It used to be easier.  Becoming a perinatal psychiatrist meant understanding some rudimentary data on the reproductive risks of a few psychotropic medications — medications like lithium and valproic acid that were known teratogens. There was some preliminary data on a few SSRI antidepressants, the tricyclic antidepressants, and the older antipsychotic medications.  Most of the time, consultations involved weighing the risks of untreated psychiatric illness in the mother against the as yet unknown risks to the child of the medications used to treat these disorders. 

Now we have a lot of data to wade through, and it is a daunting task to familiarize oneself with this body of information.  Having a solid, well-researched review article is a good place to start, but many of those articles are in books which are sometimes difficult to locate.  This article from Hanna Betcher and Katherine Wisner is available online (free) and is an excellent foundational article.  It provides clinically relevant data but also helps the reader navigate some of the more controversial issues in the field.    

Have a Happy and Healthy New Year!

Ruta Nonacs, MD PhD

Betcher HK, Wisner KL. Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles. J Womens Health (Larchmt). 2020;29(3):310-318. doi:10.1089/jwh.2019.7781