Pharmaceuticals 2013, 6, 1221-1286; doi:10.3390/ph6101221 OPEN ACCESS pharmaceuticals ISSN 1424-8247 www.mdpi.com/journal/pharmaceuticals Review The Use of Central Nervous System Active Drugs During Pregnancy Bengt Källén 1,*, Natalia Borg 2 and Margareta Reis 3 1 Tornblad Institute, Lund University, Biskopsgatan 7, Lund SE-223 62, Sweden 2 Department of Statistics, Monitoring and Analyses, National Board of Health and Welfare, Stockholm SE-106 30, Sweden; E-Mail:
[email protected] 3 Department of Medical and Health Sciences, Clinical Pharmacology, Linköping University, Linköping SE-581 85, Sweden; E-Mail:
[email protected] * Author to whom correspondence should be addressed; E-Mail:
[email protected]; Tel.: +46-46-222-7536, Fax: +46-46-222-4226. Received: 1 July 2013; in revised form: 10 September 2013 / Accepted: 25 September 2013 / Published: 10 October 2013 Abstract: CNS-active drugs are used relatively often during pregnancy. Use during early pregnancy may increase the risk of a congenital malformation; use during the later part of pregnancy may be associated with preterm birth, intrauterine growth disturbances and neonatal morbidity. There is also a possibility that drug exposure can affect brain development with long-term neuropsychological harm as a result. This paper summarizes the literature on such drugs used during pregnancy: opioids, anticonvulsants, drugs used for Parkinson’s disease, neuroleptics, sedatives and hypnotics, antidepressants, psychostimulants, and some other CNS-active drugs. In addition to an overview of the literature, data from the Swedish Medical Birth Register (1996–2011) are presented. The exposure data are either based on midwife interviews towards the end of the first trimester or on linkage with a prescribed drug register.