Psychotropic medication and the fetal brain

Medications known to cross the blood-brain barrier (psychotropic medications) are commonly prescribed to women during pregnancy, often for the management of mental illness. Although there is little evidence of gross neurological teratogenicity of any medication in current widespread use, a growing body of evidence from animal models, human magnetic resonance imaging and behavioural studies suggests that more subtle adverse effects on early life neurodevelopment may result from in utero psychotropic exposure. Understanding these consequences is of crucial importance as prescribing rates of psychotropic medication during pregnancy have increased rapidly in recent years. We review current studies directly quantifying early life brain correlates of exposure, discuss plausible mechanistic pathways and make suggestions for future research.