Referral

• Preconceptual referral is recommended for women:
  - with a history of bipolar disorder or other psychosis, including a previous puerperal episode, who have a high risk of puerperal psychosis
  - taking any mood stabilizers or long-term antipsychotics (ref 210)
  
  
• Refractory cases of depression should be referred to the community mental health team.
• In severe cases, referral to inpatient services may be necessary, ideally to a specialist mother and baby unit (babies should not be admitted to general psychiatric wards).

References

210 Altshuler LL, Cohen L, Szuba MP et al. Pharmaceutical management of psychiatric illness during pregnancy. Am J Psychiatry 1996, 153: 592-606. (BI) This is a review. The use of psychotropic medications during pregnancy is appropriate in many clinical situations and should include thoughtful weighing of risk of prenatal exposure with risk of relapse following drug discontinuation.

Last edited: 2/2/2004

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