Use of psychotropic / antipsychotic drugs during pregnancy and breast-feeding


Sertraline and citalopram are first-line treatment among selective serotonin reuptake inhibitor for depression. It is recommended to use lithium for bipolar disorders if an overall assessment finds an indication for mood-stabilizing treatment during pregnancy. Lamotrigine can be used. Valproate and carbamazepin are contraindicated.

Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia.


It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how it has to be administered.



Hah…needed something like this to read during those few months of self - beating, self-doubting hell.

But the full article won’t open.

Yes - it typically only becomes available for free after 6 months or a year.

Thanks. I’ll figure out something.
Our therapists here have a bad habit to assume that their pacients are not educated enough to read researches for themselves.

It’s my understanding that they are all safe to take during pregnancy. However, breastfeeding is another story. The SSRI’s are safe, but AP’s are not for breastfeeding as they cross the barrier.

Well this is something to keep in mind. My doctor told me that if I get pregnant she won’t let me stay on anything. She said she thinks I can manage without medication for that long. I know both the meds I take (amitriptyline and ziprasidone) cause birth defects and amitriptyline causes withdrawal in the baby. Risperidone makes me sick, but I will research the others. I’m not taking anything that makes me gain weight though. That never goes away.

Mine told me the same thing.

When I talked to my pdoc a couple months ago he said he would recommend I stay on my AP and SSRI and bottlefeed. He thought the risks outweighed the chance of birth defect from the AP because of stress and depression would cause more harm during the pregnancy and postpreg.

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Although my DR. insisted my meds were safe, I went off them during my pregnancies. I’d rather suffer for 9 months than give birth to a child who would suffer the rest of his/ her life with a birth defect or some other defect.

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The trouble with this idea is that if you are suffering - then your child inside you is also suffering. Stress hormones during pregnancy are one of the things that is thought to predispose a child to mental health issues - so if you’re suffering, it greatly increases the chance that your child will also be suffering and ultimately develop schizophrenia.

There are also some things - like high EPA omega 3 fish oils and Choline (in the form of Lecithin - at the level of 6 grams of choline (much more Lecithin because choline is just a small part of Lecithin) that when taken during pregnancy, seem to help protect the brain of the baby from stress hormones that would otherwise harm the developing baby’s brain.

Some news and reading about how the stress hormones (cortisol and glucocorticoids) negatively impact a child’s brain development during pregnancy:

“Research suggests that high stress levels experienced by the mother during pregnancy can increase the chances that the child will have schizophrenia later in life. Higher stress levels during pregnancy has also been linked to lower child IQ.”

Stressed Moms, Schizophrenic Kids

Severe emotional stress during the first delicate months of a woman’s pregnancy may permanently impair the neurodevelopment of her unborn child, leading to an increased risk of schizophrenia later in life, new research suggests.


Additional reading on how stress negatively impacts brain development in children during pregnancy:


I’m happy to report my children were born healthy. :slight_smile: One has mild OCD as do I, but they’re doing very good at age 12 and 13. :slight_smile: Thank you for your concern and advice.

Please give them daily High EPA fish oil - and read up on the schizophrenia prevention research:

Orygen’s fish oil research, being led by Professor Patrick McGorry and Associate Professor Paul Amminger is testing whether omega-3 fatty acids (specifically those high in the EPA version of omega-3 fish oils) can help delay the onset of psychosis. Amminger believes the research could have breakthrough implications for prevention of schizophrenia.

"Preferably the composition includes about 700 mg of EPA and at least about 480 mg of DHA.

the … dose of EPA administered to the subject per day is about 700 mg and the final dose of DHA administered to the subject per day is 480 mg. The composition may be administered in multiple dosages over the period of the day. For example, 4 capsules may be administered over the course of the day (two in the morning and two in the evening). However, other administration (such as once daily, or twice daily) are not excluded."


And more details on Preventing Schizophrenia:


God bless you SzAdmin…this was exactly what I needed.
Although…I don’t quite understand this part of research;
“Whilst it is possible that EPA and DHA be administered alone, it is preferable that they are administered together in a single composition. When in a single composition, EPA and DHA are present in a ratio of between about 3:1 and 7:5, preferably between about 3:2 and 7:5. Accordingly, preferably the composition includes EPA and DHA (when combined) in a concentration of more than about 50%, preferably more than about 55%, more preferably about 60%.”

Now I’m considering to include omega3-fish oil to my kid’s nutrition…but I’m not sure what would be the right dosage?

Hardest decision ever…at least for me.
Both my pdoc and gynecologist agreed that low dose of Zolof won’t do any harm…but the problem was that the lowest effective dose wasn’t quite effective for me… And I was searching on forums for similar experiences - which i sincerely don’t recommend - because every pregnancy is different, with different family history, stress tolerance, risk factors, etc.
I was taking Zoloft for two weeks, then I would dropped it, started again, dropped it again…and finally went off…but it wasn’t easy at all.

Also, I think there are certain periods during the pregnancy with higher risk factors for developmental defects, which would be the first few weeks and the last trimester.

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The research above says:

Preferably the composition includes about 700 mg of EPA and at least about 480 mg of DHA.

For any family where there is a history of mental health problems - this is what I would give the the children.

You can find sources that are cheaper by searching on the google shopping engine for “high EPA fish oil” and find one that meets the specifications:

You can find flavored liquid High EPA fish oils that kids like too - they have fruit flavor, etc. and just give them a table spoon every day with breakfast. Check to make sure it doesn’t have too much Vitamin A in it (check the limits here:

Google Shopping search example here:

like this one (I don’t know this brand - I’m just using it as an example):

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Oh, I was confused with EPA/DHA but those are just two kinds of omega3 :smile:
Thank you.

Right - Omega 3 oils - with High EPA and lower DHA content… so that the person is getting about 700 mg a day of EPA and 480 Mg of DHA.

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Be sure to watch out for kids getting too much Vitamin A (which some Omega 3 oils have): Too much can hurt the child’s brain.

Table 1: Recommended Dietary Allowances (RDAs) for Vitamin A [5]
0–6 months* 400 mcg
7–12 months* 500 mcg
1–3 years 300 mcg
4–8 years 400 mcg
9–13 years 600 mcg

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Just an update on fish oil supplement here.
I just bought a package of omega3 capsules with the highest amount of both acids per one dose, which is: 180mg of EPA and 120mg of DHA. So three capsules would contain 540 EPA and 360 DHA.
(Not to mention that the girl in the pharmacy gave me that weird look while I was counting the measures)
But it is still not close to recommended dosage :confused: