Psychotropic medication prescribing patterns during pregnancy in two South African Maternal Mental Health clinics

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Stellenbosch : Stellenbosch University
ENGLISH SUMMARY: Background: There is a significant burden of mental illness during pregnancy and the safety of medication use in pregnancy is an ongoing focus of research. There is potential risk for the developing fetus and the mother from the increased risk for psychiatric illness and medication effects. Psychotropic polypharmacy during pregnancy is common, but not well- researched and there is a paucity of data on the use of psychotropic medication during pregnancy in South African women suffering from a mental illness. Aim: To determine the psychotropic medication prescription patterns in pregnant patients attending one of two maternal mental health clinics in Cape Town in terms of: the general classes of medication prescribed, the frequency and duration of psychotropic use, medication exposure according to pregnancy trimester and the prevalence of polypharmacy use. Methods: Pregnant women attending two maternal mental health clinics were studied from presentation to six weeks postpartum. Demographic data, psychiatric history, medical comorbid illnesses, pregnancy related data and medication prescription was collected and tabulated at treatment-as-usual visits. Polypharmacy prevalence was determined by using the definition of the use of two or more psychotropic medication prescriptions for a period of at least ninety days. Results: Data was collected on 303 pregnancies and the majority of pregnant women (51.8%) were diagnosed with major depressive disorder. Anti-depressant medication was the most commonly prescribed medication class (64.3%). A third of participants received prescriptions in all three trimesters. Polypharmacy criteria was met in 18.8% of the sample population. Conclusion: Prescribing psychotropic drugs in pregnancy is challenging because of the need to weigh up the potential risks of drug- related effects on the mother and child against those of discontinuing treatment. Our data contributes to raising awareness and aids medical professionals with regards to the rational use of psychotropic medication in pregnant women.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MMed)--Stellenbosch University, 2023.