The use of atypical antipsychotics to treat women who suffer from underlying psychiatric illness frequently makes the difference between substantial suffering or takes patients from partial remission to euthymia. In the end, precise quantification of the reproductive safety of atypical antipsychotics may be challenging given the frequency of polytherapy – whether an atypical is used as mood stabilizers for patients with bipolar or as an adjunct to antidepressants in a woman with depression. However, after 2 decades of clinical work and research with the population of women who take psychiatric medications and who are either planning to conceive or who are pregnant, I maintain that little should trump the very significant downside of active psychiatric disorder during pregnancy.
For information on enrolling in the National Pregnancy Registry for Atypical Antipsychotics, women and clinicians can call 866-961-2388.
Dr. Cohen is the director of the Center for Women's Mental Health at Massachusetts General Hospital in Boston, which provides information about pregnancy and mental health. He is the principal investigator on the National Pregnancy Registry for Atypical Antipsychotics, which is sponsored by multiple manufacturers of atypical antipsychotics. To comment, e-mail him at obnews@frontlinemedcom.com.