Psychotropic drugs in pregnancy and lactation

INTRODUCTION: The prescription of psychotropic drugs during pregnancy is a constantly increasing practice, but its safety information remains limited. On the other side, while concerns about teratogenicity persist, it is also evident that mothers' psychiatric disorders represent a risk factor for both them and the infants and cannot be neglected or left untreated. Therefore, careful monitoring and dose adjustments are essential to minimize risks while ensuring treatment efficacy. AREAS COVERED: The present article is a narrative review of the literature on psychotropic drug use in pregnancy and lactation, attempting to summarize their benefits and risks while considering maternal and fetal outcomes. EXPERT OPINION: Whenever possible, medications should be avoided in the first trimester, with the lowest effective dose used throughout pregnancy. In severe cases, drugs cannot be stopped as discontinuation can lead to relapse, but they require individualized risk-benefit assessments. For lactating mothers, drugs with established safety profiles should be prioritized. Further research is needed to clarify long-term effects and support evidence-based decisions in maternal mental health care.