Medicus, Vol. 32 No. 1. Psihoze, 2023.
Review article
Antipsychotics in Pregnancy and Breastfeeding
Maja Živković
Paula Marinović
Alma Mihaljević-Peleš
Abstract
Antipsychotics use in pregnancy and breastfeeding is possible after carefully weighing down the pros and cons for each pregnant woman and her fetus or newborn, respectively. More than half of women discontinue antipsychotics use on their own, out of fear of their impact on the fetus, which leads to a greater risk for relapse of their mental illness and with that a higher possibility of a negative outcome for the pregnancy. Adequate clinical studies are almost non-existent and consequentially there are no official guidelines for prescribing antipsychotics in pregnancy and breastfeeding. It is known that all antipsychotics pass through the placenta. If it is at all possible, it is advisable to discontinue antipsychotic treatment in the first trimester during organogenesis, while closely monitoring the patient. The lowest effective dose is used if antipsychotics are necessary during the first trimester. Untreated psychosis and bipolar disorder are independent risk factors in pregnancy, thus caution while weighing down the costs and benefits of antipsychotic treatment is necessary. Most antipsychotics in breastfeeding mothers are found in the milk which is why it is important to closely monitor a breastfed newborn. Remission in the mother is the priority to prevent endangering the life of her newborn or herself. If it is required for a breastfeeding woman to take more than one antipsychotic or any other medication in combination with an antipsychotic, ablactation is recommended.
Keywords
psychosis; pregnancy; antipsychotics; breastfeeding
Hrčak ID:
308628
URI
Publication date:
9.10.2023.
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