The Use of Olanzapine in Pregnancy and Congenital Cardiac and Musculoskeletal Abnormalities
2007; American Psychiatric Association; Volume: 164; Issue: 11 Linguagem: Inglês
10.1176/appi.ajp.2007.07010176
ISSN1535-7228
Autores Tópico(s)Child and Adolescent Psychosocial and Emotional Development
ResumoBack to table of contents Previous article Next article Letters to the EditorFull AccessThe Use of Olanzapine in Pregnancy and Congenital Cardiac and Musculoskeletal AbnormalitiesYONATAN YESHAYAHU M.D., M.H.A.,YONATAN YESHAYAHU M.D., M.H.A.,Published Online:1 Nov 2007https://doi.org/10.1176/appi.ajp.2007.07010176AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To The Editor: There are very few reports concerning the risk of olanzapine treatment during pregnancy, and it is not considered contraindicated for use in pregnant women with psychosis. We report a case of a neonate infant born to a 25-year-old primigravida woman treated with olanzapine for schizophrenia throughout her pregnancy."Ms. A," a 25-year-old primigravida woman, had not received any prescribed medication other than olanzapine 10 mg daily. She had not been smoking, using drugs, or drinking alcohol during her pregnancy. There was no family history of birth defects; no viral infections occurred during pregnancy, and no work exposures were present. There was no consanguinity between her and the father of the baby. The baby was born with an atrioventricular canal defect and unilateral clubfoot. No additional phenotypic abnormalities were observed, and the karyotype was found to be 46XY. The baby was treated for the clubfoot with a plaster cast with satisfactory results and at the age of 6 months underwent open heart surgery because of the atrioventricular canal, with full recovery. Olanzapine was the third atypical antipsychotic to gain approval by the Food and Drug Administration and has become one of the most commonly used atypical antipsychotics. Information regarding the safety of the drug during pregnancy has primarily been based on several case reports of women receiving the drug throughout pregnancy or from the second and third trimester onward. Most of the reports have been favorable, reporting no birth abnormalities (1 – 5) . A prospective clinical trial showed no statistically significant differences in any of the pregnancy outcomes between patients receiving atypical antipsychotics relative to a comparison group. The only significant difference between the groups was higher rates of low-birth-weight babies in the treated group of women (6) . Other case reports in the literature involving treatment with olanzapine throughout pregnancy include a report of a baby born with hip dysplasia (7) as well as reports of a meningocele and ankyloblepharon (8) . Association between schizophrenia itself and congenital cardiac anomalies was suggested recently (9) and therefore could be the reason for the atrioventricular canal in our patient's baby, regardless of the olanzapine treatment. Additional reports would be helpful in clarifying whether our case was incidental or because of a teratogenic effect of olanzapine, and the limitations of a single case report need to be taken into consideration. Jerusalem, IsraelDr. Yeshayahu reports no competing interests.This letter (doi: 10.1176/appi.ajp.2007.07010176) was accepted for publication in August 2007.References1. Littrell KH, Johnson CG, Peabody CD, Hilligoss N: Antipsychotics during pregnancy. Am J Psychiatry 2000; 157:1342Google Scholar2. Mendhekar DN, War L, Sharma JB, Jiloha RC: Olanzapine and pregnancy. Pharmacopsychiatry 2002; 35:122–123Google Scholar3. Kirchheiner J, Berghofer A, Bolk-Weischedel D: Healthy outcome under olanzapine treatment in a pregnant woman. Pharmacopsychiatry 2000; 33:78–80Google Scholar4. Neumann NU, Frasch K: Olanzapine and pregnancy: 2 case reports. Nervenarzt 2001; 72:876–878Google Scholar5. Nagy A, Tenyi T, Lenard K, Herold R, Wilhelm F, Trixler M: Olanzapine and pregnancy. Orv Hetil 2001; 142:137–138Google Scholar6. McKenna K, Koren G, Tetelbaum M, Wilton L, Shakir S, Diav-Citrin O, Levinson A, Zipursky RB, Einarson A: Pregnancy outcome of women using atypical antipsychotic drugs: a prospective comparative study. J Clin Psychiatry 2005; 66:444–449Google Scholar7. Spyropoulou AC, Zervas IM, Soldatos CR: Hip dysplasia following a case of olanzapine exposed pregnancy: a questionable association. Arch Womens Ment Health 2006; 9:219–222; Epub 2006 Jun 8Google Scholar8. Arora M, Praharaj SK: Meningocele and ankyloblepharon following in utero exposure to olanzapine. Eur Psychiatr; 2006; 21: 345–356. Epub 2006 Mar 20Google Scholar9. Jablensky AV, Morgan V, Zubrick SR, Bower C, Yellachich LA: Pregnancy, delivery, and neonatal complications in a population cohort of women with schizophrenia and major affective disorders. Am J Psychiatry 2005; 162:79–91Google Scholar FiguresReferencesCited byDetailsCited byNovel report on congenital talipes equinovarus (CTEV) following olanzapine exposure during pregnancy: case report and short review14 March 2022 | Archives of Women's Mental Health, Vol. 25, No. 3Severe and persistent mental illness (SPMI) in pregnancy and breastfeeding: focus on second-generation long acting injectable antipsychotics28 July 2021 | Expert Opinion on Drug Safety, Vol. 20, No. 10Quality of Life Research, Vol. 26, No. 5Drug Safety - Case Reports, Vol. 4, No. 1BMC Psychiatry, Vol. 17, No. 1Drugs & Therapy Perspectives, Vol. 32, No. 9OlanzapinePregnancy Exposure to Olanzapine, Quetiapine, Risperidone, Aripiprazole and Risk of Congenital Malformations. A Systematic Review28 January 2015 | Basic & Clinical Pharmacology & Toxicology, Vol. 116, No. 4Mood stabilizers in pregnancy and lactationIndian Journal of Psychiatry, Vol. 57, No. 6, Vol. 214BMC Pharmacology and Toxicology, Vol. 14, No. 1Bipolar Disorder Differences between Genders: Special Considerations for Women1 November 2011 | Women's Health, Vol. 7, No. 6Antipsychotic drugsSchizophrenia Bulletin, Vol. 36, No. 3Current awareness: Pharmacoepidemiology and drug safety28 May 2008 | Pharmacoepidemiology and Drug Safety, Vol. 17, No. 6 Volume 164Issue 11 November, 2007Pages 1759-1760THE AMERICAN JOURNAL OF PSYCHIATRY November 2007 Volume 164 Number 11 Metrics PDF download History Published online 1 November 2007 Published in print 1 November 2007
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