{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:11Z","timestamp":1787028371890,"version":"build-2736575974"},"reference-count":264,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: The initiative of a consensus on the topic of antidepressant and anxiolytic drug use in pregnancy is developing in an area of clinical uncertainty. Although many studies have been published in recent years, there is still a paucity of authoritative evidence-based indications useful for guiding the prescription of these drugs during pregnancy, and the data from the literature are complex and require expert judgment to draw clear conclusions. Methods: For the elaboration of the consensus, we have involved the scientific societies of the sector, namely, the Italian Society of Toxicology, the Italian Society of Neuropsychopharmacology, the Italian Society of Psychiatry, the Italian Society of Obstetrics and Gynecology, the Italian Society of Drug Addiction and the Italian Society of Addiction Pathology. An interdisciplinary team of experts from different medical specialties (toxicologists, pharmacologists, psychiatrists, gynecologists, neonatologists) was first established to identify the needs underlying the consensus. The team, in its definitive structure, includes all the representatives of the aforementioned scientific societies; the task of the team was the evaluation of the most accredited international literature as well as using the methodology of the \u201cNominal Group Technique\u201d with the help of a systematic review of the literature and with various discussion meetings, to arrive at the drafting and final approval of the document. Results: The following five areas of investigation were identified: (1) The importance of management of anxiety and depressive disorders in pregnancy, identifying the risks associated with untreated maternal depression in pregnancy. (2) The assessment of the overall risk of malformations with the antidepressant and anxiolytic drugs used in pregnancy. (3) The evaluation of neonatal adaptation disorders in the offspring of pregnant antidepressant\/anxiolytic-treated women. (4) The long-term outcome of infants\u2019 cognitive development or behavior after in utero exposure to antidepressant\/anxiolytic medicines. (5) The evaluation of pharmacological treatment of opioid-abusing pregnant women with depressive disorders. Conclusions: Considering the state of the art, it is therefore necessary in the first instance to frame the issue of pharmacological choices in pregnant women who need treatment with antidepressant and anxiolytic drugs on the basis of data currently available in the literature. Particular attention must be paid to the evaluation of the risk\/benefit ratio, understood both in terms of therapeutic benefit with respect to the potential risks of the treatment on the pregnancy and on the fetal outcome, and of the comparative risk between the treatment and the absence of treatment; in the choice prescription, the specialist needs to be aware of both the potential risks of pharmacological treatment and the equally important risks of an untreated or undertreated disorder.<\/jats:p>","DOI":"10.3390\/ijerph20166565","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T12:10:30Z","timestamp":1691755830000},"page":"6565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Consensus Panel Recommendations for the Pharmacological Management of Pregnant Women with Depressive Disorders"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0662-866X","authenticated-orcid":false,"given":"Georgios","family":"Eleftheriou","sequence":"first","affiliation":[{"name":"Italian Society of Toxicology (SITOX), via Giovanni Pascoli 3, 20129 Milan, Italy"},{"name":"Poison Control Center, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5193-6909","authenticated-orcid":false,"given":"Riccardo","family":"Zandonella Callegher","sequence":"additional","affiliation":[{"name":"Italian Society of Psychiatry (SIP), piazza Santa Maria della Piet\u00e0 5, 00135 Rome, Italy"},{"name":"Psychiatry Unit, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Butera","sequence":"additional","affiliation":[{"name":"Italian Society of Toxicology (SITOX), via Giovanni Pascoli 3, 20129 Milan, Italy"},{"name":"Poison Control Center, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"De Santis","sequence":"additional","affiliation":[{"name":"Italian Society of Obstetrics and Gynecology (SIGO), via di Porta Pinciana 6, 00187 Rome, Italy"},{"name":"Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Franca","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"Italian Society of Obstetrics and Gynecology (SIGO), via di Porta Pinciana 6, 00187 Rome, Italy"},{"name":"Department of Gynecology and Obstetrics, Fatebenefratelli Gemelli, Isola Tiberina, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Vecchio","sequence":"additional","affiliation":[{"name":"Italian Society of Toxicology (SITOX), via Giovanni Pascoli 3, 20129 Milan, Italy"},{"name":"Ser.D Biella\u2014Drug Addiction Service, 13875 Biella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Pistelli","sequence":"additional","affiliation":[{"name":"Italian Society of Toxicology (SITOX), via Giovanni Pascoli 3, 20129 Milan, Italy"},{"name":"Division of Clinic Toxicology, Azienda Ospedaliera Universitaria Careggi, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Mangili","sequence":"additional","affiliation":[{"name":"Italian Society of Neonatology (SIN), Corso Venezia 8, 20121 Milan, Italy"},{"name":"Department of Neonatology, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-7886","authenticated-orcid":false,"given":"Emi","family":"Bondi","sequence":"additional","affiliation":[{"name":"Italian Society of Psychiatry (SIP), piazza Santa Maria della Piet\u00e0 5, 00135 Rome, Italy"},{"name":"Department of Psychiatry, ASST Papa Giovanni XXIII, 24100 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Somaini","sequence":"additional","affiliation":[{"name":"Ser.D Biella\u2014Drug Addiction Service, 13875 Biella, Italy"},{"name":"Italian Society of Addiction Diseases (SIPAD), via Tagliamento 31, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariapina","family":"Gallo","sequence":"additional","affiliation":[{"name":"Poison Control Center, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy"},{"name":"Italian Society for Drug Addiction (SITD), via Roma 22, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Balestrieri","sequence":"additional","affiliation":[{"name":"Psychiatry Unit, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy"},{"name":"Italian Society of Neuropsychopharmacology (SINPF), via Cernaia 35, 00158 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-4219","authenticated-orcid":false,"given":"Umberto","family":"Albert","sequence":"additional","affiliation":[{"name":"Italian Society of Psychiatry (SIP), piazza Santa Maria della Piet\u00e0 5, 00135 Rome, Italy"},{"name":"Italian Society of Neuropsychopharmacology (SINPF), via Cernaia 35, 00158 Rome, Italy"},{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34128 Trieste, Italy"},{"name":"Division of Clinic Psychiatry, Azienda Sanitaria Universitaria Giuliano-Isontina, 34148 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"ref_1","unstructured":"APA (2013). 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