精神药物在妊娠期使用的安全性探讨

Dosing safety of psychotropic agents during pregnancy

妊娠期内,精神疾病的治疗面临两难处境。一方面,妊娠期很多精神疾病(如双相障碍)的新发/复发风险显著高于非妊娠期,药物治疗对于很多患者而言是必需的;另一方面,很多患者及医生担心,用药可能造成种种不良后果,特别是对胎儿造成畸形、早产、神经发育受损等。本文主要通过国内外精神科相关专家小组发布的指南、美国食品药品监督管理局(FDA)妊娠期用药分级、Gerald G等主编的《妊娠期和哺乳期用药》及近年来的最新循证医学研究证据对精神药物在妊娠期使用的安全性进行探讨,以期为临床用药选择提供合理参考。

During pregnancy, the management of mental illness is particularly problematic.On the one hand, the risk of new onset and recurrence of many mental disorders in pregnancy is significantly higher than that in non-pregnancy period, such as bipolar disorder.Drug therapy is essential for these patients.On the other hand, both patients and doctors are concerned that medication may cause various adverse consequences, especially for fetal malformations, premature delivery, neurodevelopmental damage and so on.This study mainly discusses the safety of psychotropic agents during pregnancy through the guidelines issued by domestic and foreign psychiatric expert groups, FDA classification of medications during pregnancy, Medications during Pregnancy and Lactation edited by Gerald G and the latest evidence-based medicine research to provide practical reference for rational clinical medications.