Schizophrenia affects men and women equally and generally first occurs in adults aged 25 to 30 years, which is considered the prime for childbearing. Although no cure for schizophrenia currently exists, antipsychotic medications can help alleviate and prevent symptoms, but there is a fine balance between preventing symptoms in pregnancy and ensuring the safety of the baby.
Antipsychotic medication during pregnancy
The first trimester is the most crucial time during pregnancy for organ development. This process of organogenesis is very sensitive to illicit drugs, prescription drugs and even diet. Antipsychotics are generally safe in pregnancy and the benefits of preventing psychotic symptoms far outweigh the risks.
During pregnancy the best time to avoid antipsychotics, as with many other prescriptions, is during gestational weeks four through 10, as these are the most crucial weeks for organogenesis. The older antipsychotics, known as first-generation antipsychotics, increase birth defects in this period by 4 percent. The newer antipsychotics have not been studied extensively enough to demonstrate the risks and benefits.
Women in pregnancy are no more likely to experience psychotic symptoms due to schizophrenia compared with women who are not pregnant. In other words, there is no increase in prevalence in schizophrenia symptoms in the antenatal period.
Antipsychotic medications are four times higher in the newborn’s blood than in the mother’s serum or the placenta; therefore, it is highly recommended that antipsychotic medication dosages be decreased two weeks before delivery to avoid newborn toxicity.
The vulnerable postpartum period
The postpartum period is the most vulnerable time for women with schizophrenia, as they are under a great amount of stress due to their new baby. Every part of their day has changed and these new mothers are constantly adjusting. Postpartum depression and postpartum blues are two mood disorders that are quite frequent after giving birth.
Women who have schizophrenia are more likely to show symptoms in the postpartum period compared to the antenatal period, so it is imperative that antipsychotic medications are immediately re-started after delivery to prevent postpartum psychosis, which is increased in patients who have previously been diagnosed with schizophrenia.
Due to this large increase in risk, it is advised that patients actually increase their dose of antipsychotic medication in the first six weeks after delivery, as this is when the risk for postpartum psychosis is highest. It is recommended that women taking antipsychotics do not breastfeed, as antipsychotic medications are found in high concentrations in breast milk and, therefore, can potentially harm the baby.
The importance of treatment
Although schizophrenia can be a debilitating disease, it does not have to be. It is very possible to live a normal, healthy life with very few episodes if individuals seek the proper treatment and care. Pregnancy in patients with schizophrenia should be no different.
Sovereign Health of Arizona is a women’s treatment center that specializes in providing therapy for trauma and abuse, addiction, mental health disorders including schizophrenia, and dual diagnosis. For more information, please call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.
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