WASHINGTON — Eighteen U.S. states have enacted laws that exclude mental health or risk of suicide among the medical reasons a woman can have an abortion.

But women who spoke to CQ Roll Call faced obstacles finding answers on how to treat mental illness during pregnancy even when they were not considering abortion.

The Food and Drug Administration has not approved psychiatric drugs for use during pregnancy, though they can be prescribed off label.

Instead, pregnant patients are often advised not to discontinue their medications for mental health and substance use disorder because of the risk of exacerbating symptoms or relapsing.

The American College of Obstetricians and Gynecologists recommends that patients that do end up stopping medications restart them postpartum. Women with a history of postpartum psychosis, for instance, have a 66 percent chance of recurrence without medication.

Physicians largely agree that certain medications carry strong risks, especially several used to treat bipolar disorder, including Tegretol, Valproate, Lamotrigine and Depakote.

Other mental health medications with fewer risks might require more careful monitoring or only be used in case other medications aren’t working.

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