Dilemma of treating schizophrenia during pregnancy: a Case series and a review of literature

BMC Psychiatry

Case Report

Petru Ifteni¹  Andreea Teodorescu¹  Victoria Burtea²  Marius Alexandru Moga³  Nicusor Bigiu³ 

[1] Psychiatry and Neurology Hospital, 18th Mihai Eminescu Street, Brasov, Romania;Transilvania University, Faculty of Medicine, 29th Eroilor Bvd, Brasov, Romania;Transilvania University, Faculty of Medicine, 29th Eroilor Bvd, Brasov, Romania;Transilvania University, Faculty of Medicine, 29th Eroilor Bvd, Brasov, Romania;Clinical Hospital of Obstetrics and Gynecology, 36th George Baritiu Street, Brasov, Romania;

关键词: Schizophrenia;    Pregnancy;    Olanzapine;    Antipsychotics;   

DOI  :  10.1186/s12888-017-1475-z

 received in 2017-01-31, accepted in 2017-08-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe choice of antipsychotic treatment during pregnancy remains controversial, mainly due to a lack of exposure and outcome data. Randomized clinical trials are practically impossible due to ethical reasons. Our reports describe three cases of closely monitored female patients with schizophrenia who were treated with olanzapine during pregnancy. The novelty of reports is that all patients were previously treated with olanzapine long acting injectable (LAI) for an average period of 3.8 years. During the LAI treatment period they were in remission and then refused to continue with LAI mainly due to treatment modality (injectable administration).Case presentationThe patients were relatively young, diagnosed with schizophrenia and were previously successfully treated with long acting injectable. The women were pregnant for the first time. In two cases, the patients had become pregnant during remission and they continued treatment with oral olanzapine. In the third case, olanzapine treatment was initiated during admission for a relapse.ConclusionsThere are no controlled studies for the use of olanzapine therapy in pregnant women. More studies are needed to determine the effects of antipsychotics, including olanzapine, on pregnant women and the developing fetus. Schizophrenia relapse during pregnancy may expose the mother and the fetus to high risk if olanzapine is stopped. It is important to assess the risks and benefits of treating pregnant or breastfeeding women with antipsychotics, and weigh these against possible risks of anomalies and developmental problems to the fetus or child.

【 授权许可】

CC BY   
© The Author(s). 2017