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The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review

CNS drugs, 2018-04, Vol.32 (4), p.351-366 [Peer Reviewed Journal]

Springer International Publishing AG, part of Springer Nature 2018 ;Copyright Springer Science & Business Media Apr 2018 ;ISSN: 1172-7047 ;EISSN: 1179-1934 ;DOI: 10.1007/s40263-018-0517-5 ;PMID: 29637530

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Title:
The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review
Author: Damkier, Per ; Videbech, Poul
Subjects: Analgesics ; Antidepressants ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Antipsychotics ; Aripiprazole ; Autism ; Bipolar disorder ; Birth weight ; Children ; Clozapine ; Congenital defects ; Congenital diseases ; Decision making ; Drugs ; Female ; Gestational age ; Health risk assessment ; Humans ; Intrauterine exposure ; Medicine ; Medicine & Public Health ; Mental Disorders - complications ; Mental Disorders - drug therapy ; Metabolism ; Miscarriage ; Neonates ; Neuroleptics ; Neurology ; Neurosciences ; Olanzapine ; Patients ; Pharmacotherapy ; Pregnancy ; Pregnancy Complications - drug therapy ; Psychiatry ; Psychopharmacology ; Psychosis ; Psychotropic drugs ; Quetiapine ; Review Article ; Risk assessment ; Risperidone ; Safety ; Small-for-gestational age ; Stillbirth ; Studies ; Systematic review ; Ziprasidone
Is Part Of: CNS drugs, 2018-04, Vol.32 (4), p.351-366
Description: The issue of antipsychotic treatment during pregnancy is subject to substantial uncertainty and some controversy among healthcare providers, specifically pertaining to second-generation antipsychotics (SGAs) that are subject to a large gap in safety data during pregnancy compared with antidepressants. The amount of safety data for the use of SGAs during pregnancy is rapidly increasing, thus constantly changing the level of evidence. We performed a clinically focused review on the safety of SGA during pregnancy. Twenty-three studies provided various pregnancy outcomes for 14,382 pregnant women exposed to an SGA during pregnancy. In utero exposure to aripiprazole, olanzapine, and quetiapine is not associated with increased risks of major congenital malformations, whereas risperidone and paliperidone may be associated with a very minor increased risk of congenital malformations. Safety data on ziprasidone and clozapine remain scarce and insufficient for a quantitative safety evaluation. No or minimal safety data are available for amisulpride, asenapine, lurasidone, and sertindole. For other pregnancy outcomes of interest, e.g. miscarriage, stillbirth, and small for gestational age, the available data overall do not suggest a clinically important increased risk, and do not allow for a meaningful stratification on individual drug level. Furthermore, for neonatal adaption and childhood neurodevelopment, the data do not allow for a meaningful risk assessment. It is imperative that factors in addition to safety data, e.g. individual disease history, characteristics and treatment response, adverse reaction profile, and patient preferences, be considered for the individual patient when choosing specific SGA treatment during pregnancy.
Publisher: Cham: Springer International Publishing
Language: English
Identifier: ISSN: 1172-7047
EISSN: 1179-1934
DOI: 10.1007/s40263-018-0517-5
PMID: 29637530
Source: ProQuest One Psychology
MEDLINE
ProQuest Central

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The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review

Springer International Publishing AG, part of Springer Nature 2018 ;Copyright Springer Science & Business Media Apr 2018 ;ISSN: 1172-7047 ;EISSN: 1179-1934 ;DOI: 10.1007/s40263-018-0517-5 ;PMID: 29637530

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