Mental Health Meds During Pregnancy

Antipsychotics during pregnancy may increase risk of gestational diabetes

(RxWiki News) Taking medications during pregnancy is an important decision for a woman. It requires a risk-benefit analysis regarding the value of the drug for the mother versus the possible effects on the fetus.

A recent study has found that one class of mental health drugs, antipsychotics, may have little or no impact on the size of the baby, but they are linked to a higher risk of gestational diabetes in the mother.

"Consult your OB/GYN or midwife about taking medications during pregnancy."

Robert Bodén, MD, PhD, of the Department of Medicine at the Karolinska Institutet's Centre for Pharmacoepidemiology, in Stockholm, Sweden, and co-authors analyzed the records of 357,696 women who gave birth between July 1, 2005 and December 31, 2009.

They divided the women into three groups: the 169 women who filled prescriptions for olanzapine (Zyprexa) and/or clozapine (Clozaril), the 338 women who filled prescriptions for other antipsychotics and the remaining women, who did not fill prescriptions for any antipsychotics.

Antipsychotics are typically prescribed for conditions such as schizophrenia, bipolar disorder and other mental health disorders.

The researchers found that more than twice as many women who had filled prescriptions for antipsychotics other than olanzapine and/or clozapine were diagnosed with gestational diabetes.

Although there were slightly higher rates of gestational diabetes among those taking olanzapine and/or clozapine as well, the risk appeared too small to be attributed to anything other than coincidence.

They also found that women who took antipsychotics tended to have a higher likelihood of having an underweight baby, but this appeared to be more likely linked to the rates of smoking and other factors in these women.

The use of olanzapine and/or clozapine was linked to a larger measure of a baby's head circumference.

"In conclusion, maternal use of antipsychotics during pregnancy, regardless of the drug group, is associated with an increased risk of gestational diabetes," the authors wrote. "Pregnant women treated with antipsychotics should be closely monitored for gestational diabetes and deviating fetal growth."

The study was published July 2 in the Archives of General Psychiatry. The research was funded by grants from the Lennander’s Foundation and Gillbergska Foundation. The authors reported no conflicts of interest.

Review Date: 
July 2, 2012