A patient diagnosed with depression has been taking a selective ...

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A patient diagnosed with depression has been taking a selective serotonin-reuptake inhibitor (SSRI) throughout her pregnancy. What neonatal consequences are possible?
 
  1. Malformations
  2. High birth weight
  3. Neural tube defects
  4. Poorer neurobehavioral adaptation

Question 2

A patient with bipolar disorder has unexpectedly become pregnant and is concerned about the possible impact of valproate on her and her baby. What can the nurse tell her?
 
  1. Valproate is not associated with any fetal risks.
  2. There is no problem if you stop your medications.
  3. Valproate has been associated with several significant fetal risks.
  4. If you take other medications, you can reduce the risks of valproate.

[LegendaryAnswers]

Answer to Question 1

Answer: 4
Explanation: Poorer neurobehavioral adaptation (PNA), similar to the discontinuation symptoms of SSRIs, has been shown in neonates whose mothers were taking SSRIs. There is no association between malformations and SSRI use in pregnancy. Low birth weight may be an adverse outcome of maternal SSRI use. Neural tube defects have been associated with certain mood stabilizers.

Answer to Question 2

Answer: 3
Explanation: Both sodium valproate and carbamazepine have been associated with an increased risk of neural tube defects and fetal anticonvulsant syndromes. Valproate is associated with multiple fetal risks. There is a significant risk of a bipolar relapse if the patient stops taking her medications suddenly. Increased teratogenic risk is actually compounded by polypharmacy.

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Correct answers!

[LegendaryAnswers]

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