Therapy options for psychiatric disorders in pregnancy

Abstract

While psychotherapy is often preferred in treating mild psychiatric disorders, drug and other non-drug options are adopted in treating moderate and severe conditions during pregnancy. In addition, cognitive behavioral therapy (CBT) has become prominent among psychotherapies. Regarding antidepressants, Sertraline, Citalopram, and Escitalopram are recommended as the first choices. Benzodiazepines are not recommended unless necessary; they are prescribed in the minimum dose and duration if highly needed. Mood stabilizers are considered risky and should be carefully used. Moreover, the expectant mother should be required for fetal follow-up more frequently and in detail when such drugs are prescribed. The safest among them is considered Lamotrigine. If antipsychotics are to be prescribed, the expectant mother�s blood glucose, weight, and blood pressure should be followed up frequently. Due to the possible side effects to occur in the infant following delivery, antipsychotics may be considered to be discontinued immediately before birth and restarted after delivery. It is argued that there is no notable difference between the first and second generations. Besides, electroconvulsive therapy (ECT) is recommended in cases of suicidal depression, manic attack, psychotic attack, and catatonia where rapid response is required. Although promising results were previously reported about transcranial magnetic stimulation (TMS) and bright light therapy, their utilization areas are still limited.