Psychiatric and nervous disorders

There has recently been increased occasions to treat patients complicated with psychiatric and nervous disorders, in accordance with the rise of interest in human right and the improved social acceptance of these diseases. In the past, most cases were reluctantly terminated because of the prejudice against diseases and anxiety about the teratogenicity of the drugs. In this paper, the management of pregnancy and delivery including neonatal period are discussed. 1) Epilepsy Epilepsy is one of the most common medical complications of pregnancy with about 0.5%. Pregnancy has no obvious effect on epilepsy. Although the teratogenicity of the antiepileptic drugs has been repeatedly reported, anticonvulsant therapy should be continued during pregnancy. Because the risk of the fetal brain damage from hypoxia under the epileptic convulsion of the untreated patients is higher than that of the teratogenicity of drugs. Phenobarbital or phenytoin are commonly used. Trimethadione which has been used for the petit mal epilepsy should not be used because of the high potent of teratogenicity. The serum concentrations of these drugs tend to decrease in the third trimester. Therefore the frequent monitoring of the serum drug concentration is very important. The monitoring of the blood clotting factors after delivery is also very important to avoid the neonatal vitamin K deficiency bleeding. Vitamin K is administered if required. Breast feeding is not contraindicated. Withdrawal syndrome in the neonatal state should not be overlooked. 2) Schizophrenia Pregnancy has no effect on schizophrenia. The teratogenicity of chlorpromazine or haloperidol in human pregnancy is thought to be negative. The function of the fetal central nervous system is suppressed with antipsychotic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)