Psychotropic Drugs May Be Needed in Pregnancy : Maternal psychiatric illness, if inadequately treated or untreated, may result in poor compliance with care.

Given the uncertainties of sexual behavior and the possibility of undetected pregnancy in female patients, “you should treat all women as though they are pregnant, starting at age 9. From 9 to 49, they are pregnant until proven otherwise,” he said.

Regarding the possibility of passing medications to infants during breast-feeding, “the dose in pregnancy is huge compared to the dose in lactation. Worrying about the medicine in lactation, if you used it in pregnancy, is really a waste of time. Our medicines in the bloodstream for antidepressants are nanograms per milliliter; for anticonvulsants they are in micrograms per milliliter. That's what gets into breast milk,” he said.

Dr. Stowe is on advisory boards for Bristol-Myers Squibb Co. and GlaxoSmithKline Inc. He has received grants from GlaxoSmithKline, Pfizer Inc., and Wyeth Pharmaceuticals. He is on the speakers bureaus of Eli Lilly, GlaxoSmithKline, Pfizer, and Wyeth Pharmaceuticals.