ANTIPSYCHOTIC MEDICATION DURING PREGNANCY AND POSSIBLE BIRTH DEFECTS

Abstract

Antipsychotics drugs like chlorpromazine, haloperidol, clozapine, risperidone, olanzapine and many other are commonly used in psychiatric medicine. Approximately one third of pregnant women with psychotic symptoms use antipsychotics at least once. Although adequate and well-controlled studies have not been done in any one of these antipsychotic drugs, animal studies have revealed evidence of teratogenic or embryo/fetotoxic effects in all of them. Use of typical drugs like chlorpromazine and haloperidol shows congenital malformations like skeletal malformations, central nervous system (CNS) defects, cleft palate, cardiac abnormalities, decreased fetal growth, and fetal death. The extrapyramidal symptoms and respiratory distress in infants born to mothers treated with these medications is also reported. Effects of antipsychotic use in lactating mothers are mostly unknown. With increase in the use of newer psychotropics, there is a growing concern in relation to the teratogenicity. As, it is not possible to carry out prospective studies in pregnant women and as a result physicians caring for such patients have to rely on case reports, case series, and retrospective studies. Available evidence shows that the safety of these drugs in pregnancy is still unresolved and the decision to prescribe antipsychotic drugs in pregnancy should be taken in the light of severity of mental disease and drugs should be prescribed only when the potential risk to the foetus from exposure is outweighed by the risk of untreated maternal disorder. In this review we discussed the current evidence of the teratogenic risks antipsychotic drugs commonly used to treat psychiatric disorders