Safer prescribing for pregnant women with mental illness

Around the world, a growing number of women with serious mental illness are becoming pregnant. But when they ask for guidance on how to manage their drug therapies during pregnancy, psychiatrists have few recommendations that are based on high-quality evidence.

“Pregnancy is a reality of life for most women, and yet little research exists about the safety of using medications that effectively manage serious mental illness during pregnancy,” says Dr. Simone Vigod.

But is discontinuing drug therapy the safer option? As fertility rates rise in women with schizophrenia, it’s a question that urgently needs an answer.

“Right now, my patients and I need to carefully consider potential risks of drug therapies, or of stopping drug therapies,” says Vigod. “Each path can be risky and can impact both the baby and the mother, and right now there are few guidelines to inform our recommendations.”

Through her research, Vigod is seeking answers to the questions that women and their doctors are asking. She is leading a number of population-based studies focused on psychiatric, obstetrical and neonatal outcomes for women with serious mental illness.

“The aim is to develop evidence-based guidelines that will steer physicians’ recommendations, and improve safety for women and their babies.”

Dr. Simone Vigod is a Women’s College scientist and psychiatrist and an assistant professor in Department of Psychiatry at the University of Toronto. Vigod and her work are supported by the Canadian Institutes of Health Research, the Schizophrenia Society of Ontario, the Ontario Ministry of Health and Long-Term Care Physician Innovation Fund, and the American Society of Clinical Psychopharmacology. She was awarded the inaugural Clinician-Scientist Award funded by the Shirley Brown Chair in Women’s Mental Health Research (held by Dr. Cindy-Lee Dennis, WCRI scientist and professor at the University of Toronto’s Bloomberg School of Nursing).