A 23-year-old pregnant woman has been referred to the PMHNP by her OB/GYN for management of bipolar disorder. Of the following, which one is NOT an acceptable choice for this client due to teratogenic risks?

Choice A reason: Carbamazepine is associated with significant teratogenic risks, including neural tube defects and craniofacial abnormalities. It is contraindicated in pregnancy due to its potential to cause congenital malformations, especially during the first trimester. Choice B reason: Lurasidone has limited data on teratogenicity but is generally considered safer than mood stabilizers like carbamazepine. It is often used cautiously in pregnancy when benefits outweigh risks. Choice C reason: Lamotrigine is considered one of the safer mood stabilizers during pregnancy. It has not been strongly associated with major congenital malformations and is often preferred for bipolar maintenance in pregnant patients. Choice D reason: Quetiapine is an atypical antipsychotic with a relatively low teratogenic risk profile. It is frequently used in pregnancy for mood stabilization due to its favorable safety data.