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[孕期心理药物治疗:哪些抗精神病药、镇静剂和催眠药适用?]

[Psychopharmacotherapy during pregnancy : Which antipsychotics, tranquilizers and hypnotics are suitable?].

作者信息

Bergemann N, Paulus W E

机构信息

Sächsisches Krankenhaus Rodewisch, Zentrum für Psychiatrie, Psychotherapie, Psychosomatik und Neurologie, Bahnhofstraße 1, 08228, Rodewisch, Deutschland.

Institut für Reproduktionstoxikologie, Krankenhaus St. Elisabeth, Ravensburg, Deutschland.

出版信息

Nervenarzt. 2016 Sep;87(9):943-54. doi: 10.1007/s00115-016-0192-z.

Abstract

BACKGROUND

When administering psychotropic drugs during pregnancy not only the potential teratogenic effects on the child must be addressed but also the fetotoxic implications for pregnancy and/or the peripartum phase as well as possible neurocognitive developmental disorders must be considered.

OBJECTIVE

Evaluation of the risks and benefits of administering psychotropic drugs during pregnancy or for women who wish to become pregnant.

METHODS

The literature has been reviewed with the purpose of providing information on psychotropic drugs which can safely be administered during pregnancy. The review considers antipsychotics as well as tranquilizers and hypnotics.

RESULTS

Data are available for a multitude of psychotropic drugs that allow a safe estimation on their suitability for use during pregnancy.

CONCLUSION

When treating mental illnesses during pregnancy the option of administering drugs must not principally be ruled out. What is required is an individual assessment of benefits and risks. The risk of an untreated mental illness versus the benefit of a suitable treatment, which may include the use of medication and the potential harm to the infant must be evaluated. If certain rules are observed and a suitable drug is selected the risk to the newborn child and/or mother during pregnancy can be minimized. During pregnancy, therapeutic drug monitoring is indicated and increases the safety for use of drugs and preventing harm to both mother and infant.

摘要

背景

在孕期使用精神药物时,不仅要考虑对胎儿潜在的致畸作用,还必须考虑对妊娠和/或围产期的胎儿毒性影响以及可能的神经认知发育障碍。

目的

评估孕期或希望怀孕的女性使用精神药物的风险和益处。

方法

对文献进行综述,目的是提供有关孕期可安全使用的精神药物的信息。该综述涵盖了抗精神病药物以及镇静剂和催眠药。

结果

有大量精神药物的数据,可据此安全评估它们在孕期使用的适用性。

结论

孕期治疗精神疾病时,原则上不应排除用药选项。需要对益处和风险进行个体化评估。必须评估未治疗的精神疾病风险与适当治疗(可能包括用药)的益处以及对婴儿的潜在危害。如果遵守某些规则并选择合适的药物,可将孕期对新生儿和/或母亲的风险降至最低。孕期需要进行治疗药物监测,以提高用药安全性并防止对母婴造成伤害。

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