Medication Treatment in Pregnancy and Postpartum Mood Disorders

Deciding to start a new medication or to continue a medication during pregnancy or lactation can weigh heavy on many parents' minds.  Pregnant parents have tremendous guilt when even considering medication, and they hear many inaccurate statements about risk.

It is vital that parents have access to accurate, sensitive messages about medication use during pregnancy and lactation.

Key messages to convey when talking to a pregnant or lactating parent about medication use:

  • Needing medication is not a weakness.
  • There is always exposure, be it to medication or illness.
  • This isn’t a parent’s needs against their baby’s needs.
  • There are solutions that can benefit both parent and baby while posing the least amount of risk to both.
  • A parent doing well will lead to a child doing well.

For prescribing providers who want to learn more and increase their skills, check out our Training page.

For a list of local specialists who treat PMADS, go to our Referrals and Whatcom County Resources page.

The resources listed below can be helpful in your conversation with parents.  

Recommended Steps before Beginning Antidepressants Medication Algorithm and Antidepressant Treatment Algorithm:
Part of the Massachusetts Child Psychiatry Access Program (MCPAP) For Moms Toolkit, these easy-to-follow visuals can help providers quickly follow evidence-based best practices when prescribing medication in the perinatal period.

Mother to Baby:
A service of Organization of Teratology Information Specialists, it is dedicated to providing evidence-based information about medications and other exposures during pregnancy and lactation.  Parents and providers can access over 250+ medication Fact Sheets or connect with an Information Specialist directly via call, text, or live chat.

Antidepressant Medication Chart
From Wisconsin Association for Perinatal Care, this chart provides a basic overview to clinicians when considering medication.

LactMed:
National Institute of Health database users can search for specific medications and find detailed information regarding their impact (if known) on lactation.

ACOG Guidelines on Psychiatric Medication Use in Pregnancy and Lactation (2008):
This overview chart that includes FDA Pregnancy Category, AAP Rating, and lactation Risk Category for psychiatric medications.

Infant Risk Center:
Consumers can call the center directly to receive information about medication use in pregnancy and lactation.  The website also offers a ton of helpful articles!

Perinatal Psychiatry Consult Line at University of Washington:
Washington state providers caring for pregnant and postpartum parents can consult with a UW perinatal psychiatrist.

Massachusetts General Hospital (MGH) Center for Women’s Mental Health:
This library contains many useful articles both for continuing education, and also to share with patients.