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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO301

Safety of psychotropic medication use during breastfeeding: a systematic review of observational studies

SAFETY OF PSYCHOTROPIC MEDICATION USE DURING BREASTFEEDING: A SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES

The available observational evidence on psychotropic medication use during breastfeeding is generally reassuring, but limited in quality and scope.

The aim was to systematically synthesize controlled observational studies evaluating infant and child outcomes following maternal psychotropic medication use, to clarify the clinical dilemma between continuing psychiatric treatment in the postpartum period and infant exposure to medication through breastfeeding. Searches of PubMed (1,231), Embase (2,392), PsycINFO (133), and Web of Science (598) yielded a total of 4,345 records; after 1,527 duplicates were removed, 2,827 records were screened and 19 studies were included in the review. Risk of bias was assessed using the ROBINS-I tool for non-randomized studies of interventions. The 19 included cohort studies encompassed 3,453 mother–child pairs and reported 70 child outcomes. Across the 70 reported outcomes, no clinically significant adverse events requiring medical intervention were identified (number of severe events: 0). By medication class, no serious toxicity or adverse clinical events were reported for SSRIs (6 studies), and no consistent differences were found in long-term cognitive, language, behavioral, or neurological development; no acute adverse events or developmental impairment were observed for tricyclic antidepressants (2 studies); no major adverse events were reported for antipsychotics (3 studies), although the evidence remained insufficient because of small samples and heterogeneity; for lithium (2 studies), mild and transient symptoms were observed at high exposure levels, while long-term developmental data were largely lacking; and for mood stabilizers and antiepileptic medications (9 studies), no clinically significant toxicity or consistent adverse effects on cognition, language, motor development, or intelligence quotient were identified. The evidence is limited by short follow-up periods, heterogeneity, and inadequate control of confounding factors. In conclusion, clinicians are advised to individualize treatment decisions, and high-quality prospective studies are needed.

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