Skip to main content
SpringerLink
Log in

Psychopharmaka in Schwangerschaft und Stillzeit

  • Chapter
  • First Online:
Kompendium der Psychiatrischen Pharmakotherapie

  • 2358 Accesses

Zusammenfassung

Die medikamentöse Therapie psychischer Störungen in Schwangerschaft und Stillzeit erfordert besondere Kenntnisse möglicher Auswirkungen der Psychopharmakotherapie auf den intrauterin exponierten Embryo/Fetus bzw. den gestillten Säugling. Mögliche substanzspezifische Risiken sind bei ihrem Einsatz dem natürlichen Risiko für Schwangerschafts-, Geburts- und neonatale Komplikationen, das mit der jeweiligen (unbehandelten) psychischen Erkrankung verbunden ist, gegenüberzustellen. Pharmakokinetische Veränderungen während dieser Zeit erfordern eine besondere Fokussierung auf die Arzneimitteltherapiesicherheit und den Behandlungserfolg und können mithilfe von Therapeutischem Drug Monitoring (TDM) kontrolliert werden. Bei jeder Therapieentscheidung handelt es sich um eine Einzelfallentscheidung unter Würdigung der Gesamtkonstellation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Ankarfeldt MZ, Petersen J, Andersen JT et al (2023) Duloxetine exposure during pregnancy and the risk of offspring being born small for gestational age or prematurely: a nationwide Danish and Swedish safety study. Drugs Real World Outcomes 10:69–81

    Article  PubMed  Google Scholar 

  • Beex-Oosterhuis MM, Van Gool AR, Heerdink ER et al (2021) Clozapine treatment during pregnancy and the postpartum period: a systematic literature review. J Clin Psychiatry 83(1):21r13952

    Article  PubMed  Google Scholar 

  • Besag FMC, Vasey MJ (2023) Should antidepressants be avoided in pregnancy? Drug Saf 46:1–17

    Article  CAS  PubMed  Google Scholar 

  • Bjørk MH, Zoega H, Leinonen MK et al (2022) Association of prenatal exposure to antiseizure medication with risk of autism and intellectual disability. JAMA Neurol 79:672–681

    Article  PubMed  Google Scholar 

  • Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (2022) Nationale VersorgungsLeitlinie Unipolare Depression – Langfassung, Version 3.1. 2022. https://www.leitlinien.de/depression. Zugegriffen: 13. Mai 2023

  • Cohen LS, Rhodes SM, Claypoole LD et al (2022) Neurobehavioral follow-up of children exposed to selective serotonin reuptake inhibitors in utero. Ann Clin Psychiatry 34:197–206

    Article  PubMed  Google Scholar 

  • Dao K, Shechtman S, Diav-Citrin O et al (2023) Reproductive safety of trazodone after maternal exposure in early pregnancy: a comparative ENTIS cohort study. J Clin Psychopharmacol 43:12–19

    Article  CAS  PubMed  Google Scholar 

  • Desaunay P, Eude L-G, Dreyfus M et al (2023) Benefits and risks of antidepressant drugs during pregnancy: a systematic review of meta-analyses. Pediatr Drugs 25:247–265

    Article  Google Scholar 

  • DGPPN (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde e. V.) (Hrsg) (2019) S3-Leitlinie Schizophrenie. AWMF-Register Nr. 038-009. Langfassung, Stand: 15. März 2019. https://www.awmf.org/leitlinien/detail/ll/038-009.html. Zugegriffen: 13. Mai 2023

  • Dudukina E, Szépligeti SK, Karlsson P et al (2023) Prenatal exposure to pregabalin, birth outcomes and neurodevelopment – a population-based cohort study in four Nordic countries. Drug Saf 46(7):661–675

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eleftheriou G, Butera R, Sangiovanni A et al (2023) Long-acting injectable antipsychotic treatment during pregnancy: a case series. Int J Environ Res Public Health 20(4):3080

    Article  PubMed  PubMed Central  Google Scholar 

  • Grigoriadis S, Alibrahim A, Mansfield JK et al (2022) Hypnotic benzodiazepine receptor agonist exposure during pregnancy and the risk of congenital malformations and other adverse pregnancy outcomes: a systematic review and meta-analysis. Acta Psychiatr Scand 146:312–324

    Article  CAS  PubMed  Google Scholar 

  • Hálfdánarson Ó, Cohen JM, Karlstad Ø et al (2022) Antipsychotic use in pregnancy and risk of attention/deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study. Evid Based Ment Health 25:54–62

    Article  PubMed  Google Scholar 

  • Heinonen E, Tötterman K, Bäck K et al (2022) Lithium use during breastfeeding was safe in healthy full-term infants under strict monitoring. Acta Paediatr 111:1891–1898

    Article  PubMed  Google Scholar 

  • Huybrechts KF, Straub L, Karlsson P et al (2023) Association of in utero antipsychotic medication exposure with risk of congenital malformations in Nordic countries and the US. JAMA Psychiatry 80:156–166

    Article  PubMed  Google Scholar 

  • Janiri D, Sampogna G, Albert U et al (2023) Lithium use in childhood and adolescence, peripartum, and old age: an umbrella review. Int J Bipolar Disord 11:8

    Article  PubMed  PubMed Central  Google Scholar 

  • Kananen A, Bernhardsen GP, Lehto SM et al (2023) Quetiapine and other antipsychotic medications during pregnancy: a 15-year follow-up of a university hospital birth register. Nord J Psychiatry. https://doi.org/10.1080/08039488.2023.2205852

    Article  PubMed  Google Scholar 

  • Lebin LG, Novick AM (2022) Selective serotonin reuptake inhibitors (SSRis) in pregnancy: an updated review on risks to mother, fetus, and child. Curr Psychiatry Rep 24:687–695

    Article  PubMed  PubMed Central  Google Scholar 

  • Leutritz AL, Van Braam L, Preis K et al (2023) Psychotropic medication in pregnancy and lactation and early development of exposed children. Br J Clin Pharmacol 89:737–750

    Article  CAS  PubMed  Google Scholar 

  • Liu X, Kolding L, Momen N et al (2023) Maternal antipsychotic use during pregnancy and congenital malformations. Am J Obstet Gynecol MFM 5:100950

    Article  CAS  PubMed  Google Scholar 

  • Lou Z-Q, Zhou Y-Y, Zhang X et al (2022) Exposure to selective noradrenalin reuptake inhibitors during the first trimester of pregnancy and risk of congenital malformations: a meta-analysis of cohort studies. Psychiatry Res 316:114756

    Article  CAS  PubMed  Google Scholar 

  • Ostenfeld A, Petersen TS, Pedersen LH et al (2022) Mirtazapine exposure in pregnancy and fetal safety: a nationwide cohort study. Acta Psychiatr Scand 145:557–567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Paulzen M, Schoretsanitis G (2023a) Psychopharmakotherapie in Schwangerschaft und Stillzeit, Möglichkeiten der Unterstützung durch Therapeutisches Drug Monitoring. Teil I: Schwerpunkt Schwangerschaft. Nervenarzt doi: https://doi.org/10.1007/s00115-023-01528-x. Online ahead of print

  • Paulzen M, Schoretsanitis G (2023b) Psychopharmakotherapie in Schwangerschaft und Stillzeit, Möglichkeiten der Unterstützung durch Therapeutisches Drug Monitoring. Teil II: Schwerpunkt Stillzeit. Nervenarzt doi: https://doi.org/10.1007/s00115-023-01526-z. Online ahead of print

  • Poels EMP, Kamperman AM, Bijma HH et al (2023) Brain development after intrauterine exposure to lithium: a magnetic resonance imaging study in school-age children. Bipolar Disord 25(3):181–190

    Article  CAS  PubMed  Google Scholar 

  • Poels EMP, Schrijver L, White TJH et al (2022) The effect of prenatal lithium exposure on the neuropsychological development of the child. Bipolar Disord 24:310–319

    Article  CAS  PubMed  Google Scholar 

  • Poweleit EA, Cinibulk MA, Novotny SA et al (2022) Selective serotonin reuptake inhibitor pharmacokinetics during pregnancy: clinical and research implications. Front Pharmacol 13:833217

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Richardson JL, Damkier P, Diav-Citrin O et al (2023) A critical appraisal of controlled studies investigating malformation risks following pregabalin use in early pregnancy. Br J Clin Pharmacol 89:630–640

    Article  CAS  PubMed  Google Scholar 

  • Robiyanto R, Schuiling-Veninga CCM, Bos JHJ et al (2023) Exposure to psychotropic drugs before and during pregnancy: what has changed over the last two decades? Arch Womens Ment Health 26:39–48

    Article  PubMed  PubMed Central  Google Scholar 

  • Rommel AS, Momen NC, Molenaar NM et al (2022) Antidepressant use during pregnancy and risk of adverse neonatal outcomes: a comprehensive investigation of previously identified associations. Acta Psychiatr Scand 145:544–556

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sagué-Vilavella M, Solé E, Pinzón-Espinosa J et al (2022) Obstetric outcomes regarding the use of lithium in pregnant women with bipolar disorders: a prospective cohort study. Arch Womens Ment Health 25:729–737

    Article  PubMed  Google Scholar 

  • Schmidt CT, Deligiannidis KM, Kittel-Schneider S et al (2023) Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: a systematic review & combined analysis. Prog Neuropsychopharmacol Biol Psychiatry 124:110733

    Article  CAS  PubMed  Google Scholar 

  • Schoretsanitis G, Augustin M, Saßmannshausen H et al (2019) Antidepressants in breast milk; comparative analysis of excretion ratios. Arch Womens Ment Health 22(3):383–390

    Article  PubMed  Google Scholar 

  • Schoretsanitis G, Spigset O, Stingl JC et al (2020a) The impact of pregnancy on the pharmacokinetics of antidepressants: a systematic critical review and meta-analysis. Expert Opin Drug Metab Toxicol 16(5):431–440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schoretsanitis G, Westin AA, Deligiannidis KM et al (2020b) Excretion of antipsychotics into the amniotic fluid, umbilical cord blood, and breast milk: a systematic critical review and combined analysis. Ther Drug Monit 42(2):245–254

    Article  CAS  PubMed  Google Scholar 

  • Spowart KM, Reilly K, Mactier H et al (2023) Executive functioning, behavioural, emotional, and cognitive difficulties in school-aged children prenatally exposed to methadone. Front Pediatr 11:1118634

    Article  PubMed  PubMed Central  Google Scholar 

  • Straub L, Hernández-Díaz S, Bateman BT et al (2022) Association of antipsychotic drug exposure in pregnancy with risk of neurodevelopmental disorders: a national birth cohort study. JAMA Intern Med 182:522–533

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Suarez EA, Bateman BT, Hernández-Díaz S et al (2022) Association of antidepressant use during pregnancy with risk of neurodevelopmental disorders in children. JAMA Intern Med 182:1149–1160

    Article  PubMed  PubMed Central  Google Scholar 

  • Viguera AC, Freeman MP, Kobylski LA et al (2023) Risk of major malformations following first-trimester exposure to olanzapine: preliminary data from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications. J Clin Psychopharmacol 43:106–112

    Article  PubMed  Google Scholar 

  • Wiggs KK, Sujan AC, Rickert ME et al (2022) Maternal serotonergic antidepressant use in pregnancy and risk of seizures in children. Neurology 98:e2329–2336

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zheng L, Yang H, Dallmann A (2022) Antidepressants and antipsychotics in human pregnancy: transfer across the placenta and opportunities for modeling studies. J Clin Pharmacol 62(Suppl 1):S115–S128

    CAS  PubMed  Google Scholar 

  • Zilles-Wegner D, Trost S, Walliser K et al (2021) Electroconvulsive therapy in pregnancy: case report and interdisciplinary treatment suggestions. Nervenarzt 92:50–56

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mannheim, Deutschland

    PD Dr. med. Michael Paulzen

  2. Mainz, Deutschland

    Prof. Dr. med. Otto Benkert

Authors
  1. PD Dr. med. Michael Paulzen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Prof. Dr. med. Otto Benkert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Otto Benkert .

Editor information

Editors and Affiliations

  1. ehemals Universitäts-Klinikum Mainz, Mainz, Deutschland

    Otto Benkert

  2. ehemals Universitäts-Klinikum München, München, Deutschland

    Hanns Hippius

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Paulzen, M., Benkert, O. (2023). Psychopharmaka in Schwangerschaft und Stillzeit. In: Benkert, O., Hippius, H. (eds) Kompendium der Psychiatrischen Pharmakotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-67685-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-67685-1_14

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-67684-4

  • Online ISBN: 978-3-662-67685-1

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation