Mood Disorders · NEET PG Preparation Psychiatry
A 36-year-old pregnant woman at 12 weeks gestation presents with a severe depressive relapse. She has a history of severe recurrent major depressive…
Practice question from Mood Disorders (NEET PG Preparation Psychiatry), with the correct answer and a step-by-step solution.
hard · MCQ · Q-58BD96
A 36-year-old pregnant woman at 12 weeks gestation presents with a severe depressive relapse. She has a history of severe recurrent major depressive disorder and previously responded well to sertraline and lamotrigine, but has been off medications during pregnancy. After a risk-benefit discussion, the treatment team and patient decide to use pharmacotherapy. Which of the following first-generation or second-generation antidepressants is most strongly associated with an increased risk of congenital cardiac malformations (specifically Ebstein anomaly) when exposed during the first trimester?
- A.Sertraline
- B.LithiumCorrect answer
- C.Lamotrigine
- D.Fluoxetine
Solution
First-trimester exposure to lithium carries a well-documented, albeit small, increased risk of cardiovascular malformations, most notably Ebstein anomaly (downward displacement of the tricuspid valve). SSRIs like sertraline and fluoxetine are generally considered safer alternatives during pregnancy.
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