title: Antipsychotic use in pregnancy.
abstract: BACKGROUND
  Antipsychotic medications are being prescribed for a growing number of women with mental illnesses. However, evidence regarding their safety in pregnancy is still insufficient to provide adequate support for clinical practice, creating increasing concern among pregnant women and clinicians.
  
  
  METHODS
  The aim of this article is to review published data regarding the safety of antipsychotic medications in pregnancy with a focus on the most commonly used atypical antipsychotics.
  
  
  CONCLUSIONS
  Given the potential harm of not treating severe psychiatric illnesses during pregnancy, careful administration of antipsychotics is recommended for pregnant women who suffer from severe mental disorders. The most frequently used antipsychotics in pregnancy are olanzapine, risperidone and quetiapine, and do not appear to cause consistent, congenital harm to the fetus. No specific patterns of fetal limb or organ malformation related to these drugs have been reported. There is some evidence suggesting an association between antipsychotic use in pregnancy and the development of gestational diabetes. Also there appears to be an association between antipsychotic medication use in pregnancy and increased neonatal respiratory distress and withdrawal symptoms. Further studies are needed for clinicians to balance good maternal mental health, healthy pregnancies and good infant health outcomes.
authors.affiliation: Central Clinical School - Monash University and the Alfred Hospital, The Monash Alfred Psychiatry Research Centre , Level 4 607 St Kilda Rd Melbourne , Australia j.kulkarni@alfred.org.au.
authors.forename: Jayashri
authors.initials: J
authors.lastname: Kulkarni
authors.forename: Adele
authors.initials: A
authors.lastname: Storch
authors.forename: Analin
authors.initials: A
authors.lastname: Baraniuk
authors.forename: Heather
authors.initials: H
authors.lastname: Gilbert
authors.forename: Emmy
authors.initials: E
authors.lastname: Gavrilidis
authors.forename: Roisin
authors.initials: R
authors.lastname: Worsley
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008431:Maternal-Fetal Exchange; D001523:Mental Disorders / Q000188:drug therapy*; D000077152:Olanzapine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000517:prevention & control; D011446:Prospective Studies; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine
keywords: antipsychotics; fetal development; mental illness; pregnancy; teratogenicity