Perinatal EvidenceCompass
Prepopulated workbenchMED-258

Psychiatric adjuncts — metabolic mitigation

GLP-1 receptor agonists

Nonpsychotropic preconception/metabolic co-medication

Not a categorical safety rating

This record organizes questions; it does not close them.

The clinical fields and position statements are prepopulated from the public-source corpus. They have not completed individual dual extraction, formal appraisal, exact-label reconciliation, or multidisciplinary sign-off. Do not use this page to justify abrupt discontinuation or reflexive switching.

Inventory identity

What this record represents

Canonical generic name
GLP-1 receptor agonists
Entity type
drug class placeholder
Active component(s)
Agent-specific (for example semaglutide, liraglutide, tirzepatide is dual GIP/GLP-1)
Formulation / route / interval
Product-specific oral or subcutaneous formulations
Attachment entry
GLP-1 receptor agonists
Separate monograph status
No — create agent-specific cross-references if present in source data
Identity and cross-reference
Not populated in v0.95
Inventory verification confidence
Moderate — molecule-level source; exact product/jurisdiction pending

Decision taxonomy

Five positions kept separate

These are workbench statements for reviewer execution. They are not independently commissioned, patient-specific recommendations.

  1. 01

    Stable continuation

    Workbench statement

    Do not withhold or discontinue solely because of pregnancy or lactation. For this record, assess indication, prior response, relapse severity, dose/formulation, alternatives, exposure timing, and mapped evidence; individual commissioned adjudication remains pending.

  2. 02

    New initiation in pregnancy

    Workbench statement

    For a new start, prefer an effective option with the strongest diagnosis-specific efficacy and reproductive evidence when clinically suitable. This record has not received an individual, independently verified initiation ranking.

  3. 03

    Switch before conception

    Workbench statement

    Before conception, consider a switch only when expected benefit exceeds relapse, withdrawal, failed-switch, and dual-exposure risks. Build and monitor the plan before pregnancy when feasible; no universal switch direction is assigned here.

  4. 04

    Unplanned exposure

    Workbench statement

    After unplanned exposure, confirm product, route, dose, timing, indication, co-exposures, and symptoms; do not advise abrupt cessation. Use the mapped evidence and current label to decide whether any targeted fetal assessment is indicated.

  5. 05

    Delivery, postpartum & lactation

    Workbench statement

    Create separate delivery, postpartum-dose, neonatal-observation, and lactation plans. Do not infer breastfeeding suitability from pregnancy evidence or routinely taper before delivery without drug-specific support.

Linked evidence

2 mapped claim summaries

Mapping can include class-wide, framework, formulation, regulatory, or evidence-gap claims. A linked claim is not necessarily a drug-specific causal estimate.

C-041Provisional public source

Observational early-pregnancy GLP-1 receptor agonist cohorts have not shown a clear major-congenital-malformation increase versus insulin or selected comparators, but are too limited to support continuation for weight loss or psychiatric metabolic mitigation.

Public-source certainty descriptor
Low-to-moderate; observational and indication-confounded
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Periconception and early pregnancy
Comparator
GLP-1 exposure versus insulin or nonexposed comparator
Effect or numbers carried forward

No greater MCM risk observed in studied cohorts; estimates remain imprecise

Limitations

Mostly diabetes exposures, early windows, few molecule-specific cases; live-birth selection possible

Sources, citation controls, and verification state

Linked sources

PMID
38079178
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
C-042Provisional public source

Semaglutide labeling advises stopping at least two months before a planned pregnancy; pregnancy and lactation recommendations are molecule- and formulation-specific and must not be generalized across the GLP-1 class.

Public-source certainty descriptor
High label certainty; low class-wide reproductive certainty
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Preconception, pregnancy, and lactation
Comparator
Semaglutide versus other GLP-1 products
Effect or numbers carried forward

Two-month preconception interval for semaglutide

Limitations

Long half-life and oral absorption enhancer matter; labels change and differ by product/indication

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending