The article by Ward and Zamorski (2002) published in American Family Physician is focused on the effects of psychiatric drugs on the health of pregnant female patients. The work presents a literature review that summarizes the existing data for various types of medications, including antipsychotics, SSRIs, TCAs, and benzodiazepines. Based on the results, the authors develop a range of recommendations concerning the pharmacological treatment of depression and bipolar I and II disorders in pregnant women.
The topic of risks surrounding the use of psychiatric medications is introduced with special attention to their impact on the fetus. Explaining the mechanism of such medications’ work, the researchers claim that all psychopharmacologic agents are capable of crossing the human placenta with the help of simple diffusion and other metabolic processes (Ward & Zamorski, 2002). The potential effects of drugs on the fetus and pregnant women can be divided into three groups.
Structural and behavioral teratogenesis refers to different types of birth defects and behavioral abnormalities, whereas perinatal syndromes stem from the use of medications “proximate to delivery” (Ward & Zamorski, 2002, p. 630). In order to avoid unwanted effects, healthcare specialists are recommended to make care plans individualized by considering past medical histories, the manifestations of suicidal ideation, and the ability to perform social functions without medications.
The researchers conclude that the most popular groups of psychiatric medications vary in terms of safety in pregnant women. For instance, the safety of antidepressants in depression and bipolar disorder has extensive research support. In women with bipolar disorder, the failure to implement mood stabilizers such as lithium into care plans is associated with high rates of postpartum relapses ranging from 30 to 50% (Ward & Zamorski, 2002, p. 633).
The same is true for the cases of schizophrenia and anxiety disorders. Practical recommendations provided in the article can be reduced to the use of patients’ medical history in care planning and alternative non-medicamental methods such as CBT and interpersonal therapy.
Reference
Ward, R. K., & Zamorski, M. A. (2002). Benefits and risks of psychiatric medications during pregnancy. American Family Physician, 66(4), 629-636.