Overview of psychotropic pregnancy data

The recommendations in these guidelines for psychotropic use during pregnancy are drawn on expert consensus based on evidence of low to moderate quality.

Although there is no reason to suspect that a psychotropic would be ineffective during pregnancy, there have been no randomised controlled trials, so the effectiveness of psychotropics in this patient group remains unproven. Although pharmacokinetics and pharmacodynamics alter during pregnancy, the clinical implications of these changes are relatively unknown.

Psychotropic safety data in pregnancy are limited to observational studies that have significant confounders (eg psychiatric disorder, age, weight, alcohol and nicotine use). However, safety data continues to improve as more patient data is submitted to pregnancy registries and studies more effectively control for confounders.