Psychopharmacology and Pregnancy: Treatment Efficacy, Risks, and Guidelines (2014) (PDF) by Megan Galbally

Description

This book examines the role of psychopharmacological treatment in a range of disorders that may be encountered during pregnancy, including major depressive disorders, anxiety disorders, bipolar affective disorder, schizophrenia, eating disorders and substance abuse. The natural history of each condition pre and post-partum is analyzed and the evidence for the efficacy of drug treatments, evaluated. Special attention is paid to the potential dangers of different treatment options for both mother and fetus, covering risks of malformation, pregnancy and obstetric risks, neonatal risks and possible long-term consequences. The risks of not treating a particular condition are also analyzed. On the basis of the available evidence, management guidelines are provided that additionally take into account non-pharmacological options. Closing chapters consider the value of complementary and alternative medicine and ECT and explore future research directions.

User’s Reviews

“Psychopharmacology and Pregnancy: Treatment Efficacy, Risks, and Guidelines provides guidance on the psychopharmacologic treatment of both pregnant women and women considering pregnancy, and it addresses several important topics to keep in mind when treating this special population, including consent procedures, ongoing critical review of the literature, and available alternative treatments. It would be a valuable reference to any clinician who may potentially treat peripartum women.” (Annette M. Matthews, Journal of Clinical Psychiatry, Vol. 76 (6), June, 2015)

I definitely did not get adequate training on what to do when a patient on psychotropics informs you they’re pregnant. This book is a very easy read for the psychiatric prescriber (and likely accessible for primary care providers as well), and lays out the risks/benefits of treatment vs nontreatment for a variety of psychiatric conditions, including risks to maternal and fetal health based on disease process and how that compares to risks seen with exposure to certain medications. This, along with the MGH Center for Women’s Health database, are the best foundations I’ve found for outpatient psychiatric management of the pregnant patient.

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