Zażywanie środków psychotropowych w czasie ciąży i karmienie piersią
DOI:
https://doi.org/10.18778/1427-969X.10.09Słowa kluczowe:
leki psychotropowe, ciąża, karmienie piersią, leki przeciwdepresyjne, stabilizatory nastroju, leki przeciwpsychotyczneAbstrakt
Cel. Prezentacja zasad leczenia zaburzeń psychicznych u kobiet w okresie reprodukcyjnym. Metoda. Analiza prac przeglądowych i wyników prowadzonych badań Rezultaty. Sole litu, karbamazepina i kwas walproinowy nie powinny być stosowane w pierwszym trymestrze ciąży. Stosunkowo bezpieczne są w tym okresie trójpierścieniowe leki przeciwdepresyjne. Haloperidol również nie wywołuje uszkodzeń płodu. Redukcja dawki pod koniec ciąży pozwoli uniknąć objawów zatrucia i objawów odstawienia u noworodka. U zdrowych niemowląt korzyści związane z karmieniem piersią wydają się ważniejsze niż możliwe zagrożenie związane z działaniem trójpierścieniowych leków przeciwdepresyjnych, a także z działaniem soli litu. Niewiele wiadomo natomiast o skutkach działania znajdujących się w mleku matki takich środków jak inhibitory zwrotnego wychwytu serotoniny, leki przeciwpsychotyczne czy karbamazepina. Wnioski. Wskazane jest stosowanie leków o udowodnionej skuteczności i znanych efektach ubocznych (a więc substancji dłużej znanych niż wprowadzonych ostatnio). Zalecana jest terapia jednym lekiem podawanym w najniższych efektywnych dawkach. Psychoterapia i elektrowstrząsy mogą być alternatywą dla leczenia farmakologicznego.
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