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Use of Antipsychotic Drugs During Pregnancy

  • Schizophrenia and Other Psychotic Disorders (J Csernansky, Section Editor)
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Abstract

Purpose of review

Antipsychotics are frequently prescribed to women of childbearing age and are increasingly prescribed during pregnancy. A small, but growing, body of research on implications for pregnancy and infant outcomes is available to inform the risks and benefits of in utero exposure to antipsychotics. This review examines the existing published research on the use of common typical and atypical antipsychotics in pregnancy and the implications for pregnancy and infant outcomes.

Recent findings

The majority of studies do not show associations with major malformations and antipsychotic use in pregnancy, with the possible exception of risperidone. There is concern that atypical antipsychotics may be associated with gestational diabetes. Metabolic changes during pregnancy may necessitate dose adjustments.

Summary

In general, it is recommended that women who need to take an antipsychotic during pregnancy continue the antipsychotic that has been most effective for symptom remission. Further study on risperidone is needed to better understand its association with malformations, and it is not considered a first-line agent for use during pregnancy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Department of Psychiatry, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Ste 1000, Chicago, IL, 60611, USA

    Hannah K. Betcher MD, Catalina Montiel BS & Crystal T. Clark MD, MSc

  2. Mayo Clinic, Rochester, MN, USA

    Hannah K. Betcher MD

  3. Department of Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Crystal T. Clark MD, MSc

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  1. Hannah K. Betcher MD
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Correspondence to Hannah K. Betcher MD.

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Dr. Clark reports grants from NICHD-K23 grant, during the conduct of the study, and Miller Medical Communications as a speaker for CME activities on postpartum depression.

Hannah K. Betcher and Catalina Montiel declare that they have no conflict of interest.

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Betcher, H.K., Montiel, C. & Clark, C.T. Use of Antipsychotic Drugs During Pregnancy. Curr Treat Options Psych 6, 17–31 (2019). https://doi.org/10.1007/s40501-019-0165-5

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