Psychopharmacology in Pregnancy and Lactation

  • Jennifer L. PayneEmail author


Psychiatric illness during and immediately after pregnancy is common and potentially life-threatening. The proper management of psychiatric disorders during the peripartum time period remains controversial, though this is likely secondary to the stigma associated with psychiatric illness rather than a lack of data. Much of the early literature exploring the relationship between in utero psychiatric medication exposure and infant outcomes was flawed by inappropriate control populations, small sample sizes, and a lack of controls for confounds including psychiatric illness itself and associated health risk factors and behaviors. More recent studies are generally better designed to study whether infant outcomes are influenced by in utero medication exposure or by exposure to maternal psychiatric illness or both. The preponderance of the literature is reassuring regarding the safety of the use of most (not all) psychiatric medications during pregnancy and lactation. The preponderance of the literature also supports that unfavorable infant outcomes are associated with exposure to maternal mental illness. This chapter attempts to summarize what is currently known about the safety of psychiatric medications during pregnancy and lactation and, in addition, describes a clinical approach to designing a treatment plan for individual patients during this critical time for both mother and child.


Pregnancy Postpartum Lactation Major depression Bipolar disorder Schizophrenia Anxiety Antidepressants Mood stabilizers Antipsychotics Benzodiazepines 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of Medicine, Women’s Mood Disorders CenterBaltimoreUSA

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