The authors noted that there were no significant differences among the three groups with regard to age, marital status, education level, employment status, socioeconomic status, gender of the baby, number of children, or mode of delivery.
They also excluded women with comorbid depression or other anxiety disorders. Women were excluded if they had a major medical illness or pregnancy-related complications, use of alcohol and/or tobacco, or use of psychotropic medications other than antidepressants.
#Panic mode while pregnant manual
The diagnosis of panic disorder was confirmed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The study included 146 pregnant women (44 with panic disorder treated with antidepressants, 52 with untreated panic disorder, and 50 healthy controls without psychiatric illness) recruited during pregnancy.
In a recent prospective study Uguz and colleagues compared neonatal outcomes, including gestational age, birth weight and hospital admission of newborns, in pregnant women with panic disorder treated with antidepressants to women with untreated panic disorder. Understandably women focus primarily on the reproductive safety of medications, but we must also consider the impact of untreated anxiety on the mother and her baby. Although many women with panic disorder attempt to discontinue their medications during pregnancy, we see high rates of relapse in this population. Also, if possible, nonpharmacologic treatment, such as cognitive-behavioral therapy, should be first-line treatment in pregnant women with GAD or panic disorder.While we have focused a great deal on the emergence of mood disorders during pregnancy and the postpartum period, there is a growing body of literature that indicates that anxiety symptoms are prevalent during this period of time and may also affect pregnancy outcomes. To minimize the potential for neonatal withdrawal and maternal toxicity after delivery, vigilant monitoring of side effects is indicated. The goal of treatment during pregnancy and lactation is sufficient treatment for syndrome remission. It is important that physicians understand the course of these disorders during pregnancy and available treatments so they appropriately counsel women who are or intend to become pregnant. Review articles and primary pharmacologic treatment trials were analyzed and incorporated into the review based on adequate methodology, completeness of data, and information on pregnancy outcome.
Review articles and primary pharmacologic treatment articles were selected for discussion.ĭespite the extensive use of psychotropic drugs such as antidepressants during pregnancy, there is a scarcity of information regarding the effect of such exposure on the developing fetus. This article reviews the literature on the course of generalized anxiety disorder (GAD) and panic disorder during pregnancy and the postpartum period and presents guidelines for management.Īn English language electronic search of relevant studies using PubMed (January 1, 1985-January 2004) was performed using the search terms anxiety and pregnancy, maternal mental illness, panic and pregnancy, psychotropic medications in pregnancy, and treatment options in pregnancy. In addition, some evidence exists that anxiety disorders can affect pregnancy outcomes. Approximately 30% of women experience some type of anxiety disorder during their lifetime.
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