Are antipsychotics safe to use during pregnancy?

GPs can safely prescribe antipsychotic medications to their pregnant patients, with a new Australian study revealing the exposure will not lead to their child developing learning difficulties.
 
Published in eClinicalMedicine, the University of New South Wales research aimed to help both clinicians and women manage their mental health during pregnancy.
 
The research analysed 20 years of nationwide register data from the children of pregnant women diagnosed with a psychiatric disorder, with patients hailing from Denmark, Finland, Iceland, Norway, and Sweden.
 
Of the 213,302 children studied, 5.5% were exposed to antipsychotics prenatally, with medication analysed including quetiapine and olanzapine.
 
After tracking the children for an average of six years, researchers found antipsychotics did not suggest an increased risk of neurodevelopmental disorders, poor academic performance in maths and language, or learning, speech, and language disorders.
 
The study’s lead author Dr Claudia Bruno said many women and pregnant people using these medications may have felt concerned about the potential risks they pose to their unborn baby. 
 
‘The findings are really reassuring for both women managing these psychiatric conditions during pregnancy and their providers,’ she said.
 
‘There’s no increased risk when taking the medication during pregnancy, not only for the specific neurodevelopmental disorders that we looked at, but also ADHD and autism as shown in our team’s previous studies.’
 
The research comes as rates of mental health continue to spike across Australia, with almost one quarter of Australian adults experiencing a mental disorder.
 
Around 15% of adults have experienced high or very high levels of psychological distress, with females aged 16–34 more likely to experience the condition than males of this age group.
 
Dr Ka-Kiu Cheung, Chair of RACGP Specific Interests Antenatal and Postnatal Care, told newsGP the research should prompt GPs to embark on regular conversations with women interested in falling pregnant who are also taking medication.
 
‘It is very reassuring for pregnant women to know that continuing their regular medication does not increase the risk of harm to her child,’ she said.
 
‘This is particularly important for women who require medication to optimise their emotional health as mental health conditions are one of the top complications of pregnancy.
 
‘Population health data is an important component of research in pregnancy, especially in regard to medication exposure where randomised clinical trials may not be feasible or ethical.’
 
The research comes after a similar study was released last month, revealing dexamphetamine does not put mothers or their babies at risk.
 
For doctors wanting more information for their patients, Dr Cheung suggested reaching out to the GP Psychiatry Support Line, which connects GPs to psychiatrists.
 
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