Pharmacopsychiatry 2004; 37(6): 303-304
DOI: 10.1055/s-2004-832689
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Clozapine and Pregnancy

A Case HistoryH. Karakuła1 , K. Szajer1 , B. Śpila1 , A. Grzywa1 , M. Chuchra1
  • 1Dept. of Psychiatry, Medical University of Lublin, Lublin, Poland
Further Information

Publication History

Received: 15.4.2003 Revised: 11.9.2003

Accepted: 21.1.2004

Publication Date:
19 November 2004 (online)

Introduction

According to the FDA, clozapine [1] is listed in category B [4], which includes drugs for which there is a lack of evidence about its teratogenic effects in humans. In the opinion of some investigators, the use of clozapine during pregnancy is connected with the potential risk of birth defects (category C), for example retinopathy [8] and toxic effects of a newborn: seizures and withdrawal phenomenon [9], gastroesophageal reflux [2], neonatal risk of clozapine-induced agranulocytosis [7] and risk of ”floppy infant syndrome” [3]. Based on the report of the Novartis it can be confirmed that clozapine is not a major teratogen [4].

References

  • 1 Adler G, Grieshaber S, Faude V, Thebaldi B, Dressing H. Clozapine in Patients with Chronic Schizophrenia: Serum Level, EEG and Memory Performance.  Pharmacopsychiatry. 2002;  35 190-194
  • 2 Baker R, Chengappa K NR. Gastroesophageal Reflux as a Possible Result Of Clozapine Treatment.  Am J Psychiatry. 1998;  59 257
  • 3 Barnas C h, Bergant A, Hummer M, Saria A, Fleischhacker W W. Clozapine Concentrations in Maternal and Fetal Plasma, Amniotic Fluid, and Breast Milk.  Am J Psychiatry. 1994;  151 945
  • 4 Bazire S. Psychotropic Drug Directory. Quay Books Division Salisbury; 2002
  • 5 Cannon M, Jones P B, Murray R M. Obstetric Complications and Schizophrenia: Historical and Meta-Analytic Review.  Am J Psychiatry. 2002;  159 1080-1092
  • 6 Patton S W, Misri S, Korral M R, Perry K F, Kuan A J. Antipsychotic Medication During Pregnancy and Lactation in Women With Schizophrenia: Evaluating the Risk.  Can J Psychiatry. 2002;  47 959-965
  • 7 Pinkofsky H, Fitz-Gerald M, Reeves R. Psychotropic Treatment During Pregnancy.  Am J Psychiatry. 1997;  154 718-719
  • 8 Rzewuska M. Leczenie zaburzeá psychicznych. PZWL Warszawa; 2000
  • 9 Stoner S, Sommi R, Marken P, Anya I, Vaughn J. Clozapine Use in Two Full-Term Pregnancies.  Am J Psychiatry. 1997;  58 364-365
  • 10 Wahlbeck K, Forsen T, Osmond C, Barker D JP, Eriksson J. Association of Schizophrenia With Low Maternal Body Mass Index, Small Size at Birth and Thinness During Childhood.  Arch Gen Psychiatry. 2001;  58 48-52

H. Karakula, M.D., PhD.

Department of Psychiatry

Medical University of Lublin

Ul. Kurantowa 4 m. 117

20-836 Lublin

Poland

Email: karakulahw@poczta.onet.pl