Salvatore Giovanni Vitale1, Antonio Simone Laganà1, Maria Rosaria Anna Muscatello2, Valentina Lucia La Rosa3, Veronica Currò4, Gianluca Pandolfo5, Rocco Antonio Zoccali6, Antonio Bruno5. 1. Resident, Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina. 2. Associate Professor, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina. 3. Psychologist, Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy. 4. Resident. 5. Researcher. 6. Head, Psychiatric Unit, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
Abstract
IMPORTANCE: Fifteen percent to 20% of pregnant women suffer from mental disorders, and 86% of them are not treated due to potential teratogenic risks for the fetus. Several drugs seem to be safe during pregnancy but knowledge regarding risks of antenatal exposure to drugs is still limited. OBJECTIVE: The aim of this article is to provide a review of literature, data, and a clinical guideline concerning the treatment and management of mental disorders during pregnancy and lactation. EVIDENCE ACQUISITION: Bibliographical research was carried out using Medline and Pubmed (from 2005 until 2015) and articles, books and Websites were consulted. RESULTS: Regarding antidepressants, only paroxetine seems to lead to an increased risk of malformations, whereas fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram and venlafaxine do not appear to increase this risk. The use of duloxetine is associated with an increased risk of miscarriage during pregnancy but not with an increased risk of adverse events, such as birth defects. There is no clear evidence of malformation risk associated with the use of antipsychotics, whereas a risk associated with pregnancy and newborn outcome has been detected. All mood stabilizers are associated with risks of birth defects and perinatal complications. CONCLUSIONS AND RELEVANCE: Taking psychoactive drugs is possible during pregnancy, but it is important to consider various effects of the drugs. Future research should focus on prospective and longitudinal studies with an adequate evaluation of confounding variables. This should be followed by long-term studies to obtain accurate measures of child development.
IMPORTANCE: Fifteen percent to 20% of pregnant women suffer from mental disorders, and 86% of them are not treated due to potential teratogenic risks for the fetus. Several drugs seem to be safe during pregnancy but knowledge regarding risks of antenatal exposure to drugs is still limited. OBJECTIVE: The aim of this article is to provide a review of literature, data, and a clinical guideline concerning the treatment and management of mental disorders during pregnancy and lactation. EVIDENCE ACQUISITION: Bibliographical research was carried out using Medline and Pubmed (from 2005 until 2015) and articles, books and Websites were consulted. RESULTS: Regarding antidepressants, only paroxetine seems to lead to an increased risk of malformations, whereas fluoxetine, fluvoxamine, sertraline, citalopram, escitalopram and venlafaxine do not appear to increase this risk. The use of duloxetine is associated with an increased risk of miscarriage during pregnancy but not with an increased risk of adverse events, such as birth defects. There is no clear evidence of malformation risk associated with the use of antipsychotics, whereas a risk associated with pregnancy and newborn outcome has been detected. All mood stabilizers are associated with risks of birth defects and perinatal complications. CONCLUSIONS AND RELEVANCE: Taking psychoactive drugs is possible during pregnancy, but it is important to consider various effects of the drugs. Future research should focus on prospective and longitudinal studies with an adequate evaluation of confounding variables. This should be followed by long-term studies to obtain accurate measures of child development.
Authors: Rosalia Ragusa; Marina Marranzano; Valentina Lucia La Rosa; Gabriele Giorgianni; Elena Commodari; Rosalba Quattrocchi; Salvatore Cacciola; Vincenzo Guardabasso Journal: Int J Environ Res Public Health Date: 2021-04-30 Impact factor: 3.390
Authors: Gemma Biviá-Roig; Valentina Lucia La Rosa; María Gómez-Tébar; Lola Serrano-Raya; Juan José Amer-Cuenca; Salvatore Caruso; Elena Commodari; Antonio Barrasa-Shaw; Juan Francisco Lisón Journal: Int J Environ Res Public Health Date: 2020-08-15 Impact factor: 3.390
Authors: Kornelia Zaręba; Valentina Lucia La Rosa; Ewelina Kołb-Sielecka; Michał Ciebiera; Rosalia Ragusa; Jacek Gierus; Elena Commodari; Grzegorz Jakiel Journal: Int J Environ Res Public Health Date: 2020-05-31 Impact factor: 3.390