For the safety of the child, it is best to stop all medications in the first trimester to avoid fetal malformations and affect fetal development However, it is human nature that patients and families often want to have their own children. Discontinuing medication can easily lead to relapse, and there is a conflict between the two.
The FDA classifies drugs into five categories based on the magnitude of their effect on the fetus.
Pregnancy A. A sufficient number of well-controlled human studies have shown no adverse effects on the fetus in early pregnancy (and no such signs in late pregnancy).
Pregnancy B: Animal studies have failed to show adverse effects on the embryo, but there are not enough well-controlled human studies to confirm this; or Animal studies have shown possible adverse effects on the embryo, but there are enough well-controlled human studies to show no adverse effects on the fetus during pregnancy.
Pregnancy C Although animal studies have shown that the drug may have adverse effects on the embryo, there is a lack of sufficient number of well-controlled human studies to confirm this; however, due to therapeutic needs, the drug should be administered to pregnant women on balance, even if this potential exists.
Pregnancy D is known from market research or feedback on ‘adverse reactions’ or from human studies to be potentially harmful to the fetus; however, due to therapeutic need, the drug should be administered to the pregnant woman on balance, even if there is such potential.
Pregnancy X. If the drug has been shown to cause embryonic malformation from animal or human studies and/or ‘adverse reaction’ information from market research or information feedback, or from human studies, and the drug is known to be potentially harmful to the fetus, it is clear on balance that the drug should not be used in pregnant women, even if it is necessary for treatment. The drug should not be used in pregnant women, even if it is necessary for treatment.
The relationship between psychiatric medication and pregnancy and the fetus is described as follows.
1. All antipsychotics.
Except for clozapine for pregnancy B, all are pregnancy C;
2, antidepressants.
Clomipramine, doxepin, citalopram, fluvoxamine, trazodone, mianserin, mirtazapine, fluoxetine, sertraline are pregnancy C;
3, anti-anxiety (sleeping) drugs.
Benzodiazepines (Valium class I) such as alprazolam, eszopiclone, clonazepam, lorazepam, etc., are pregnancy D
Zolpidem (Synthroid) for pregnancy B;
4. Mood stabilizers.
Lithium carbonate, carbamazepine, sodium valproate, for pregnancy D, and
Lamotrigine, for pregnancy C;
5.Dementia treatment drugs.
Enrichment, Arsenal, both pregnancy C.
According to domestic and foreign experts’ opinions, in case of pregnancy while suffering from mental illness, the following can be implemented.
1, when pregnant, it is completely possible to use antipsychotics or antidepressants (excluding methylphenidate and paroxetine), generally speaking, there is no teratogenic problem.
2, the general antianxiety (sleeping) drugs of the tranquilizer class are teratogenic, you can choose zolpidem (Sinox).
3, lithium carbonate, carbamazepine, sodium valproate may be teratogenic, or can be replaced by lamotrigine.
Professor Yan Wenwei believes that: only female patients with manic-depressive disorder can stop medication during pregnancy and will not relapse; however, medication must be taken immediately after delivery.
Special reminder : For all medication use, it is necessary to consult psychiatrists, because all medication classification needs psychiatrists’ guidance. If you take medication, it is recommended to do more prenatal examinations, such as multidimensional ultrasound, amniotic fluid examination to see if the fetus has any limb malformation, heart malformation, spina bifida, etc., to prevent accidents, remember.
Special reminder: take medication during breastfeeding and do not breastfeed if your milk contains medication, so as not to affect the development of your infant.
According to Prof. Yan Wenwei: Whether a child will inherit a mental illness or not is completely unrelated to taking medication. There is a 1% chance that a child will develop a mental illness if the parent does not have schizophrenia. If one parent has the disease, the likelihood is 5-10 times greater. 90% of the time, there is no problem. And even if the gene for the disease is inherited, it doesn’t necessarily develop; if it does, it will be a decade or so later. By that time, science will be more advanced and treatment methods may be very advanced.
However, in the end, the choice of how to choose and how to have a child is ultimately at the discretion of the patient and family, and the decision rests with the patient and family.