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Antipsychotics in Pregnancy

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Perinatal Psychopharmacology

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Abstract

Women suffering from major mental illness such as schizophrenia or bipolar affective disorder are vulnerable to a host of challenges in pregnancy to their social, economic and emotional wellbeing. Each woman faces a decision at this point as to whether or not to continue her antipsychotic medication in pregnancy. This decision must be an individualised one made by each woman and her treating team, balancing the risks associated with relapse of psychiatric illness in the peripartum against the risks to the developing baby from antipsychotic medication treatment. In order to fully inform this decision, clinicians need access to the best information available on the safety profile of antipsychotic medications.

Fortunately, current research suggests that antipsychotics do not increase the rate of congenital malformations significantly beyond the background population rates of these events. However, a growing body of evidence suggests that obesity and gestational diabetes are related to use of antipsychotics in women of childbearing age and during pregnancy. Additionally, it seems that babies of women taking antipsychotic medications are vulnerable to medication withdrawal symptoms and to distress symptoms at delivery, suggesting that they should be delivered in centres with access to neonatal support. Available evidence supports the view that babies exposed to antipsychotic medications in pregnancy develop in line with their peers at 1 year postpartum, though there is a need for more long-term studies on developmental outcomes.

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  1. Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC, Australia

    Carolyn Breadon & Jayashri Kulkarni

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  2. Jayashri Kulkarni
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  1. Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Faruk Uguz

  2. Psychopharmacological, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK

    Laura Orsolini

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Breadon, C., Kulkarni, J. (2019). Antipsychotics in Pregnancy. In: Uguz, F., Orsolini, L. (eds) Perinatal Psychopharmacology. Springer, Cham. https://doi.org/10.1007/978-3-319-92919-4_7

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