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Psychopharmacology and Psychiatry Updates

Antipsychotics in Pregnancy: A Balancing Act

Sep 23, 2024
Vivien Burt, Professor Emeritus of Psychiatry at UCLA, discusses the intricate decision-making process surrounding atypical antipsychotics use during pregnancy, particularly for women with bipolar disorder. She highlights recent research showing no significant risk of major birth defects, emphasizing the need to balance maternal mental health with fetal safety. The conversation stresses the importance of effective communication between healthcare providers and patients to navigate treatment benefits and potential risks for newborns.
07:34

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Quick takeaways

  • Recent studies indicate atypical antipsychotics in early pregnancy do not significantly increase congenital malformation risks for mothers with bipolar disorder.
  • Neonates may experience extrapyramidal side effects post-delivery, highlighting the need for careful monitoring despite benefits for maternal mental health.

Deep dives

Safety of Atypical Antipsychotics During Pregnancy

Current research indicates that the use of atypical antipsychotics during the first trimester of pregnancy is not associated with an increased risk of major congenital malformations. Studies, including the ongoing National Pregnancy Registry for Atypical Antipsychotics, suggest that these medications do not present a significant risk of teratogenicity. A large Japanese cohort study corroborates these findings, showing no notable pattern of malformations in women exposed to atypical antipsychotics. This data underscores that continuing treatment with these medications for pregnant women with serious psychiatric conditions, such as bipolar disorder, may be a prudent and safe choice.

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