Psychiatrists' attitudes toward psychopharmacologic treatments during pregnancy and lactation periods: a survey study

Abstract

Objective: Pregnancy and lactation are risk periods when women are susceptible to psychiatric illnesses. As well as side effects and teratogenic effects of drug utilization, negative effects of untreated psychiatric illnesses on the fetus and mother may be issues of concern. Management of pregnancy and lactation periods may become complicated by a relapse of a psychiatric illness or by using a drug with unexpected harm effecting mother or baby. Mental health professionals are commonly confronted with patients who ask for advice during such times. In determining the course of treatment, the attitudes of mental health professionals are as important as the attitudes of patients. This study was conducted to evaluate attitudes and personal opinions of psychiatrists.Methods: An Internet survey was designed to ask questions about the tendency to use pharmacotherapy, electroconvulsive therapy (ECT), or psychotherapy, or to stop or lower the dosage of medicines, and the personal principles of psychiatrists during pregnancy and lactation. The relationship between academic degrees and professed knowledge levels of psychiatrists about management of treatments of pregnant and lactating women and personal comments were also evaluated. Of those asked, 246 psychiatrists replied and 213 online-surveys were completed.Results: Of the respondents, 22.2% were psychiatry residents, 50.9% were attending psychiatrists, 6.6% were assistant professors, 9% were associate professors, and 11.3% were full professors. The results showed that avoidance of starting drug therapy, terminating an ongoing drug treatment, seeking alternatives to drug treatment, transitioning to ECT treatment and consulting a higher center were significantly more common in pregnancy than during the lactation period (p