McGrath C, Buist A, Norman T R
University of Melbourne, Heidelberg, Victoria, Australia.
Drug Saf. 1999 Feb;20(2):171-86. doi: 10.2165/00002018-199920020-00006.
Pregnancy is a time of great emotional change for a woman, producing increased stress and anxiety. Medication may be required for the treatment of anxiety disorders at this time. Given the fact that psychotropic drugs readily cross the placenta and could have important implications for the developing fetus, it is necessary to balance the possible effects of medication against the potential effects to both the mother and fetus if the anxiety disorder is left untreated. Despite the widespread use of psychotropic drugs such as benzodiazepines and antidepressants during pregnancy, there is a paucity of information regarding the effect of such exposure on the developing fetus. From a review of the literature it is clear that the issue of safety of psychotropic drugs during pregnancy is far from resolved. While some of the findings from animal studies are alarming, these studies cannot be directly extrapolated to humans. In addition, varying sample sizes and multiple drug exposures further complicate interpretation of human studies. Nonpharmacological treatments such as cognitive behavioural therapy should be employed whenever possible for the treatment of anxiety disorders during pregnancy. However, if medication is required pregnant women should be prescribed the lowest dosage for the minimum amount of time.
对女性而言，怀孕是一个情绪变化很大的时期，会产生更多的压力和焦虑。此时可能需要药物来治疗焦虑症。鉴于精神药物很容易穿过胎盘，并且可能对发育中的胎儿产生重要影响，所以有必要在药物治疗的可能效果与焦虑症不治疗对母亲和胎儿的潜在影响之间进行权衡。尽管在孕期广泛使用苯二氮䓬类药物和抗抑郁药等精神药物，但关于此类药物暴露对发育中胎儿影响的信息却很匮乏。从文献综述来看，孕期精神药物的安全性问题远未得到解决。虽然动物研究的一些结果令人担忧，但这些研究结果不能直接外推至人类。此外，样本量不同以及多种药物暴露的情况进一步使人类研究的解读变得复杂。只要有可能，在孕期治疗焦虑症时应采用认知行为疗法等非药物治疗方法。然而，如果需要用药，应为孕妇开具最低剂量的药物，并使用最短的时间。
