Course of Mood and Anxiety Disorders During Pregnancy and the Postpartum Period

Because the onset of mood and anxiety disorders often occurs during the childbearing years, manywomen may be taking psychotropic medications for these disorders when they conceive. These medicationseasily diffuse across the placenta, and their impact on the fetus is of concern. But discontinuationmay lead to relapse, in which case psychiatric symptoms may affect the fetus. Thoughtful treatmentplanning presents a dilemma to the clinician. Limited data suggest heightened vulnerability torelapse of mood and anxiety disorders in women during the postpartum period. Pregnancy appears toexacerbate symptoms of obsessive-compulsive disorder, while panic disorder patients may remainwell after discontinuing medication. Future studies should address the prevalence and relapse rates ofmood and anxiety disorders, particularly after medication discontinuation, among pregnant women.