Neurodevelopmental and growth follow-up of the baby exposed to antipsychotics during pregnancy and lactation: a case report

Abstract

Clozapine is an antipsychotic drug for the treatment-resistant schizophrenia. Although clozapine is superior to other antipsychotics, it is less common in psychiatric prescriptions due to clozaphobia. Little is known about the use of clozapine during pregnancy and lactation, or its effect on the mother, foetus and baby. Pregnancy category of clozapine is considered to be of relatively reliable category B, while it is recommended to be avoided during breastfeeding. Switching from clozapine to other antipsychotics during breastfeeding may lead to psychotic exacerbations. In this case, low dose of clozapine may need to be added to the antipsychotic treatment initiated during breastfeeding. However, data on the safety of combination antipsychotics during breastfeeding are limited. Psychiatrists, obstetricians and pediatricians should closely monitor with team spirit on such cases, thus drug exposure and side effects of infant are minimized while the mother’s mental health is maintained. We aimed to present the growth and neurodevelopmental outcomes of infant exposed to clozapine during pregnancy and exposed to clozapine plus olanzapine during the lactation period.