[Prescription of psychotropic drugs in pregnant women]

ABSTRACT

Taking psychotropic drugs during pregnancy is now a common situation. It confronts the prescriber to the problem of risk-benefit balance. In pregnant women, there is a significant increase in the distribution and excretion of drugs; most of psychotropic medications pass easily the placenta, while the capacity of liver metabolism and renal excretion in the fetus are low. The use of those substances [antidepressants, anxiolytics, mood stabilizers and antipsychotics] is however possible during pregnancy, taking into account the precautions for each class. In the first trimester, the prescription is usually not recommended, especially for mood stabilizers belonging to the family of anticonvulsants. Using the lowest effective dose, of molecules having the more perspective, and reducing dosage, late in pregnancy, is recommended. Finally, parental involvement in decision-making is mandatory