigh the risks of treating the pregnant/nursing mother with meds

Answer 2

T, especially if severe sxs or postpartum

Question 3

When is the mother at the highest risk of developing postpartum depression?

Answer 3

4-6 weeks postpartum

Question 4

What is a major factor influencing postpartum depression?

Answer 4

Sleep deprivation

Question 5

What is the recommended treatment for MDD during pregnancy?

Answer 5

Psychotherapy without meds, especially during the 1st trimester, and 1-2 months before delivery

Question 6

What are the risks of using AD’s in 1st trimester?

Answer 6

Cardiac malformations,especially with paroxetine (Paxil)

Question 7

What are the risks of using AD’s anytime during pregnancy?

Answer 7

• Prematurity, low birth weight
• Long-termn neurodevelopmental abnormalities
• Increased risk of maternal suicide in mother up to age 25

Question 8

What are the risks of using AD in the 3rd trimester?

Answer 8

• Neonatal withdrawal syndrome
• Newborn persistent pulmonary hypertension from SSRI’s
• BREAST FEEDING IS NOT RECOMMENDED

Question 9

What are the risks of NOT treating MDD or continuing an AD in pregnancy?

Answer 9

• Relapse or recurrence of MDD
• Suicide, substance use
• Poor prenatal care
• Lack of bonding or care of infant
• Harm to infant
• Low birth weight, developmental delay
• Stress to mother and baby

Question 10

What meds are used for bipolar or psychosis during pregnancy?

Answer 10

Atypical antipsychotics are safer than lithium or anticonvulsants, but caution must be used

Question 11

What must you watch for if pregnant mother is using atypical antipsychotics during pregnancy/breastfeeding?

Answer 11

Infant withdrawal syndrome