Question

Generic Name Trade Name Classification Reason for Use Effects on Mom & Comments Baby Pitocin Methergine Prostaglandins Iron Supplements Multivitamin Stool Softener Laxative Analgesics Opioids RhoGam Rubella (Meruvax II) Antipsychotic Medications Haldol Mellaril Atypical Abilify Zyprexa Seroquel Risperdal Geodon

last 4 only. please help with reason for use during pregnancy, effects on mom and baby, and comments..

Answer 1

1. Zyprexa ( olanzapine ) - Maternal hyperglycaemia and increased fetal growth have been reported with use of olanzapine in pregnancy . Given that weight gain is a recognised complication of olanzapine therapy and that both complications are associated with an increased risk of adverse pregnancy outcome.

Exposure in later pregnancy has been associated with a significantly increased risk of neonatal complication.Use of olanzapine throughout pregnancy or near delivery has been associated with withdrawal symptoms in the neonate and/or poor neonatal adaptation syndrome (PNAS). These symptoms are likely to be more severe in infants exposed in utero to more than one CNS acting drug.

It is important to ensure that maternal mental health is treated appropriately. Where a patient is stabilised on olanzapine, either prior to conception or during pregnancy, the risk of discontinuing or changing medication, or reducing the dose, should be carefully weighed against the risk of relapse of the maternal condition. Where clinically appropriate, clinicians are encouraged to discuss the advantages and disadvantages of continued olanzapine use during pregnancy with the patient. Where the benefit of continued treatment is considered to outweigh any potential or known risks, olanzapine may be prescribed for use in pregnancy.

2. Seroquel :-

Seroquel is used to treat schizophrenia and manic episodes associated with bipolar I disorder.

Pregnancy Safety Rating: Category C

Pregnancy Recommendation: There is limited human data. Animal data suggest risk.

Side Effects:

Frequent: (19-10%) Headache, dizziness, drowsiness.

Occasional: (9%-3%) Constipation, orthostatic hypotension, dyspepsia (heartburn, indigestion, epigastric pain), tachycardia, rash, rhinitis, dry mouth, asthenia (loss of strength, energy), abdominal pain.

Rare: (2%) Back pain, weight gain, fever.

Pregnancy/Lactation Considerations: It is unknown if quetiapine is distributed in breast milk. It is not recommended for breastfeeding mothers

3. Risperdal :-

Use of risperidone throughout pregnancy or near delivery has been associated with withdrawal symptoms in the neonate and/or poor neonatal adaptation syndrome (PNAS). These symptoms are likely to be more severe in infants exposed in utero to more than one CNS acting drug. Delivery should be planned in a unit with adequate neonatal facilities.

Maternal hyperglycaemia and increased fetal growth have been reported with use of some antipsychotics in pregnancy. Data for risperidone are lacking but monitoring for maternal diabetes and excessive weight gain, both of which confer increased risks to both mother and fetus, may be prudent.

It is important to ensure that maternal mental health is treated appropriately. Where a patient is stabilised on risperidone, either prior to conception or during pregnancy, the risk of discontinuing or changing medication, or reducing the dose, should be carefully weighed against the risk of relapse of the maternal condition. Where clinically appropriate, clinicians are encouraged to discuss the advantages and disadvantages of continued risperidone use during pregnancy with the patient. Where the benefit of continued treatment is considered to outweigh any potential or known risks, risperidone may be prescribed for use in pregnancy.

Exposure to risperidone at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case specific risk assessments.