How do you counsel patients on the risks and benefits of antidepressant use during pregnancy?
I always frame the decision as being between the risks and benefits of the medication vs. the underlying condition. We are always aiming for the "minimum effective dose" but "effective" is just as important as "minimum." Medications are, of course, not the only way to treat psychiatric illness and a...
I tell patients that untreated depression carries clear risks to both mother and fetus, and relapse rates are high if a stable regimen is stopped. For someone doing well, pregnancy is usually not the time to change medication unless we planned it well before conception. I start these conversations e...
I emphasize that although pregnant women are excluded from research studies, we have data on literally tens of thousands of women who have taken medication during pregnancy, based on international registries. All except Depakote/valproic acid and, to a lesser extent, carbamazepine have very reassuri...
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