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The pharmacological management of acute behavioural disturbance in pregnancy

Published online by Cambridge University Press:  15 February 2023

Jennifer Powell Open the ORCID record for Jennifer Powell [Opens in a new window] ,
David Taylor Open the ORCID record for David Taylor [Opens in a new window]  and
Manonmani Manoharan
Jennifer Powell*
Affiliation:
MBChB (Bsc), MRCPsych, is a higher specialty trainee in general adult psychiatry on the Maudsley Training Programme, currently working with the Oxleas Perinatal Service, Oxleas NHS Foundation Trust, London, UK. Her clinical and research interests are in perinatal psychiatry and early intervention in psychosis
David Taylor
Affiliation:
PhD, FRPharmS, FRCPEdin, FRCPsych (Hon), is Director of Pharmacy and Pathology at the Maudsley Hospital, London, and Professor of Psychopharmacology at King's College London, UK. He is the author of the Maudsley Prescribing Guidelines in Psychiatry and of over 400 published articles
Manonmani Manoharan
Affiliation:
MBBS, MSc, MRCPsych, is a consultant perinatal psychiatrist with South London and Maudsley NHS Foundation Trust, London, UK, and an honorary senior clinical lecturer and researcher at the Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK. She is the author of various publications and also works as a firm head at King's College London Medical School, London, UK.
*
Correspondence Jennifer Powell. Email: jennifer.powell15@nhs.net
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Summary

Acute behavioural disturbance is relatively common during the perinatal period. The management of agitation in pregnant women is similar to that in the general population, although with some additional considerations, such as modifications to restraint techniques, careful medication selection, monitoring of maternal and fetal well-being and the importance of a debrief. There are benefits of agreeing a pre-determined care plan for women who are at risk.

Keywords

Perinatal psychiatryantipsychoticsdrug interactions and side-effectspsychotic disordersbipolar affective disorder
Type
Clinical Reflection
Information
BJPsych Advances , Volume 30 , Issue 1 , January 2024 , pp. 67 - 70
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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References

Ban, L, West, J, Gibson, JE, et al (2014) First trimester exposure to anxiolytic and hypnotic drugs and the risks of major congenital anomalies: a United Kingdom population-based cohort study. PLoS One, 9(6): e100996.Google Scholar
Cuomo, A, Goracci, A, Fagiolini, A (2018) Aripiprazole use during pregnancy, peripartum and lactation: a systematic literature search and review to inform clinical practice. Journal of Affective Disorders, 228: 229–37.Google Scholar
Dolovich, L, Addis, A, Vaillancourt, J, et al (1998) Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ, 317: 839–43.Google Scholar
Ennis, Z, Damkier, P (2015) Pregnancy exposure to olanzapine, quetiapine, risperidone, aripiprazole and risk of congenital malformations: a systematic review. Basic & Clinical Pharmacology and Toxicology, 116: 315–20.Google Scholar
Huybrechts, K, Hernández-Díaz, S, Patorno, E, et al (2016) Antipsychotic use in pregnancy and the risk for congenital malformations. JAMA Psychiatry, 73: 938–46.Google Scholar
McAllister-Williams, H, Baldwin, D, Cantwell, R, et al (2017) British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017. Journal of Psychopharmacology, 31: 519–52.Google Scholar
National Institute for Health and Care Excellence (2014) Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance (Clinical Guideline CG192) (updated 2020). NICE (https://www.nice.org.uk/guidance/cg192).Google Scholar
Taylor, D, Okocha, C, Paton, C, et al (2008) Buccal midazolam for agitation on psychiatric intensive care wards. International Journal of Psychiatry in Clinical Practice, 12: 309–11.Google Scholar
Tinker, S, Reefhuis, J, Bitsko, R, et al (2019) Use of benzodiazepine medications during pregnancy and potential risk for birth defects, national birth defects prevention study, 1997–2011. Birth Defects Research, 111: 613–20.Google Scholar
Tosato, S, Albert, U, Tomassi, S, et al (2017) A systematized review of atypical antipsychotics in pregnant women: balancing between risks of untreated illness and risks of drug-related adverse effects. Journal of Clinical Psychiatry, 78(5): e477–89.Google Scholar
UK Teratology Information Service (2019) Promethazine (Date: December 2019. Version 3). UKTIS (https://www.medicinesinpregnancy.org/Medicine--pregnancy/Use-of-promethazine/).Google Scholar
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