The high rates of unplanned pregnancies we observed also suggest that teratogenicity should be considered when prescribing psychotropic medications to adolescent girls, as exposure could harm a developing fetus during a critical period of development (i.e., the first trimester), before the pregnancy is discovered. In one-half (N=4) of the pregnancies in our sample, psychotropic medications were being taken around the time of conception. In each case, the medications were discontinued at varying points during the first trimester: almost immediately (N=1), after 1 month (N=2), and after 3 months (N=1). Three of the four pregnancies resulted in live births, with no gross anomalies noted in the newborns. The other pregnancy, in which medication was discontinued almost immediately, resulted in a spontaneous abortion after 2 months. Further study of pregnancy outcomes in these adolescents is needed to understand the risks associated with prescribing teratogenic medications to at-risk teenage girls with bipolar disorder.