The Reproductive Safety Of Quetiapine

There is increasing awareness of perinatal mental health as a public health issue. The Government is keen for midwives to further develop their role in public health. Midwives need to be adequately prepared to take on a more developed role in perinatal mental health if practice improvements are to be made. I am aware that death from psychiatric causes has been the leading cause of maternal death for the last few years. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer a leading cause, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children’s subsequent

Perinatal mental illness is a collective term used to describe mental illnesses experienced by at least 10% of women during pregnancy and up until a year after birth (Hogg, 2014). Mental health is with paramount importance to the role of the midwife (National Institute for Health and Clinical Excellence (NICE), 2014) as mental illness is a significant threat to the lives of mothers and can have a huge effect for their babies and families (Knight et al., 2015). Between 2009 and 2013 there were 161 maternal deaths related to mental health problems, one of the leading causes of maternal mortality in the United Kingdom (UK) (Knight et al., 2015). The main types of mental health disorders, signs and symptoms along with possible treatments

Antipsychotic drugs are drugs that are used to treat schizophrenia and related psychotic disorders. Medications have undergone significant improvement over the past few decades and can be effective for psychotic symptoms, anxiety, depression and other disorders. Antipsychotic drugs work by blocking the chemical dopamine receptors in parts of the brain such as the mesolimbic

In terms of public health and associated concern, in the recent years it has been observed that mental illness has major impact on pregnant women and postpartum period which has become a concern of public health lately. The aspect that associated with pregnancy of women and their mental health that has brought this topic in the forefront is the fact that mental health problems like depression and anxiety have the probability to impact women twice as compared to men. The severity of the situation seen from a global perspective, shows that depression is one of the major reasons of maternal mental illness during the childbearing age of women, which is approximately between the age group of 18 to 40 years. As a result of this to the Global Burden of Disease (GBD) it contributes approximately 7% of the entire GBD for women of all age group (Leham, 2015).

Despite the physical changes that a woman is to expect during her pregnancy, a major concern that requires attention is a period of expected feelings of depression that a woman may encounter known as baby blues. Although normal, and expected baby blues can lead into post partum depression that involves a myriad of emotions and mood swings. If not addressed postpartum depression can lead to a more severe form of baby blues known in the clinical world as postpartum non-psychotic depression that requires professional intervention. The therapeutic goal during this time is to prevent the new mother from committing suicide where she poses a danger to both herself and her newborn.

The presence of risk factors does not guarantee that a woman will experience PPD, but it may indicate that the health care provider should pay a little more attention to possible signs and symptoms of depression. Known risk factors include depression or other mental illness prior to, and during, pregnancy, a family history of depression or other mental health disorders, a history of substance abuse, the age of the mother, financial concerns, lack of a support system, and being a single parent (Camp, 2013). In the presence of risk factors it is important for the health care provider to educate the woman on ways to

There are so many different kinds of medications used to treat patients, but the most common ones that psychiatric assistants prescribe exist as antipsychotic and antidepressants. Antidepressants usually relate to a substance that treats mood disorders. Antipsychotic medications usually are taken daily in pills or liquid form. However, some may get injected, which means their only given once or twice a month. The biggest mental disorder that antipsychotic are prescribed for has occurred in patients with schizophrenia. “Schizophrenia is a psychosis characterized by delusions, hallucinations, apathy, and a “split” between thought and emotion.” (Coon & Mitterer 487) “Patients with this disorder tend to have withdrawal from contact with other, a loss of interest in external activities, a breakdown of personal habits, and an inability to deal with daily events.” (486) “Also, it is hard for patients with schizophrenia to focus on one item of information at a time.” (486) Four major types of schizophrenia consist of catatonic, disorganized, paranoid, and undifferentiated. The first type, catatonic, involves disturbances in a person’s movement. Patients with this disorder type tend to just sit there and they do not talk or move. They show no emotion. “The second type, disorganized, or known as “hebephrenic schizophrenia”, patients experience bizarre thinking and flat or grossly inappropriate emotions.” (487) “Typically, this type of schizophrenia develops in adolescence or young adulthood.” (487) “The third type, paranoid, is marked by a preoccupation with delusions or by frequent auditory hallucinations related to a single theme, especially grandeur or persecution.” (488) “Patients think that God, the government, or “cosmic rays from space” are controlling their minds or trying to poison them.” (488) “According to the largest study ever

Estimates of the prevalence of postpartum depression range from 13% to 19% (O 'Hara & McCabe, 2013). However, major depressive episodes may go undiagnosed in 65% of pregnant women ( (Ko, Farr, Dietz, & Robbins, 2012). It is important for pregnant women and new mothers to undergo depression screening to be diagnosed and treated early if they are experiencing any symptoms of depression. Depression during pregnancy is associated with a higher risk of inadequate nutrition, poor weight gain, inadequate prenatal care, preterm birth, surgical birth and low birth weight babies (Wirz-Justice, et al., 2011). The newborns have a higher rate of neonatal intensive care admissions and increased risk of cognitive, emotional, and behavioral disorders (Wirz-Justice, et al., 2011).

According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a

Almost all women experience some type of depression during pregnancy. Depression is more than just feeling "blue" or "down in the dumps" for a few days. It's a serious illness that involves the brain. Depression makes you feel sad and lonely for a number of days, and could become a serious problem.These feelings can be mild to severe. Depression is the most common problem during pregnancy. Due to the potential birth defects, developmental issues, and negative effects on the health of both mother and child. Hormonal changes cause the depression women experience during pregnancy. The use of antidepressants by pregnant women should be highly restricted in the United States. It can really hurt the child more than

Midwives, obstetricians and gynecologists are often the central medical caregivers for women and as such they are likely to be the first or only medical providers to identify, refer and coordinate a plan of care for women who have mood disorders. Early detection, intervention, treatment in conjunction with individualized care is imperative and greatly reduces the risk of adverse effects for the mother, infant and family. However fifty percent of women with these disorders are never diagnosed because many symptoms of mood disorders overlap with the symptoms of pregnancy and often are overlooked (Center on the Developing Child at Harvard University, 2009). If left untreated these women can continue to have symptoms, sometimes for many

There are times that one feels hopeless during a situational event, but usually this feeling passes. Depression can be situational or clinical. The severity of the depression can cause one to be suicidal, especially if one is diagnosed with clinical depression, or a bipolar disorder. In the research report, Epidemiology of Women and Depression, it states that it is more common for women than men to have depression, and hormonal changes can contribute to depression. Pregnancy can cause depression, but what about mothers who also have a depressive disorder? (Kessler). This paper will look at these concerns, and will look at the risks to the mother and child, as well as the pros and cons of taking antidepressants (ADs) during pregnancy.

Antipsychotics are classified as major tranquilizers that are used to treat mental health illnesses such as schizophrenia, bipolar disorder, and other mental illnesses. They can also treat severe depression and severe anxiety. These antipsychotics drugs reduce or increase the effect of neurotransmitters in the brain to regulate levels that help transfer information throughout the brain. The neurotransmitters that are affected are the serotonin, dopamine, and noradrenaline.

Antipsychotic – Psychotropic drugs are often used for neurochemical problems, behavioral problems, schizophrenia, and other mental disorders. These drugs sometimes cause side effects

Antipsychotics are the most common form of medication that is used to help with the symptoms of schizophrenia. There are two main types of antipsychotic, traditional and new (http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml#pub9). Traditional antipsychotics are used mainly to control hallucinations, delusions, and confusion of schizophrenia. These medications, for example chlorpromazine and haloperidol, primarily block the dopamine receptors and are very effective in treating the “positive” symptoms of schizophrenia. The newer antipsychotic medications, for example Risperdal and Zyprexa, work on both serotonin and dopamine, meaning that it can treat the “positive” and the “negative” symptoms of schizophrenia. There are many side effects that can come with taking antipsychotic medications. Mild side effects include a dry mouth, blurred vision, constipation, drowsiness and dizziness. These side effects will usually disappear after a period of time (http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml). More serious side effects of antipsychotics include trouble with muscle control, muscle spasms or cramps, fidgeting or pacing, tremors and shuffling of the feet. These symptoms mimic