The use of the newer “atypical” or second-generation antipsychotic agents is increasing. Atypical antipsychotics are now used to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders. Using data from the Medicaid Analytic eXtract (MAX) data of pregnant women who delivered infants born between 2001 and 2010, Park and colleagues looked at patterns of antipsychotic use during pregnancy.
Among 1,522,247 pregnancies analyzed in this study, the prevalence of use of second-generation antipsychotics at any point during pregnancy increased about threefold, from 0.4% in 2001 to 1.3% in 2010. The use of first-generation antipsychotics remained stable at about 0.1%. The increased use of second-generation antipsychotics was driven largely by more frequent use among women with bipolar disorder. Quetiapine and aripiprazole were the most frequently used antipsychotics. Polytherapy was common; antipsychotics were combined with antidepressants (65.2%), benzodiazepines (24.9%), and other mood stabilizers (22.0%). More than have of the women taking an antipsychotic in the three months prior to pregnancy discontinued the drug during pregnancy.
Given the growing use of second-generation antipsychotics in pregnant women, this study highlights the importance of studying the safety of these drugs during pregnancy in order to inform clinical decision making for pregnant women with psychiatric illness.
We continue to recruit pregnant women for the National Pregnancy Registry for Atypical Antipsychotics. Our goal with this registry is to evaluate the safety of atypical antipsychotic medications taken by women during pregnancy. Women who are pregnant (or planning to conceive) and are taking antipsychotic medications may call TOLL-FREE to learn more about this study: 1-866-961-2388.
Ruta Nonacs, MD PhD
Antipsychotic Medication Use Among Publicly Insured Pregnant Women in the United States. Park Y, Huybrechts KF, Cohen JM, Bateman BT, Desai RJ, Patorno E, Mogun H, Cohen LS, Hernandez-Diaz S. Psychiatr Serv. 2017 Jun 15.