Prenatal and Perinatal Effects of Psychotropic Drugs on Neuro-cognitive Development in the Fetus

There has been an increased dependence on prescription drugs for psychological and mood disorders in the last few decades. Many women who take these drugs may become pregnant and not be aware of their possible adverse effects. Since thalidomide, a drug used to treat morning sickness in pregnancy, was found to be teratogenic, many drugs are being screened more stringently for possible teratogenic effects on the fetus. Although newer drugs do not appear to cause congenital malformations, some still pose a threat. This review is aimed at summarizing the teratogenic effects of commonly used antiepileptics, antidepressants and anxiolytics. The effects of these drugs on intellectual and developmental disabilities or cognitive development have not been extensively studied. It is hypothesized that these drugs can alter development via two pathways. First, prenatal effects on neurotransmitters can alter brain circuitry, thereby predisposing children to later learning and behavioural deficits. Second, perinatal events caused by drug withdrawal upon delivery of the baby, may have long lasting effects on cognitive developments, as suggested by numerous animal and human studies. Various motor and respiratory side effects resulting in especially low Apgar scores may have deleterious consequences. Psychotropic drugs should be avoided during pregnancy unless deemed absolutely necessary for the benefits of both the mother and fetus. If drugs must be utilized, strict guidelines should be set to ensure that fetal withdrawal or dependency from these drugs does not occur. Finally, perinatal events should be meticulously noted for future reference during the development of the child. JOURNAL ON DEVELOPMENTAL DISABILITIES, VOLUME 11 NUMBER 2 IN PRESS