The usage of medication for the treatment of psychiatric symptoms during pregnancy and the postpartum often provokes heated debate. There are those who argue fiercely for the life-saving relief offered through its prudent administration and those who feel uncertain that benefits outweigh risks.
The article acknowledges that research is uneven in its findings regarding side effects, efficacy and timing of administration and cessation. It is likely that some variation in results is attributable to the very specific and individualized chemistry, symptom presentation and course of each woman’s illness.
For women experiencing mild symptoms, exercise, diet, nutrition and social support may turn the tide. For more moderate depression, family and social support, supplements and participation in cognitive or interpersonal therapy may bring relief. But for severe depressive, anxious, bipolar or psychotic symptoms, medication may be a life-saving, life-renewing addition to psychotherapy and other needed support.
There have been few non biased, reliable, expert and centralized resources available to women and healthcare providers to guide these treatment decisions. A risk versus benefit analysis is the gold standard between client and healthcare provider when considering medication during these sensitive periods. But there is an additional resource which can greatly contribute to this important, careful discussion. That resource is OTIS, the Organization of Teratology Information Specialists.
I had the pleasure of interviewing Myla Moretti, OTIS President
Motherisk Program, The Hospital For Sick Children, Toronto, Canada.
Ms. Moretti is currently the Assistant Director of the Motherisk Program at Toronto’s Hospital for Sick Children. She received her Masters of Science in Clinical Pharmacology from the University of Toronto and has been involved in teaching and research since joining the program.
She is an active member of the hospital’s breastfeeding program. Her research interests have focused principally on quantifying drug transport into breast milk and related infant outcomes as well as conducting studies investigating the safety of drugs in pregnancy. Myla has been involved with OTIS for over 10 years and in addition to the Presidency, she currently chairs the web site committee.
OTIS is governed by a board of directors who appoint an executive director who manages the OTIS National Office located at the University of Arizona in Tucson, Arizona. OTIS has several working committees including education, research, website, abstract, public affairs, meeting planning, elections, and membership. Committees meet once a year at the Annual Education Conference and hold conference calls throughout the year as needed.
The current board of directors includes: President: Myla Moretti
President-Elect: Lori Wolfe
Past President, Sharon Voyer-Lavigne
Sara Riordan, Secretary
Janine Polifka, Treasurer
Member-at-Large, Diana Johnson
Member-at-Large, Kenneth Lyons Jones
Member-at-Large, Katherine Wisner, MD
Executive Director: Dee Quinn
The organization was established in 1990 throughout North America and is now a non profit whose goal is to bring members together as a scientific community to discuss current research and resources.
Expectant or lactating mothers, healthcare providers and those who love them can call a toll free number – 866-626-6847 to ask questions about medication exposure during pregnancy and lactation!
The telephone lines are operated by specialists who can be genetic counselors or other health care providers. Callers can ask questions about specific medications, how they affect pregnancy and lactation, potential risks to women, fetus and new born child.
Myla says that about 15 – 20% of calls relate to the use of anti-depressants. Typical questions from those answering the calls could be: How long the mothers has had symptoms, her psychiatric history and medical status. OTIS responders can give information about how much of the medication passes into breast milk to help reassure and offer up to date information to mothers about potential levels of toxicity and efficacy.
Noting that some infants could respond to even small amounts of medication in breast milk, Myla said that mothers are encouraged to watch baby carefully and to be sure that the pediatrian is aware of any medications she may be taking.
This fantastic free service can help mothers make informed decisions about medication usage, rather than relying on one opinion or uninformed or biased feedback that fails to reassure her or objectively clarify her options. Technology has allowed the organization to centralize its toll free number, therefore, regardless of your location, you will be routed to one of the services who can take your call. Their policy is to return calls within one business day or less.
Myla clearly emphasized that the organization is neither PRO nor ANTI the use of medication. Their role is to provide fact sheets about various medications and their impact during pregnancy and lactation.
As a non-profit private corporation, OTIS receives funding from a number of different sources including:
Membership Dues: All health care providers and members of the general public who have an interest in the field of Teratology are invited to join OTIS.
Donations: OTIS receives donations from both private individuals and from companies and businesses.
Grants: OTIS applies for and has received grants from government sources such as the Centers for Disease Control and Prevention.
Pregnancy Studies and Registries: OTIS conducts pregnancy registries for pharmaceutical companies and other research organizations.
If you would like to join OTIS or donate to this fantastic resource, please visit their website.