What is the rationale for keeping someone on medication through pregnancy?
The decision to keep a patient on medication during pregnancy is made only when pharmacologic treatment is considered essential. Patients are generally taken off of their medication unless it is completely clear that they cannot function without it. Knowing the course of the individual’s illness is critical, including what therapeutic interventions they have tried, how stable their illness is, and how long they can go without medication. Part of the decision hinges on the individual’s diagnosis. For example, a patient with bipolar disorder is far less likely to be able to function without medication for 9 months than a patient with a history of moderate depression. Knowing the patient’s clinical course, illness, and the therapeutic regimens that she has responded to in the past is important. The patient’s preference is also a critical consideration. Some women are willing to put up with symptoms if it means not taking medication for a period of time, whereas others cannot function and
