Neonatal death following clozapine self-poisoning in late pregnancy

Kłys, Małgorzata; Rojek, Sebastian; Rzepecka-Woźniak, Ewa

doi:10.1016/j.forsciint.2007.04.216

Cited by 24 publications

(5 citation statements)

References 24 publications

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“…[36][37][38][39][40][41][42][43][44][45][46][47][48] However, clozapine overdose during pregnancy may cause fatal poisoning of the newborn. 49 On the other hand, clinical observations suggesting safe use of clozapine in pregnant women are limited. [50][51][52][53][54] Olanzapine.…”

Section: Second-generation Antipsychoticsmentioning

confidence: 99%

Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

Gentile

2008

Schizophrenia Bulletin

210

166

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Reviewed information was too limited to draw definite conclusions on structural teratogenicity of FGAs and SGAs. Both classes of drugs seem to be associated with an increased risk of neonatal complications. However, most SGAs appear to increase risk of gestational metabolic complications and babies large for gestational age and with mean birth weight significantly heavier as compared with those exposed to FGAs. These risks have been reported rarely with FGAs. Hence, the choice of the less harmful option in pregnancy should be limited to FGAs in drug-naive patients. When pregnancy occurs during antipsychotic treatment, the choice to continue the previous therapy should be preferred.

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Section: Second-generation Antipsychoticsmentioning

confidence: 99%

Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

Gentile

2008

Schizophrenia Bulletin

210

166

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“…We must point out that our mean plasma neonatal concentration of clozapine was lower than that estimated by Moreno-Bruna et al ( 2012 ). In the literature there are two cases of neonatal delayed peristalsis after maternal acute clozapine intoxication in late pregnancy in two women that were not receiving regular clozapine treatment (Kłys et al, 2007 ; Novikova et al, 2009 ). In the first case, the baby died after 3 h and the woman was saved.…”

Section: Discussionmentioning

confidence: 99%

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

et al. 2018

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The current prescription of clozapine in psychotic women of reproductive age makes it crucial to understand its pharmacokinetics during pregnancy and lactation as well as its risk profile for neonatal outcome. The aim of this case series was to provide new evidence on the pharmacokinetic features of clozapine that determine its passage through the placenta and amniotic fluid, as well as the neonatal clozapine elimination half-life (t1/2). This case series demonstrates for the first time that clozapine might show partial placental passage similar to other atypical antipsychotics. Clozapine levels decreased during the first few days in nursing infants. The half-life of clozapine in neonates was slightly higher than previously estimated. Clozapine use in pregnancy may be associated with diabetes mellitus, especially if there is a family history of this disease. Although no acute toxicological effects were observed in the intrauterine exposed newborn, close follow-up of pregnancy is recommended. However, these results must be taken with caution being a case series with small sample size

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“…[ 185 187 ] However, many of these findings have been complicated by the concomitant use of other drugs, malnutrition or family history of diabetes mellitus. Clozapine overdose during pregnancy has also been shown to lead to fatal poisoning in the newborn[ 200 ] and to be associated with absent fetal heart rate variability and delayed peristalsis in the newborn. [ 201 ]…”

Section: Effects Of Psychotropics: Pregnancy and Lactationmentioning

confidence: 99%

Mood stabilizers in pregnancy and lactation

Grover

2015

Indian J Psychiatry

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Management of bipolar during pregnancy and postpartum is very challenging. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. The choice of drug should depend on the balance between safety and efficacy profile. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. During lactation, use of valproate and LTG is reported to be safe. Use of typical and/atypical antipsychotic is a good option during pregnancy in women with bipolar disorder.

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Neonatal death following clozapine self-poisoning in late pregnancy

Cited by 24 publications

References 24 publications

Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

Mood stabilizers in pregnancy and lactation

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