British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

  title={British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017},
  author={R. Hamish McAllister-Williams and David S. Baldwin and Roch Cantwell and Abigail Easter and Eilish Gilvarry and Vivette Glover and Lucian Green and Alain MRCPsych Gregoire and Louise Michele Howard and Ian Jones and Hind Khalifeh and Anne Lingford-Hughes and Elizabeth McDonald and Nadia Micali and Carmine Maria Pariante and Lesley Peters and Ann Roberts and Natalie Clare Smith and David Taylor and Angelika Wieck and Laura M. Yates and Allan H. Young},
  journal={Journal of Psychopharmacology},
  pages={519 - 552}
Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in… 
Guidelines on prescribing psychotropic medication during the perinatal period.
The purpose of the British Association of Psychopharmacology guidelines is to provide advice regarding making decisions around treating mental illness in the perinatal period and this article provides a summary and explanation of the consensus guidance.
Psychotropic medication use during pregnancy
The use of psychotropic medications in pregnancy is outlined, key considerations for those involved in providing clinical care to pregnant women with mental illness are discussed and it is essential that women do not receive conflicting information.
Epidemiology of the Use of Psychotropic Drugs in Pregnant and Nursing Women
Antidepressants account for the majority of prescribed psychotropic medications for women in the perinatal period and are indicated for a variety of conditions, other than depression.
Use of Antipsychotic Drugs During Pregnancy
It is recommended that women who need to take an antipsychotics during pregnancy continue the antipsychotic that has been most effective for symptom remission, and further study on risperidone is needed to better understand its association with malformations.
Prescription of Valproate-Containing Medicines in Women of Childbearing Potential who have Psychiatric Disorders: Is It Worth the Risk?
This review highlights recent recommendations from influential regulatory and advisory bodies, summarises the relative efficacy and tolerability of valproate preparations in the psychiatric conditions for which they have often been prescribed, and offers practical guidance for the withdrawal and replacement ofValproate-containing medicines in women with psychiatric disorders.
Psychopharmacological Decision Making in Bipolar Disorder During Pregnancy and Lactation: A Case-by-Case Approach to Using Current Evidence.
The practical questions, current controversies, and available evidence regarding psychotropic drug therapy during pregnancy and lactation in bipolar disorder are analyzed.
[Antipsychotics during pregnancy: a systematic review].
Evaluation of the risks and benefits of administering antipsychotics during pregnancy or for women who wish to become pregnant regarding teratogenic effects, risk of fetal death and stillbirths, perinatal complications, persisting postnatal impairments or disorders and gestational diabetes suggests that the group of antipsychotic seem to be safe in terms of teratogenicity during pregnancy.
Modern approaches to the pharmacotherapy of postpartum depression
This review provides a timely update on the current understanding of approaches to the diagnosis and treatment of patients with PDD as part of recurrent depression and bipolar disorder, the features of pharmacotherapy in the postpartum period depending on the manifestations and course of the disease.
Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe
There is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.


Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records.
The results support previous associations between valproate and adverse child outcomes but there is no evidence of such an association for antipsychotics.
Psychotropic drugs in lactation--Motherisk Update 2008.
  • M. Moretti
  • Psychology, Medicine
    The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique
  • 2009
The disposition of drugs in lactating patients is discussed and the available literature concerning the use of psychotropic drugs in breastfeeding women is outlined to outline what is currently known.
Schizophrenia, Psychopharmacology, and Pregnancy
Pregnancy in women with a diagnosis of schizophrenia should be considered high risk and managed accordingly, with a focus on reducing modifiable risk factors, such as obesity and smoking, ideally before conception, as well as optimising antenatal care using the lowest effective medication doses with appropriate monitoring through pregnancy.
Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: a systematic review
An overview of maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes is provided and some studies indicate a relation between prenatal exposure to antidepressants and adverse neuro developmental outcomes.
Psychomotor development in children exposed in utero to benzodiazepines, antidepressants, neuroleptics, and anti-epileptics
A follow-up study based upon a regional prescription register in Denmark found that any abnormal test result was seen much more frequently among exposed women than for not exposed.
Maintenance agonist treatments for opiate-dependent pregnant women.
The number of newborns treated for neonatal abstinence syndrome, which is the most critical outcome, did not differ significantly between groups, and the quality of evidence was very low.
BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP
The guidelines primarily cover the pharmacological management of withdrawal, short- and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people.
Substance Use in the Perinatal Period
The purpose of this review is to examine the recent literature on the use of tobacco, alcohol, cannabis, stimulants, and opioids in the perinatal period, their effects on maternal and fetal health, and current treatments.
First Trimester Exposure to Anxiolytic and Hypnotic Drugs and the Risks of Major Congenital Anomalies: A United Kingdom Population-Based Cohort Study
It is suggested that prescription of these drugs during early pregnancy may be safe in terms of MCA risk, but findings from other studies are required before safety can be confirmed.