May 27, 2015
Lower Risk Profile for New Anti-Psychotics in Pregnant Women

Toronto, Ontario—The use of antipsychotic medication during pregnancy has been increasing because of higher conception rates among women with serious mental health disorders and because more of the drugs are being prescribed for bipolar and major depressive disorder.

The balancing act between managing the mother’s mental illness while keeping them physically healthy can be extremely difficult. A new Canadian study should make that easier, however.

The report, published recently in the British Medical Journal (BMJ), found that antipsychotic medication use during pregnancy does not put women at additional risk of developing gestational diabetes, hypertensive disorders or major blood clots.

The study, led by researchers at Women’s College Hospital and the Institute for Clinical Evaluative Sciences in Toronto, is the largest to date to examine possible links between newer antipsychotic medications—such as quetiapine, olanzapine, and risperidone—and medical conditions that often develop during pregnancy or with use of older antipsychotic drug medications.

“Antipsychotic drug use during pregnancy is on the rise, but little is known about possible effects of the newer medications on maternal health or perinatal outcomes like pre-term birth or large birthweight,” said lead author Simone Vigod, MD.

For the study, researchers compared a group of 1,021 pregnant women who took antipsychotics during pregnancy to a group of 1,021 pregnant women of similar of age, income, mental health status, and healthcare utilization who did not.

In addition to the lack of additional risk for gestational diabetes, gestational hypertensive disorders or venous thromboembolism, the study also finds no significant differences in risk for preterm delivery, extremely low birth weights or extremely high birth weights in infants born to women who had taken antipsychotic medications during pregnancy and those who had not.

Results did indicate, however, that women who used antipsychotic medications during pregnancy were more likely to require induced labor compared to women who were free of the drugs.

“The maternal and perinatal medical risks associated with antipsychotic drug use itself during pregnancy appear to be minimal,” Vigod pointed out. “Ultimately, our results support better-informed decision making for women managing mental illness.”

She urged careful assessment and monitoring of pregnant women with mental illness, adding, “Our results are reassuring for women who require antipsychotic medication to maintain their mental health stability during pregnancy, at least with respect to short term maternal and infant outcomes. Research into longer term child outcomes will be needed to provide a full picture of the long term impact of antipsychotic exposure in a developing fetus.”

U.S. Pharmacist Social Connect