Use of Antipsychotics and Breastfeeding

Dayan, Jacques; Graignic-Philippe, R.; Seligmann, Carolina; Andro, Gwenaëlle

doi:10.2174/157340411794474694

Cited by 6 publications

(1 citation statement)

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“…The American Pregnancy Association recommends breastfeeding (109), but the FDA advises against it (until more clinical studies are available) when the mother is taking the newer second‐generation antipsychotics (110). Relatively few adverse effects have been reported in case studies, but the data are sparse, as shown by recent reviews (111–113).…”

Section: Resultsmentioning

confidence: 99%

Clinical interventions for women with schizophrenia: pregnancy

Seeman

2012

Acta Psychiatr Scand

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In 1997, Miller (1) inaugurated the field of specialized reproductive care for women with schizophrenia by reviewing what was then known about how the illness affects sexuality, pregnancy, the postpartum period, parenting, and family planning. She reported that women suffering Seeman MV. Clinical interventions for women with schizophrenia: pregnancy.Objective: A comprehensive treatment program for schizophrenia needs to include services to women of childbearing age that address contraception, pregnancy, and postpartum issues, as well as safe and effective parenting. To update knowledge in these areas, a summary of the recent qualitative and quantitative literature was undertaken. Method: The search terms Ôsexuality,Õ Ôcontraception,Õ Ôpregnancy,Õ Ôpostpartum,Õ Ôcustody,Õ and ÔparentingÕ were entered into PubMed, PsycINFO, and SOCINDEX along with the terms ÔschizophreniaÕ and Ôantipsychotic.Õ Publications in English for all years subsequent to 2000 were retrieved and their reference lists further searched in an attempt to arrive at a distillation of useful clinical recommendations. Results: The main recommendations to care providers are as follows: take a sexual history and initiate discussion about intimate relationships and contraception with all women diagnosed with schizophrenia. During pregnancy, adjust antipsychotic dose to clinical status, link the patient with prenatal care services, and help her prepare for childbirth. There are pros and cons to breastfeeding while on medication, and these need thorough discussion. During the postpartum period, mental health home visits should be provided. Parenting support is critical. Conclusion: The comprehensive treatment of schizophrenia in women means remembering that all women of childbearing age are potential new mothers. M. V. SeemanDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada Key words: schizophrenia; psychosis; pregnancy; postpartum; ethics Mary V. Seeman, Professor Emerita, Department of Psychiatry, University of Toronto, Toronto, ON, Canada M5P 3L6. E-mail: mary.seeman@utoronto.ca Accepted for publication May 25, 2012 Clinical recommendations• Engage all women patients with schizophrenia who are of childbearing age in discussions of intimacy, sex, sexually transmitted disease, conception, and contraception.• Carefully monitor all women with schizophrenia who are pregnant and be prepared to adjust antipsychotic doses frequently, as per clinical status.• Provide ongoing support to women with schizophrenia who are parents, and to their children. Additional comments• All women of childbearing age need to be treated as potential new mothers.• There is room for discussion as to the ÔrightÕ course of treatment of schizophrenia during pregnancy and the postpartum period.• The perspectives of all stakeholders need to be respected and considered.

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Section: Resultsmentioning

confidence: 99%