Brazilian Psychiatric Association consensus for the management of psychiatric emergencies in pregnancy and postpartum period

Abstract

Introduction: Emergencies in the pregnancy and postpartum are less frequent than in other groups, but not uncommon. However, the literature on the subject is scarce and controversial. Objective: The objective of this article is to present some recommendations for the management of the most common psychiatric emergencies that may occur in pregnancy or postpartum period. Method: These procedures were focused on the discussion and integration of the findings from peer-reviewed published research on the topic. We searched electronic database PubMed. Relevant abstracts were identified using the following search terms: Psychotropics medications at pregnancy and breastfeeding: (((psychotropic medications) AND (pregnancy)) OR (psychotropic medications)) AND (breastfeeding) - Psychiatric emergencies: (((((((psychiatric emergencies) AND (pregnancy)) OR (psychiatric emergencies)) AND (postpartum)) OR (psychiatric emergencies)) AND (peripartum)) OR (psychiatric emergencies)) AND (breastfeeding). Inclusion criteria included papers published (or in press) about pregnancy or breastfeeding or postpartum from December 2000 to January 2021 that focused on agitation in psychiatric emergencies.  Main Results:  We present recommendation for pharmacological treatment, psychomotor agitation, suicide behavior, psychotic disorders and mania, severe depression, and substance use disorders.  Conclusion: Although many of the recommendations are empirical, it is already possible to rely on information that provides better results and safety for the patient and her infant.