Angelika Wieck, United Kingdom

University of Manchester & Wythenshawe Hospital Greater Manchester Mental Health Foundation Trust
Dr Wieck is a consultant in perinatal psychiatry at the University Hospitals of Manchester, United Kingdom and the current Chair of the EPA Section Women and Gender Mental Health. She was for many years Lead for the Regional Perinatal Mental Health Service, Clinical Lead for the Greater Manchester Strategic Clinical Network for Perinatal Mental Health, and Member of the National Clinical Reference Group for Perinatal Menal Health. She was instrumental in obtaining funding for a comprehensive specialist community perinatal mental health service for Greater Manchester. This covers 40,000 births annually and is now fully functioning. She also has longstanding experience in General Adult Psychiatry and acted as Consultant for the Specialist Mood Disorders Clinic in the NorthWest of England and was the Chair of the NorthWest Affective Disorders Group. She conducted and published research in the pathogenesis of postpartum bipolar recurrences, psychoneuoendocrinology and reproductive psychopharmacology. She regularly teaches in perinatal psychiatry at the Masterclasses for the Royal College of Psychiatrists and in reproductive psychopharmacology at the Masterclasses of the British Association for Psychopharmacology and has for several years held CME courses at the Annual Congresses of the European Psychiatric Association.

Presenter of 2 Presentations

 Conference Calendar
Educational 16:30 - 18:45

The Pharmacological Management of Mood Disorders and Psychosis During Pregnancy and Lactation

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Educational
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Authors
Clinical/Therapeutic 10:00 - 10:00

Is Pharmacotherapy Safe in the Perinatal Period? - S103

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Clinical/Therapeutic
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Authors

Abstract

Abstract Body

Decisions about using psychotropic medications in pregnancy and lactation are among the most complex in clinical psychopharmacology, both for patients and their doctors. The uncertainty about the reproductive safety of these drugs contributes to the difficulty.

Because of the absence of randomized controlled trials, data - coming from studies using other designs such as population or pregnancy registers and case-control comparisons - are difficult to interpret. This design issue is particularly important in the perinatal context, where pregnancy and child outcomes can be modulated by a host of other factors, such as substance misuse, socioeconomic disadvantage, physical illness, chronic stress and others.

Nevertheless, the last few years have seen a growth of data on outcomes following the use of antidepressant medications in pregnancy and lactation. Most studies have examined the potential of these drugs for teratogenicity and indicate that the more commonly used antidepressants probably do not have a major teratogenic effect. Research is also growing on other outcomes, such as pregnancy and obstetric complications, neonatal health and neurobehavioural development. In this presentation current research in these areas will be discussed.

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Moderator of 1 Session

 Conference Calendar
Educational

Live Session - Course 6: The Pharmacological Management of Mood Disorders and Psychosis During Pregnancy and Lactation - 0110

Date
04.07.2020, Saturday
Room
Caracas/Bogota
Chair(s)
Session Description
Proposed by the EPA Section on Women, Gender and Mental Health.The management of childbearing mothers with mental illness is challenging, requiring the clinician to maintain maternal wellbeing during pregnancy, whilst preventing postnatal recurrences and avoiding harm to the child. The course will cover the use of antidepressants, antipsychotics, lithium, anti-epileptic drugs and sleep-inducers in pregnant and breastfeeding mothers. Recent evidence on potential teratogenic risks of these agents arising from early pregnancy exposure will be outlined as well as effects on obstetric and infant outcome following later pregnancy exposure. Adverse effects on neonatal health will be reviewed and the current knowledge on drug transfer from the mother to the infant during breastfeeding discussed. This evidence will be related to current pharmacological guidelines for childbearing women. An important consideration in the management of childbearing women is that risks to the child do not only arise from the use of psychotropic medication. There is increasing evidence that maternal mental illness by itself and associated lifestyle and social factors can alter infant outcomes. Although there are no optimal solutions, a thoughtful and informed approach to the evidence, consideration of the woman’s own history and preferences, and maximizing benefits of non-pharmacological treatment approaches can improve individual outcomes. Preconception consultations for women who have psychosis or severe mood disorders and are planning a pregnancy, are highlighted as a means of optimizing maternal and child outcomes.