Guidelines on managing antipsychotics and mood stabilisers during pregnancy

Melbourne psychiatrists and obstetricians have called for comprehensive multidisciplinary care for women who need to be treated with antipsychotic medications and mood stabilisers during pregnancy. “The antenatal management of women with bipolar disorder and schizophrenia is a challenge for obstetric and mental health services because both the illnesses and the medications used to treat them pose significant risks for pregnancy,” they wrote in the Australian and New Zealand Journal of Psychiatry. “There is a need for careful and close monitoring in an appropriate antenatal setting to ensure best outcomes,” they said. Their literature review discussed the specific actions required prior to conception, the teratogenic risks associated with some mood stabilisers, the details of pregnancy care, planning for delivery, and neonatal management. It detailed the need for careful postpartum management – a time when the risk of relapse was very high. More than half of pregnancies in the general population were unplanned, and many women did not realise they were pregnant until the end of the first trimester or even later. However, a New Zealand survey found that mental health professionals discussed contraception with only 17% of their female patients. Australian and New Zealand Journal of Psychiatry 2010; 44: 99-108....