Re: Week 12: Discussion 1: Pregnancy and Lactation Research
by Alysa Ramalho – Thursday, 23 March 2023, 11:40 PM
In week 5, I prescribed Lexapro 10mg PO daily for the treatment of depression. In week 7, I prescribed Lithium treatment at 300mg PO TID for the treatment of bipolar disorder. If the patient in week 5 had been pregnant, I would be more likely to prescribe her Zoloft instead of Lexapro. Zoloft is pregnancy category C, meaning that risk cannot be ruled out and there have been no satisfactory studies in pregnant women. A benefit of prescribing Zoloft to a pregnant women who needs treatment for depression is that Zoloft has a very low transmission into breast milk and is considered safe for use with lactating women (Howland, 2007). It is important to discuss the risks and benefits of treatment with pregnant women. Although most studies show that SSRIs are not associated with birth defects, they may contribute to potential complications of maternal weight changes and premature birth (Howland, 2007). However, there is also a risk to non-treatment. According to Wichman & Stern (2015), â€œwomen who are depressed during pregnancy are more likely to use alcohol, illicit substances, and tobacco throughout pregnancy and to have worse nutrition and are less likely to be adherent with optimal prenatal care and to recognize or report the signs of laborâ€. Further, â€œneonates whose mothers are depressed are more likely to have lower birth weights and preterm deliveries, as well as lower Apgar scores and a smaller head circumferenceâ€ (Wichman & Stern, 2015). If the patient in week 7 was pregnant, I would be more likely to prescribe her quetiapine. Although quetiapine is generally considered safe to use in pregnancy, it is still pregnancy category C, and should be used with caution and may increase the risk for gestational diabetes (Rowland & Marwaha, 2018). A very small amount of quetiapine passes into breast milk and it is considered to be a safe treatment in lactating women.Howland, R. H. (2007). Managing common side effects of ssris. Journal of Psychosocial Nursing and Mental Health Services, 45(2), 15â€“18. https://doi.org/10.3928/02793695 20070201-04Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic advances in psychopharmacology, 8(9), 251â€“269. https://doi.org/10.1177/2045125318769235Stahl, S. M. (2017). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications. Cambridge University Press.Wichman, C. L., & Stern, T. A. (2015). Diagnosing and Treating Depression During Pregnancy. The primary care companion for CNS disorders, 17(2), 10.4088/PCC.15f01776. https://doi.org/10.4088/PCC.15f01776
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- Week 12: Pharmacotherapeutic Considerations in the Childbearing Years
- Week 12 Discussion 1: Pregnancy and Lactation Research
Week 12 Discussion 1: Pregnancy and Lactation Research
Done: Make forum posts: 1
Value: 100 points
Due: Create your initial post by Day 4, and reply to at least two of your classmatesâ€™ posts by Day 7.
Grading Category: Discussion Forums
Note: Consider your prior case studies for Depression in Module 5 and Bipolar Disorder in Module 7. Revisit and thoroughly review them.
- How would your treatment plan (i.e., medications, therapy, and so on) change for the pregnant female in Module 5 with Depression and Module 7 with Bipolar Disorder?
- How would this change if the female were lactating (i.e., breastfeeding)?
- What patient teaching would you include?
- What additional safety components would you consider for this patient, if any? Why?
- Please include proper citations and use APA format.
Review your peersâ€™ responses and respond to at least two classmatesâ€™ posts.
Note: Two key details from the writings of each peer you reviewed.
Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80 percent. Students are directed to review the Discussion Grading Rubric for criteria that exceed expectations.
Posting to the Discussion Forum
- Select the appropriate Thread.
- Select Reply.
- Create your post.
- Select Post to Forum.