Treatment of schizophrenia in pregnancy and postpartum.

BACKGROUND The prime age of onset for schizophrenia in women is during the childbearing years from ages 25-35. 50-60% of these women will become pregnant; fifty percent of these pregnancies will be unplanned or unwanted. Discontinuation of medication will likely lead to a relapse of the illness during pregnancy or postpartum. Although research on the safety of psychotropic medication during pregnancy and breastfeeding is limited, it is still necessary to make treatment recommendations based on the accumulated information of the best available studies. OBJECTIVES To give an overview of what is known about the risks/benefits of antipsychotic medications during pregnancy and postpartum and make treatment recommendations for pregnant schizophrenic women. METHODS A review was done on Pubmed, Medline and Cochrane to locate any studies or articles addressing the safety and efficacy of antipsychotic medication use in pregnancy and during breastfeeding and treatment planning for pregnant schizophrenic women. RESULTS The majority of antipsychotic medications used to treat schizophrenia appear to be relatively safe for use during pregnancy and breastfeeding. CONCLUSIONS There appears to be greater risk for the mother and the fetus/infant in not treating schizophrenia during pregnancy and postpartum. Recommendations are made about the treatment of schizophrenic women in order to achieve the best outcome for mother and baby.