Our report focuses on the case of a pregnant women with recurrent, paranoid schizophrenia. The patient was treated with Olanzapine from the 18th gestational week until delivery and during breast-feeding. No adverse events occurred during pregnancy, and the outcome was healthy. After delivery, the plasma level of olanzapine in the infant was one-third of the maternal plasma level, and during breast-feeding, it decreased to an undetectable limit.
"The issue of breastfeeding and the use of antipsychotic medication has been well reported (Yoshida et al. 1998a,b, Hill et al. 2000, Kirchheiner et al. 2000, Friedman & Rosenthal 2003, Nordeng & Spigset 2003, Gentile 2004, Misri et al. 2006). Successful use has been described in relation to risperidone (Hill et al. 2000), olanzapine (Kirchheiner et al. 2000, Friedman & Rosenthal 2003) and quetiapine (Misri et al. 2006). "
[Show abstract][Hide abstract] ABSTRACT: Women who are pregnant and who have a history of psychosis are commonly managed with antipsychotic medications. The evidence regarding the use of antipsychotics in pregnancy has been insufficient to provide adequate support for this practice and is a concern for clinicians and women alike. This review presents literature surrounding the use of antipsychotic medications in pregnancy, providing an overview of the historical and contemporary perspectives which influence clinicians prescribing practices. Data were sourced from Medline, CINAHL, PsycINFo, using the terms antipsychotics with pregnancy and psychosis or schizophrenia. This was expanded to include the most common atypical antipsychotics: olanzapine, risperidone, clozapine, quetiapine, ziprasidone and aripiprazole. Literature was found reporting the use of antipsychotic medications in pregnancy since the introduction of antipsychotics in the 1950s, comprising mainly of authors' reviews of the literature, case studies, retrospective reports, drug company registries and more recently a prospective comparative study. This review identifies that the literature provides no clear answer for clinicians as to the risk associated with the use of antipsychotics in pregnancy. To this effect, recently in Australia, the National Register of Antipsychotic Medications in Pregnancy was established to prospectively collect information regarding outcomes for mother and baby, when antipsychotic medications have been used during pregnancy.
Journal of Psychiatric and Mental Health Nursing 03/2010; 17(2):97-104. DOI:10.1111/j.1365-2850.2009.01481.x · 0.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We here report on a psychotic mother and her breast-fed infant who was treated with olanzapine. Consecutively olanzapine concentrations in the milk and plasma of the mother and in the infant were measured with tandem mass spectroscopy over a period of five month. The results show a relatively high plasma level in the infant aged four month, probably referring to an immature hepatic transformation system, especially CYP1A2. In the following four months plasma levels of olanzapine decreased to very low, even undetectable concentrations in the infant. The infant developed normally and showed no side effects during the treatment period.
Journal of Psychopharmacology 10/2008; 24(1):121-3. DOI:10.1177/0269881108096504 · 3.59 Impact Factor
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