Outline
The presentation will begin with a detailed description of psychotropic medication and the possible risks related to its use during pregnancy. The research will offer a thorough review of the consequences of using psychotic medicines during pregnancy. The paper will then address the use of folic acid during the pregnancy period, which is an essential vitamin that prevents abnormalities. In this segment, the report will address the recommended doses and anticipated benefits of use.
Furthermore, the paper will explore toxicity of folic acid and symptoms of the drug overdose. Additionally, the paper will review the impacts of folic overdose during pregnancy. A case study within this project will help elaborate on using folic acid supplements among women using psychotic medications. The findings of this study will help the researcher come to recommendations to improve the understanding of the relationship between the use of folic acid and psychotic medicines during pregnancy.
Psychotropic Medication
Psychotropic medications describe any drugs that affect the users’ behaviors, perceptions, moods, and thoughts. It is an umbrella for different medicines, including mood stabilizers, antidepressants, antipsychotics, stimulants, and anti-anxiety agents. Psychotic drugs are vital tools in the society that helps promote wellbeing, since mental health and illnesses affect our daily livelihoods. These psychotic medications do not cure mental illnesses but rather help suppress the symptoms that might interfere with the therapy. Indeed, the drugs take the edge off and allow the patient to develop skills to cope with and better manage their mental health. Additionally, the psychotrophic medicines do not work instantly but take weeks before a patient experiences their full effect.
Risks of Psychotropic Medication during Pregnancy
Although the evidence on the risks of prescribing psychotropic medications remains limited, studies have linked exposure to antidepressants during pregnancy to malformations and long-term developmental outcomes. The drugs also cause neonatal and pregnancy complications, such as low birth weight, spontaneous abortion, persistent pulmonary hypertension of the newborn, developmental disorders, autism spectrum disorder, and neonatal serotonin discontinuation symptoms (Samochowiec et al., 2019). Niethe and Whitfield (2018) also note that exposure of the fetal to lithium during pregnancy increases the risk of cardiac malformations and other congenital disabilities. Hence, psychotropic medications may have a wide range of adverse impacts on the unborn child. The use of psychotic drugs during pregnancy can also cause long-term neurobehavioral sequelae, direct neonatal toxicity, and teratogenic effects. However, of the growing concern is the risk of untreated mental disorders, which can influence the fetoplacental integrity and the development of the central nervous systems of the fetus. Hence, weighing the benefits and risks of using psychotic medicines during pregnancy is essential.
Consequences of Using Psychotic Medication
Despite the risks these medications might pose to the unborn baby, these drugs help promote mental well-being for pregnant mothers suffering from different mental illnesses. They do so by adjusting the level of brain neurotransmitters or brain chemicals like serotonin, norepinephrine, dopamine, and gamma aminobutyric acid. However, the side effects linked to these medications are more pronounced. Commonly reported side effects to include exhaustion, nausea, blurry vision, nightmares, headaches, trembling, and dry mouth. According to Goldberg and Ernst (2018), psychotic agents cause massive weight loss and other gastrointestinal complications. Therefore, psychotic medication can cause both mental well-being and adverse health effects to the user.
Folic Acid
Folic acid is a synthetic form of vitamin B called folate that promotes the manufacture of red blood cells. The vitamin also facilitates the growth of the baby’s neural tube into the spinal cord and brain. Folic acid serves as a dietary supplement that the body converts into folate. Some people use folate in food fortification since it is more stable during handling and storage. However, folate is a vital component that enables the body to make RNA and DNA and the metabolism of amino acids, essential for cell division. Although the vitamin occurs naturally in some foods, the recommended daily intake of the vitamin among pregnant women cannot be met through foods alone.
Recommended Dosage
The Institute of Medicine Food and Nutrition Board of the National Academy of Sciences recommends all expectant mothers take a 400 mcg dose of folic acid afore and after the perinatal period to inhibit congenital infirmities (Centers of Disease Control and Prevention, 2021). However, the user can consume up to 600 mcg between the fourth and final months of pregnancy. For the folic acid to be helpful, women should take the vitamins daily, starting a period before she becomes pregnant.
Components of Folic Acid
It comprises inactive ingredients like lactose monohydrate, stearic acid, sodium starch glycolate, and microcrystalline cellulose. The folic acid supplements contain three large sub-components: glutamic acid, para-aminobenzoic acid, and pteridine ring. The glutamic acid serves as an amino acid that the body can synthesize by itself. These components of the folic acid contribute to the growth of maternal tissues and hemopoiesis during pregnancy.
Benefits of Folic Acid
Folic acid helps reduce the plasma concentration of homocysteine during pregnancy. According to a study by Shiralizadeh et al. (2017), folic supplements decrease homocysteine levels during the prenatal period. Reducing plasma homocysteine plasma levels and protein oxidation helps condense oxidative pressure and prevent the commencement of illnesses like a congenital abnormality, hypertension, and other sicknesses that emerge during the prenatal period resulting from oxidative stress. The intake of folic acid supplements is vital in different metabolic pathways, promotes nucleic acid synthesis, growth, and healthy development of the fetus.
Additional Benefits of Folic Acid
Besides the impact of folic acid use on protecting against neural tube defects and other mental illnesses, it can also safeguard the mother and the unborn child from adverse health outcomes. The supplements reduce the risk of premature birth and miscarriage. According to the Centers for Disease Control and Prevention (2021), the intake of the recommended dosage of folic acid during pregnancy reduces the risk of low birth weight, poor development in the uterus, cleft lip, and palate. Among pregnant women, the intake of folates diminishes the risk of heart disease, stroke, some forms of cancer, Alzheimer’s disease, and pregnancy complications like preeclampsia. Hence, the intake of 400 mcg during pregnancy may positively impact both the mother and the unborn baby.
Women who Need more Folate
Healthcare providers recommend consistent intake of folic acid supplements among women who have a higher risk of giving birth to a baby with neural tube defects. The at-high risk women include parents with neural tube effects, history of the flaws within the family, diagnosis with type 1 diabetes, and if the mother takes seizures and epilepsy medications that affect the folate absorption. Medical professionals should prescribe the dosages with care to pregnant women with various lifestyle diseases since the medicines can affect the treatment and control of other illnesses like seizures. High-risk women should take 5 mg of folate every day, within is ten times higher than the dosage recommended to lower-risk women. However, the women should take these medications under medical supervision.
Toxic Dose of Folic Acid
1000 mcg of folic acid intake is more than twice the recommended dietary allowance of 400 mcg. Indeed, a folic acid overdose occurs from taking a toxic level of folic acid supplements other than consuming too many folate-rich foods. Although the overdose can benefit a specific group of people like the elderly, the practice may negatively impact the users’ health. Consuming more than 1000 mcg of folic acid every day may have no benefit to the pregnant woman but can pose severe health damages.
Symptoms of Folic Acid Overdose
The development of excessive intake of the folic acid supplement can cause hypersensitive reactions, gastrointestinal issues, and difficulties sleeping due to irritability, hyperactivity, excitability, and inability to concentrate. Moreover, the overdose also causes psychotic behaviors, depression, masking the deficiency of vitamin B12, and derails the absorption of zinc in the gut (Shiralizadeh et al., 2017). Other indirect impacts entail seizures since the medication decreases the functionality of anticonvulsant drugs among the users. Hence, the overdose of folic acid may have adverse health impacts on the users. Common folic acid overdose signs include gastrointestinal difficulties like gas, nausea, bloating, diarrhea, and abdominal cramps. In extreme cases, the overdose may result in irritability and depression.
Consequences of Folic Acid Overdose among Pregnant Women
The excess intake of folic acid supplements can use adverse side effects like slower brain development for children and fastened mental decline in older women. The extra intake masks the vitamin B12 deficiency, which consequently causes irreversible brain damage, megaloblastic anemia, and thus, speed age-related mental decline (Bailey et al. 2020). Supplementing with too much folic acid increases insulin resistance and slows down children’s brain development. People who take more than 1000 mcg of folic acid stand a higher chance of developing cancer later in life. Altogether, the excessive intake of folic acid during pregnancy may affect the child’s brain development, mask a B12 deficiency, speed mental decline, and increase cancer recurrence.
Meta-analysis Case Study
Bender et al. (2017) carried out meta-analyses to assess the influence of folate levels on the functionality of psychotic medications. The study is a meta-analysis exploration that carried out a statistical analysis by combining the findings of multiple scientific studies. The researcher entails a collection of reflections about folates among pregnant women with mental illnesses. The reliance on several experiments allows Bender et al. (2017) to establish a statistical significance across the studies with conflicting results.
Study Background
Based on the analysis, people with mental illnesses like depressions tend to have lower folate levels than those without mental challenges. Similarly, the lower folate level directly impacts the probability of developing different mental illnesses, increased risk of more severe depressive symptoms, and depressive-symptom relapse. The folate deficiency emerges from different causes, including inadequate dietary intake and the destruction of the vital vitamin during cooking. Based on the review of the past studies, there is a direct affiliation between folate deficiency and mental problems like depression. Hence, it is essential to understand the impact of folic acid supplements on women patients using psychotropic medication during pregnancy.
Sample
Following the PRISMA guidelines, the current meta-analysis study used digital literature search in articles found in the PubMed and PsycINFO databases. PRISMA is a set of questions that allow scholars to report wide range of meta-analyses and systemic reviews. Commonly to assess the risks and benefit of health care. After collecting the required data, the researcher performed a meta-analysis in R Package Version 3.11 using the metaphor package. The meta-analysis comprised 43 experiments with 48 outcome sizes.
Study Findings
The current meta-analysis found out that folate or folic acid supplementation improved the efficacy of depression treatment. Based on the study findings, folate supplementation has an increased ability to add value to treating different mental disorders like depression during pregnancy. However, although the intake of folic acid supplements led to positive outcomes with depression due to shorter inpatient treatment stays and improved efficacy of traditional treatment, it has no impact on depressive symptoms. Hence, folic acid supplementation may reduce the functionality of psychotropic medications
Study Limitations
Although the study has some significant findings, it could not exist without some form of limitations. The study was heterogeneous, so it did not explain the variance of personal study effect sizes. Additionally, the study explored the affiliation between folate levels and depression, and thus, the findings cannot infer casualty. Bender et al. (2017) did not include scientific experiments that measured folate with cerebrospinal fluid (CSF) methods. These limitations can have a detrimental impact on the validity and reliability of the study results.
Recommendations
Medical scientists should consider and explore the interaction between folic acid supplements and psychotropic medications during medication. There is a literature gap in the published data on how folic acid intake during pregnancy might affect pregnant women on psychotropic drugs. The research will close the current knowledge gap and denote research areas for future scholars.
Moreover, future studies should also explore how higher or lower doses of folic acid affect the effectiveness of psychotropic medications. Indeed, there is an increased need for how underdose and overdose of folic acid supplements influence the efficacy of psychotic drugs among mentally ill pregnant women. Future studies should also collect data from pregnant women from different cultural background. The findings of such future studies will help enhance the overall well-being of pregnant women and reduce the overall cost of care. The results will also leave a substantial impact on the current body of the literature.
References
Bailey, R. L., Jun, S., Murphy, L., Green, R., Gahche, J. J., Dwyer, J. T., & Miller, J. W. (2020). High folic acid or folate combined with low vitamin B-12 status: potential but inconsistent association with cognitive function in a nationally representative cross-sectional sample of US older adults participating in the NHANES. The American Journal of Clinical Nutrition, 112(6), 1547-1557. Web.
Bender, A., Hagan, K. E., & Kingston, N. (2017). The association of folate and depression: A meta-analysis.Journal of psychiatric research, 95, 9-18. Web.
Centers of Disease Control and Prevention (2021). Recommendations: Women and Folic Acid. Web.
Goldberg, J. F., & Ernst, C. L. (2018). Managing the side effects of psychotropic medications. American Psychiatric Pub.
Niethe, M., & Whitfield, K. (2018). Psychotropic medication use during pregnancy. Journal of Pharmacy Practice and Research, 48(4), 384-391. Web.
Samochowiec, J., Rybakowski, J., Gałecki, P., Szulc, A., Rymaszewska, J., & Cubała, W. J. (2019). Recommendations of the polish psychiatric association for treatment of affective disorders in women of childbearing age. Part I: treatment of depression. Psychiatr Pol, 53(2), 245-262. Web.
Shiralizadeh, J., Barmaki, H., Haiaty, S., Faridvand, Y., Mostafazadeh, M., Mokarizadeh, N., Maroufi, N. F. (2017). The effects of high and low doses of folic acid on oxidation of protein levels during pregnancy: a randomized double-blind clinical trial. Hormone Molecular Biology and Clinical Investigation, 33(3). Web.