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OB Ch 23

Medications for Perinatal Mood disorders (for final)

TermDefinition
Class: SSRIs Drug: Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline Indications: Anxiety disorders, depression Maternal Side Effects: Gastrointestinal distress, nervousness, headache, sexual dysfunction, sedation
Class: SSRIs Infant Exposure Effects: All SSRIs are detectable in human milk. Paroxetine and sertraline usually undetectable in infant serum Infant effects: irritability, uneasy sleep, drowsiness, colic, feeding problems. Fluoxetine contraindicated during lactation.
Class: SSRIs Sertraline most common; undetectable to low levels in human milk. Long-term effects of SSRI exposure on infants: more evidence needed; recent evidence is reassuring
Class: SNRIs Drug: Venlafaxine, duloxetine, desvenlafaxine Indications: Depression Maternal Side Effects: Galactorrhea
Class: SNRIs Infant Exposure Effects: Detectable in human milk and infant serum. No proven side effects; assess weight gain and sedation *Lack of evidence on outcomes for breastfed infants*
Class: Other antidepressants (norepinephrine/dopamine/serotonin reuptake blockers) Drug: Bupropion, mirtazapine Indication: Depression Maternal Side Effects: Drowsiness, increased appetite, weight gain, dizziness, dry mouth; dose-dependent Infant Exposure Effects: Limited data; concerns range from possible irritability to seizures
Class: Other antidepressants (norepinephrine/dopamine/serotonin reuptake blockers) *Not a reason to stop breastfeeding; another drug may be preferable.*
Class: TCAs/heterocyclics Drug: Amitryptyline, amoxapine, clomipramine, desipramine, doxepin, maprotiline, nortriptyline, protriptyline, trimipramine Indication: Anxiety disorders, depression
Class: TCAs/heterocyclics Maternal Side Effects: Hypotension, sedation, urinary retention, dry mouth, weight gain, sexual dysfunction, constipation; overdose can cause cardiac arrhythmias and death
Class: TCAs/heterocyclics Infant Exposure Effects: Lack of evidence on most drugs; nortriptyline undetectable in infant serum, no adverse effects reported *Older class of drugs*
Class: Antipsychotic Drug: Quetiapine Indications: Bipolar disorder, schizophrenia Maternal Side Effects: Sedation Infant Exposure Effects: Sedation
Class: Mood stabilizer Drug: Lithium Indications: Postpoartum psychosis Maternal Side Effects: Diarrhea, vomiting Infant Exposure Effects: Elevated TSH *Dosage based on maternal blood levels, which should be checked frequently*
Class: Herbal/natural remedy Drug: St. John's wort Indications: Depression Infant Exposure Effects: Poorly excreted into human milk; possible drowsiness, lethargy *Used in Europe for many years to treat depression; use in United States is controversial*
Created by: getit
 

 



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