Long-acting injectable aripiprazole in pregnant women with schizophrenia: a case-series report

Fernández-Abascal, Blanca; Recio-Barbero, María; Sáenz-Herrero, Margarita; Segarra, Rafael

doi:10.1177/2045125321991277

Cited by 9 publications

(7 citation statements)

References 55 publications

(96 reference statements)

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“…Of these 200 publications, 17 met the inclusion criteria, and 183 were excluded (172 irrelevant publications, 6 review/consensus guidelines, 3 publications with unavailable full text, 1 conference abstract of an already included publication, and 1 conference abstract with incomplete data on pregnancy and delivery outcomes). We identified 2 additional publications via citation search; therefore, 19 publications satisfied the inclusion criteria: 3 case series[ 20 , 21 , 33 ], 15 case reports[ 34 - 48 ], and 1 conference abstract[ 49 ]. One case series reported aggregate data[ 20 ], while all others reported individual data.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 23 babies born alive who were exposed to aripiprazole LAI, one[ 21 ] experienced postural plagiocephaly and hypertonia during the first 6 wk of life that resolved with physiotherapy (he developed normally during the 3-year follow-up), one[ 21 ] remained in the incubator for 1 month due to prematurity (but developed normally during the 2-year follow-up), and one[ 33 ] was born preterm with Down’s syndrome, developed fetal hydrops complicated by septic shock and massive anuria, and died within 10 d (but this syndrome cannot be considered a drug-induced malformation).…”

Section: Resultsmentioning

confidence: 99%

“…However, in daily clinical practice, antipsychotics are likely to be discontinued when pregnancy is confirmed for fear of possible teratogenicity or fetotoxicity[ 15 , 16 ]. Moreover, despite the current evidence showing that the use of oral antipsychotics is not significantly associated with poor pregnancy outcome[ 17 , 18 ], as well as a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy that does not clearly support their avoidance[ 19 - 21 ], it has been observed that psychiatrists prefer not to start or stop the use of LAI antipsychotics, even in pregnant women with an exceptionally high risk of psychotic symptom recurrence[ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Pejčić,

Stefanović,

Milosavljević

et al. 2024

World J Psychiatry

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BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy. Long-acting injectable (LAI) antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders, but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy. AIM To summarize relevant data on maternal, pregnancy, neonatal, and developmental outcomes from published cases of LAI antipsychotic use in pregnancy. METHODS A literature search was performed through November 11, 2023, using three online databases: PubMed/MEDLINE, Scopus, and Web of Science. Case reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy, with available full texts, were included. Descriptive statistics, narrative summation, and tabulation of the extracted data were performed. RESULTS A total of 19 publications satisfied the inclusion criteria: 3 case series, 15 case reports, and 1 conference abstract. They reported the outcomes of LAI antipsychotic use in 74 women and 77 pregnancies. The use of second-generation LAI antipsychotics was reported in the majority (n = 47; 61.0%) of pregnancies. First-generation LAI antipsychotics were administered during 30 pregnancies (39.0%). Most of the women (approximately 64%) had either satisfactory control of symptoms or no information about relapse, while approximately 12% of them had developed gestational diabetes mellitus. A minority of cases reported adverse outcomes such as stillbirth, spontaneous abortion, preterm birth, low birth weight, congenital anomalies, and neurological manifestations in newborns. However, there were no reports of negative long-term developmental outcomes. CONCLUSION Currently available data seem reassuring, but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Pejčić,

Stefanović,

Milosavljević

et al. 2024

World J Psychiatry

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“…In spite of the large experience with the use of the same molecules by oral route without adverse effects on the newborn [ 1 ], there is still some concern on the use of these LAIs in pregnancy. Information is limited to few case studies and case series: inconsistent outcomes have been documented, including some negative outcomes (prematurity, babies being small for gestational age, congenital anomalies and neonatal adjustment problems), which are difficult to generalize [ 2 , 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Acting Injectable Antipsychotic Treatment during Pregnancy: A Case Series

Eleftheriou

Butera

Sangiovanni

et al. 2023

IJERPH

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Introduction: Data from the literature show that prolonged-release injectable antipsychotics (LAIs) ensure constant blood drug levels better patient compliance and offer a simpler treatment regimen for both patients and caregivers. This observational–descriptive study aims to detect the possible complications found in newborns of women with bipolar or psychotic disorders and LAI therapy during pregnancy. Methods: This study involved women with psychotic disorders during pregnancy who contacted the Teratology Information Center of Bergamo, Italy between 2016 and 2021 to receive counseling on the possible risks of exposure to LAI therapy. The follow-up procedure was carried out by telephone interview or direct contact with the patient and/or her physician. Results: In this study, LAI treatment in pregnancy was not associated with an increased risk of malformations. All but one of the children in the sample were born healthy and the mothers maintained psychopathological compensation during pregnancy. Conclusions: This study showed that, despite the small size of the sample under examination, the administration of LAIs do not compromise the normal intrauterine development of the unborn child and there were no evident major malformations.

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“…It is well known that the disturbance in glucose during pregnancy can increase the risk of gestational mellitus diabetes [ 20 ]. Several studies have shown that ARI, both oral form, and long-acting injection, was not associated with an increased risk of major congenital defects and neurological malformations [ 21 – 23 ]. Surprisingly, it was established that ARI (10–20 mg/day) has the potency to normalize significantly elevated levels of serum prolactin caused by antipsychotic-induced prolactinemia [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic drug—aripiprazole against schizophrenia, its therapeutic and metabolic effects associated with gene polymorphisms

et al. 2022

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Second-generation antipsychotics are widely used for the treatment of schizophrenia. Aripiprazole (ARI) is classified as a third-generation antipsychotic drug with a high affinity for dopamine and serotonin receptors. It is considered a dopamine-system stabilizer without severe side effects. In some patients the response to ARI treatment is inadequate and they require an effective augmentation strategy. It has been found that the response to the drug and the risk of adverse metabolic effects can be related to gene polymorphisms. A reduced dose is recommended for CYP2D6 poor metabolizers; moreover, it is postulated that other polymorphisms including CYP3A4, CYP3A5, ABCB1, DRD2, and 5-HTRs genes influence the therapeutic effect of ARI. ARI can increase the levels of prolactin, C-peptide, insulin, and/or cholesterol possibly due to specific genetic variants. It seems that a pharmacogenetic approach can help predict drug response and improve the clinical management of patients with schizophrenia.

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Long-acting injectable aripiprazole in pregnant women with schizophrenia: a case-series report

Cited by 9 publications

References 55 publications

Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Long-Acting Injectable Antipsychotic Treatment during Pregnancy: A Case Series

Antipsychotic drug—aripiprazole against schizophrenia, its therapeutic and metabolic effects associated with gene polymorphisms

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