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. 2024 Apr 19;14(4):582-599.
doi: 10.5498/wjp.v14.i4.582.

Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Ana V Pejčić  1 , Srdjan M Stefanović  2   3 , Miloš N Milosavljević  4 , Vladimir S Janjić  5   6 , Marko M Folić  3   7 , Nevena D Folić  8   9 , Jovana Z Milosavljević  10
Affiliations

Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review

Ana V Pejčić et al. World J Psychiatry. .

Abstract

Background: Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy. Long-acting injectable (LAI) antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders, but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy.

Aim: To summarize relevant data on maternal, pregnancy, neonatal, and developmental outcomes from published cases of LAI antipsychotic use in pregnancy.

Methods: A literature search was performed through November 11, 2023, using three online databases: PubMed/MEDLINE, Scopus, and Web of Science. Case reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy, with available full texts, were included. Descriptive statistics, narrative summation, and tabulation of the extracted data were performed.

Results: A total of 19 publications satisfied the inclusion criteria: 3 case series, 15 case reports, and 1 conference abstract. They reported the outcomes of LAI antipsychotic use in 74 women and 77 pregnancies. The use of second-generation LAI antipsychotics was reported in the majority (n = 47; 61.0%) of pregnancies. First-generation LAI antipsychotics were administered during 30 pregnancies (39.0%). Most of the women (approximately 64%) had either satisfactory control of symptoms or no information about relapse, while approximately 12% of them had developed gestational diabetes mellitus. A minority of cases reported adverse outcomes such as stillbirth, spontaneous abortion, preterm birth, low birth weight, congenital anomalies, and neurological manifestations in newborns. However, there were no reports of negative long-term developmental outcomes.

Conclusion: Currently available data seem reassuring, but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.

Keywords: Antipsychotic agents; Long-acting injectable; Outcome; Pregnancy; Review.

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Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflict of interests for this article.

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References

    1. Kishimoto T, Hagi K, Nitta M, Leucht S, Olfson M, Kane JM, Correll CU. Effectiveness of Long-Acting Injectable vs Oral Antipsychotics in Patients With Schizophrenia: A Meta-analysis of Prospective and Retrospective Cohort Studies. Schizophr Bull. 2018;44:603–619. - PMC - PubMed
    1. Russu A, Savitz A, Mathews M, Gopal S, Feng Y, Samtani MN. Pharmacokinetic-Pharmacodynamic Characterization of Relapse Risk for Paliperidone Palmitate 1-Month and 3-Month Formulations. J Clin Psychopharmacol. 2019;39:567–574. - PubMed
    1. Taipale H, Mittendorfer-Rutz E, Alexanderson K, Majak M, Mehtälä J, Hoti F, Jedenius E, Enkusson D, Leval A, Sermon J, Tanskanen A, Tiihonen J. Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia. Schizophr Res. 2018;197:274–280. - PubMed
    1. Kishimoto T, Hagi K, Kurokawa S, Kane JM, Correll CU. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry. 2021;8:387–404. - PubMed
    1. Lin D, Thompson-Leduc P, Ghelerter I, Nguyen H, Lafeuille MH, Benson C, Mavros P, Lefebvre P. Real-World Evidence of the Clinical and Economic Impact of Long-Acting Injectable Versus Oral Antipsychotics Among Patients with Schizophrenia in the United States: A Systematic Review and Meta-Analysis. CNS Drugs. 2021;35:469–481. - PMC - PubMed