Medication Use for Trauma symptoms and PTSD in Pregnant and Breastfeeding Women

Traumatic events are relatively common in the lives of pregnant and breastfeeding women. Some trauma-exposed women will develop posttraumatic symptoms and others will meet full criteria for PTSD. Comprehensive trauma treatment involves a wide range of activities including patient education, peer support, EMDR, and traumafocused psychotherapy. Clinicians treating women trauma survivors may also treat them while they are either pregnant or breastfeeding. Most of the standard treatments for PTSD are non-pharmacologic and therefore quite safe for both. But medications are also commonly used to treat PTSD and trauma symptoms. Medications have three potential benefits for patients: 1) they ameliorate PTSD symptoms, 2) they treat comorbid disorders, and 3) they reduce symptoms that can negatively affect both psychotherapy and daily living. Recent articles have outlined the state of the art in terms of medication choices for trauma symptoms and PTSD. The classes of medications used to treat PTSD include SSRIs, SNRIs, mirtazapine, SARIs, adrenergic agents, and atypical antipsychotics. Benzodiazepines, anticonvulsants, cyproheptadine, and buspirone cannot be recommended at this time. In each of these classes of medications, there are saferchoices for pregnant and breastfeeding women. In perinatal health, the standard reference regarding medication use in this population is Medications and Mothers’ Milk. This article is a summary of current medications recommended for trauma symptoms/PTSD, with their pregnancy and lactation risk categories. The pregnancy risk categories are based on U.S. F.D.A. guidelines.

Keywords:

Medication , Trauma symptoms , PTSD , Pregnancy , , Breastfeeding