Volume 199 - Issue 10
Psychotropic medication in pregnancy
Authors: Roisin N Worsley, Heather Gilbert and Jayashri Kulkarni
Med J Aust 2013; 199 (10): 661. || doi: 10.5694/mja13.10719
Published online: 18 November 2013
Published online: 18 November 2013
The increasing use of psychotropic medicines has led to a need to understand the safety of antipsychotics in pregnancy.
To the Editor: The report by O’Donnell and colleagues on the increasing rate of mental illness in parents of infants highlights a very important issue and is consistent with overseas studies that suggest there is increasing use of psychotropic medication in pregnancy.1,2
To address the lack of information on the safety of psychotropic medication in pregnancy, particularly the safety of antipsychotics, we have established the National Register of Antipsychotic Medication in Pregnancy. Women are prospectively or retrospectively recruited to the register through referrals from health professionals or self-referral.3 So far, 237 women have consented to join the register. We continue to recruit women taking antipsychotics in pregnancy and pregnant women with mental illness who have elected not to take antipsychotic medication, from all over Australia.
Our data reveal that the women included on the register so far use antipsychotic medication during pregnancy for a wide range of disorders. This includes psychotic disorders (42.5% of those currently on the register), bipolar disorders (42%), depression (10%), anxiety disorders (3.5%), obsessive compulsive disorder (1%), and borderline personality disorder (1%). This is a small but growing dataset, with potential limitations on its interpretability such as potential selection bias in the sample, but it provides some insight into the current use of antipsychotic medications during pregnancy in Australia. With use of antipsychotics expanding beyond psychotic disorders, an increasing incidence of mental illness in new parents,1 and the knowledge that most women with mental illness become mothers,4 there is a growing need to understand the safety of antipsychotics in pregnancy.
Competing interests
No relevant disclosures.
References
- O’Donnell M, Anderson D, Morgan VA, et al. Trends in pre-existing mental health disorders among parents of infants born in Western Australia from 1990 to 2005. Med J Aust 2013; 198: 485-488. 0_CHDEAJAG
- Epstein RA, Bobo WV, Shelton RC, et al. Increasing use of atypical antipsychotics and anticonvulsants during pregnancy. Pharmacoepidemiol Drug Saf 2013; 22: 794-801. 0_i1142867
- Kulkarni J, McCauley-Elsom K, Marston N, et al. Preliminary findings from the National Register of Antipsychotic Medication in Pregnancy. Aust N Z J Psychiatry 2008; 42: 38-44. 0_i1142869
- Miller LJ, Finnerty M. Sexuality, pregnancy and childrearing among women with schizophrenia-spectrum disorders. Psychiatr Serv 1996; 47: 502-506. 0_CBBHACDH