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

R Hamish McAllister-Williams; David S Baldwin; Roch Cantwell; Abby Easter; Eilish Gilvarry; Vivette Glover; Lucian Green; Alain Gregoire; Louise M Howard; Ian Jones; Hind Khalifeh; Anne Lingford-Hughes; Elizabeth McDonald; Nadia Micali; Carmine M Pariante; Lesley Peters; Ann Roberts; Natalie C Smith; David Taylor; Angelika Wieck; Laura M Yates; Allan H Young; endorsed by the British Association for Psychopharmacology

doi:10.1177/0269881117699361

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

J Psychopharmacol. 2017 May;31(5):519-552. doi: 10.1177/0269881117699361. Epub 2017 Apr 25.

Authors

R Hamish McAllister-Williams^{1

2}, David S Baldwin^{3

4}, Roch Cantwell⁵, Abby Easter⁶, Eilish Gilvarry^{2

7}, Vivette Glover⁸, Lucian Green⁹, Alain Gregoire^{3

10}, Louise M Howard^{11

12}, Ian Jones¹³, Hind Khalifeh^{11

12}, Anne Lingford-Hughes¹⁴, Elizabeth McDonald^{15

16

17}, Nadia Micali¹⁸, Carmine M Pariante^{12

19}, Lesley Peters²⁰, Ann Roberts^{20

21

22}, Natalie C Smith²³, David Taylor^{12

24}, Angelika Wieck^{25

26}, Laura M Yates^{27

28}, Allan H Young^{12

19}; endorsed by the British Association for Psychopharmacology

Affiliations

¹ 1 Institute of Neuroscience, Newcastle University, Newcastle, UK.
² 2 Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
³ 3 Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
⁴ 4 University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
⁵ 5 NHS Greater Glasgow and Clyde, Glasgow, UK.
⁶ 6 Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ 7 Institute of Health and Society, Newcastle University, Newcastle, UK.
⁸ 8 Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
⁹ 9 Ealing, Hounslow, Hammersmith & Fulham Perinatal Mental Health Service, West London Mental Health Trust, London, UK.
¹⁰ 10 Hampshire Perinatal Mental Health Service, Winchester, UK.
¹¹ 11 Section of Women's Mental Health, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
¹² 12 South London and Maudsley NHS Foundation Trust, London, UK.
¹³ 13 National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.
¹⁴ 14 Centre for Psychiatry, Imperial College London, London, UK.
¹⁵ 15 Royal College of Psychiatrists, London, UK.
¹⁶ 16 East London Foundation Trust, London, UK.
¹⁷ 17 Tavistock and Portman NHS Foundation Trust, London, UK.
¹⁸ 18 Behavioural and Brain Sciences Unit, GOSH Institute of Child Health, University College London, London, UK.
¹⁹ 19 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
²⁰ 20 St Martin's Healthcare Services CIC, Leeds, UK.
²¹ 21 Hertfordshire Partnership University NHS Foundation Trust, Hatfield, Hertfordshire, UK.
²² 22 Postgraduate School of Medicine, University of Hertfordshire, Hatfield, Hertfordshire, UK.
²³ 23 Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, County Durham, UK.
²⁴ 24 Institute of Pharmaceutical Science, King's College London, London, UK.
²⁵ 25 Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
²⁶ 26 University of Manchester, Manchester, UK.
²⁷ 27 UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
²⁸ 28 Institute of Genetic Medicine, Newcastle University, Newcastle, UK.

PMID: 28440103
DOI: 10.1177/0269881117699361

Abstract

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 pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.

Keywords: Antidepressants; antipsychotics; anxiolytics; birth defects; breastfeeding; child development; conception; fertility; hypnotics; mood stabilisers; neonatal problems; postpartum; pregnancy; pregnancy outcome; psychiatric illness; psychotropics; teratogenicity.

MeSH terms

Female
Humans
Mental Disorders / drug therapy*
Postpartum Period / drug effects*
Pregnancy
Psychopharmacology / standards*
Psychotropic Drugs / therapeutic use*

Substances

Psychotropic Drugs

Abstract

MeSH terms

Substances

Grants and funding