Einarson A, Selby P, Koren G
Motherisk Program, Division of Clinical Pharmacology/Toxicology, Hospital for Sick Children, 555 University Ave., Toronto ON 5G 1X8.
J Psychiatry Neurosci. 2001 Jan;26(1):44-8.
To assess the consequences to mother and baby of abruptly discontinuing antidepressant or benzodiazepine medication during pregnancy and to assess the impact of our counselling.
All women who consulted the Motherisk Program between November 1996 and December 1997 and who stopped taking antidepressant or benzodiazepine medication when pregnancy was confirmed agreed to participate in the study.
Subjects were interviewed, received counselling, and completed a questionnaire 1 month after their initial call and after the birth of their baby.
Of 36 women who completed the study, 34 discontinued their medication abruptly for fear of harming the fetus, 28 on the advice of their physician; 26 (70.3%) women reported physical and psychological adverse effects, 11 reported psychological effects only, and 11 reported suicidal ideation (4 were admitted to hospital). After counselling, 22 of 36 (61.1%) women resumed taking their medication, and 4 found that they no longer required it. One woman had a therapeutic abortion and 2 experienced spontaneous abortions; there were therefore 35 healthy babies (including 2 sets of twins) born to 33 women; 14 of 21 mothers breast-fed their babies while taking their psychotropic medication, with no adverse effects reported.
When assessing the risks and benefits of taking psychotropic medication during pregnancy, women and their physicians should be aware that the abrupt discontinuation of psychotropic drugs can lead to serious adverse effects. Counselling is effective in reassuring women to adhere to therapy.
评估孕期突然停用抗抑郁药或苯二氮䓬类药物对母婴的影响，并评估我们的咨询服务所产生的影响。
1996年11月至1997年12月期间咨询过母婴风险评估项目且在确认怀孕后停止服用抗抑郁药或苯二氮䓬类药物的所有女性均同意参与该研究。
对受试者进行访谈，提供咨询服务，并在其首次致电后1个月及婴儿出生后让她们填写一份问卷。
在完成研究的36名女性中，34名因担心伤害胎儿而突然停药，其中28名是听从医生的建议；26名（70.3%）女性报告有身体和心理方面的不良反应，11名仅报告有心理方面的影响，11名报告有自杀念头（4名入院治疗）。咨询后，36名女性中有22名（61.1%）恢复服药，4名发现自己不再需要服药。1名女性进行了治疗性流产，2名经历了自然流产；因此，33名女性共诞下35名健康婴儿（包括2对双胞胎）；21名母亲中有14名在服用精神药物期间进行母乳喂养，未报告有不良反应。
在评估孕期服用精神药物的风险和益处时，女性及其医生应意识到突然停用精神药物可能会导致严重的不良反应。咨询服务能有效地让女性安心坚持治疗。
