p.4
Symptoms and Management of Postnatal Depression
What are common symptoms of postnatal depression?
Symptoms include loss of interest in the baby, irritability, anxiety, decreased energy, and feelings of guilt or unworthiness.
p.1
Psychotropic Medication Considerations for Pregnant Women
What is recommended for women taking psychotropic medications who are planning a pregnancy?
Consider discontinuing treatment if well and at low risk of relapse, or switching to a low-risk medication if at high risk of relapse.
p.6
Management of Mental Illness in Pregnant Women
What psychological support is recommended for mothers experiencing postnatal psychosis?
Psychoeducation for the mother and her partner.
p.2
Psychotropic Recommendations During Pregnancy
Which antidepressants may be considered when initiating treatment postpartum?
Sertraline or mirtazapine.
p.1
Impact of Smoking on Pregnancy and Mental Health
What is the recommendation for smoking in pregnant women with psychiatric illness?
Encourage switching to nicotine replacement therapy, as smoking has numerous adverse outcomes.
p.6
Psychotropic Medication Considerations for Pregnant Women
What medication is recommended for mood disorders in breastfeeding mothers?
Sertraline or mirtazapine.
p.2
Psychotropic Recommendations During Pregnancy
What is the general recommendation for antidepressants during pregnancy?
It is usually advisable to continue the medication that has been used during pregnancy.
p.4
Aetiology - risk factors
What is a significant biological risk factor for postnatal depression?
A past history of depression.
p.5
Management of Mental Illness in Pregnant Women
What is a key component of the risk assessment in mental health examinations for new mothers?
Assessment of suicide risk and risk of harm to others, particularly the baby.
p.5
Classification of Postpartum Disorders
When does postpartum psychosis typically peak after birth?
Within two weeks, often as early as 48-72 hours after birth.
p.2
Psychotropic Medication Considerations for Pregnant Women
What is the recommendation for women taking valproate if they become pregnant?
Valproate should be stopped.
p.4
Aetiology - risk factors
What are some psychosocial risk factors for postnatal depression?
Poor relationship with the partner, adverse life events, and bonding difficulties.
p.6
Management of Mental Illness in Pregnant Women
What is the role of Mother and Baby Units in managing postnatal psychosis?
They offer specialist inpatient treatment and support for mothers with mental health problems after childbirth.
p.5
Symptoms and Management of Postnatal Depression
What rating scale can be used to assess postnatal depression?
The Edinburgh Postnatal Depression Rating Scale.
p.5
Psychotropic Medication Considerations for Pregnant Women
What should be monitored in infants of breastfeeding mothers taking psychotropic medication?
Adverse effects of the medications, as well as feeding patterns, growth, and development.
p.5
Medication Safety and Teratogenic Risks
What should be done if there are safety concerns regarding a mother and her infant?
Do not leave the infant alone with the mother.
p.4
Aetiology - risk factors
How does poor social support affect postnatal depression?
It increases the risk, particularly for single mothers.
p.1
General Principles of Prescribing During Pregnancy
What should be documented in the care of pregnant women on psychotropic medications?
All decisions regarding medication management.
p.3
Management of Mental Illness in Pregnant Women
What management strategies are used for postnatal depression?
Cognitive behavioral therapy, antidepressants, and psychoeducation.
p.3
Management of Mental Illness in Pregnant Women
What management strategies are used for postnatal psychosis?
Antipsychotics, lithium treatment, and ECT.
p.4
Symptoms and Management of Postnatal Depression
What is postnatal depression?
A pervasive low mood lasting at least two weeks after childbirth, associated with reduced sleep, energy, concentration, and appetite.
p.1
General Principles of Prescribing During Pregnancy
What should be ensured for all pregnant women regarding medication?
Use the lowest effective dose and the medication with the lowest known risk to mother and fetus.
p.5
Management of Mental Illness in Pregnant Women
What are the potential harms of untreated depression in new mothers?
Harm to the mother (e.g., poor self-care, suicide) and harm to the baby (e.g., neglect, infanticide).
p.2
Management of Mental Illness in Pregnant Women
What should be assessed regarding the mother-baby relationship in women with mental health problems?
Verbal interaction, emotional sensitivity, and physical care.
p.5
Management of Mental Illness in Pregnant Women
What psychological therapies are recommended for mothers experiencing mental health issues postpartum?
Psychoeducation, cognitive behavioral therapy, and family therapy.
p.4
Symptoms and Management of Postnatal Depression
What is the peak onset period for postnatal depression?
3 to 4 weeks after birth.
p.1
Psychotropic Recommendations During Pregnancy
What should be done if a woman discovers she is pregnant while on psychotropic medication?
Avoid abrupt discontinuation of treatment, especially for those at high risk of relapse.
p.5
Classification of Postpartum Disorders
What are common symptoms of postpartum psychosis?
Severe depression, mania, rapidly changing moods, delusions, hallucinations, and confusion.
p.1
Medication Safety and Teratogenic Risks
Which medications should be avoided in women of reproductive age?
Medications that are contraindicated during pregnancy, notably valproate and carbamazepine.
p.2
Psychotropic Recommendations During Pregnancy
What should be done for women taking clozapine during breastfeeding?
They should be advised against breastfeeding while continuing clozapine.
p.1
General Principles of Prescribing During Pregnancy
What should be discussed with all women of childbearing potential?
The possibility of pregnancy, as half of all pregnancies are unplanned.
p.4
Symptoms and Management of Postnatal Depression
What distinguishes postnatal depression from postnatal psychosis?
Postnatal depression is a non-psychotic depressive episode.
p.6
Classification of Postpartum Disorders
What is a key component of the investigation for postnatal psychosis?
A thorough risk assessment, including suicide risk.
p.2
Psychotropic Medication Considerations for Pregnant Women
What should be monitored in women taking antipsychotic medication during pregnancy?
Gestational diabetes, with an oral glucose tolerance test offered.
p.2
Psychotropic Medication Considerations for Pregnant Women
What are the potential symptoms of antipsychotic discontinuation in neonates?
Crying, agitation, and increased sucking.
p.3
Symptoms and Management of Postnatal Depression
What are the symptoms of postnatal depression?
Low mood, reduced self-esteem, tearfulness, and anxiety (particularly about the baby’s health).
p.2
Psychotropic Medication Considerations for Pregnant Women
What should be done if a pregnant woman is stable on an antipsychotic?
Advise her to continue the antipsychotic to avoid relapse.
p.6
Classification of Postpartum Disorders
What is a significant biological risk factor for postnatal psychosis?
A history of bipolar disorder, schizophrenia, or schizoaffective disorder.
p.1
Psychotropic Recommendations During Pregnancy
What should be monitored in neonates after birth?
Withdrawal effects from psychotropic medications.
p.6
Classification of Postpartum Disorders
What is the recurrence risk for women who have had postpartum psychosis?
About 50% will experience it again after the birth of another baby.
p.1
Psychotropic Recommendations During Pregnancy
What is a key consideration when prescribing antidepressants during pregnancy?
Patients at high risk of relapse should be maintained on the same antidepressant during and after pregnancy.
p.6
Psychotropic Medication Considerations for Pregnant Women
What is advised against breastfeeding while on lithium?
Women taking lithium should be advised against breastfeeding.
p.6
Classification of Postpartum Disorders
What is a poor prognostic factor for women who have experienced postpartum psychosis?
Family history of psychiatric illness.
p.3
Classification of Postpartum Disorders
What are the three classifications of postpartum disorders?
Postpartum blues, postnatal depression, and postnatal psychosis.
p.3
Symptoms and Management of Postpartum Blues
What management is recommended for postpartum blues?
Support and reassurance; medication is unnecessary.
p.2
Psychotropic Medication Considerations for Pregnant Women
What is the preferred approach for managing sedatives during pregnancy?
Non-drug measures are preferred; if medication is needed, use one with a short half-life.
p.4
Symptoms and Management of Postnatal Depression
What cognitive symptoms should be focused on in postnatal depression?
Ideas of guilt, unworthiness, and bleak views of the future.
p.3
Symptoms and Management of Postpartum Blues
What is the typical duration of postpartum blues?
Symptoms peak over the next few days and resolve within 10-14 days of onset.
p.3
Symptoms and Management of Postpartum Blues
What are the symptoms of postpartum blues?
Emotional lability, tearfulness, increased feelings of vulnerability, irritability, and loneliness.
p.3
Symptoms and Management of Postnatal Psychosis
What are the symptoms of postnatal psychosis?
Marked insomnia, irritability, restlessness, hallucinations, and delusions.
p.3
Symptoms and Management of Postnatal Psychosis
When does postnatal psychosis typically occur after childbirth?
Within 2 weeks, often as early as 48-72 hours after birth.
