Pharmacological treatment

When prescribing pharmacological treatments, the potential for harm to the foetus and the breastfed infant must be carefully balanced against the likelihood of harm to mother and foetus/infant if the mother remains untreated.

• Select treatment based on the woman’s preferences.
• Consider the risks and benefits to the woman and foetus/ infant of treatment versus non-treatment.
• Minimise possibility of harm to the foetus or exposure of the infant during breastfeeding.
• Involve a psychiatrist when considering prescription of clozapine, sodium valproate or lithium.
• Consult guidelines for the use of pharmacological treatments in the general population (Therapeutic Goods Administration (TGA), Electronic Therapeutic Guidelines and Australian Medications Handbook).
• Explain risks and benefits, side effects and any delay in onset of effect.
• Closely monitor and have a plan to identify relapse early.

Due to the overall paucity of evidence, no absolute assurance can be given about any medication used during pregnancy or breastfeeding.