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Difficult Decisions: Women of Childbearing Age, Mental Illness, and Psychopharmacologic Therapy

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The movement of the management of mental illness to community settings has provided an opportunity for persons with serious mental illness to engage in sexual activities, which often results in pregnancy. The need for psychotropic medication during pregnancy and lactation must be weighted against the possible teratogenic organic and behavioral effects of these drugs. A review of the literature presents the risk and benefit considerations of psychotropic drugs to inform care of pregnant and lactating mentally ill women. Although some psychotropic medications are clearly associated with teratogenic effects for offspring, many psychotropic drugs demonstrate no relationship with ill effects. Mental illness, pregnancy, and lactation can be managed in a safe manner if the clinician is knowledgeable about specific teratogenic drug effects and assists the client to make appropriate decisions.

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