Increasing use of atypical antipsychotics and anticonvulsants during pregnancy

Epstein R.A., Bobo W.V., Shelton R.C., Arbogast P.G., Morrow J.A., Cooper W.O. Increasing use of atypical antipsychotics and anticonvulsants during pregnancy. Pharmacoepidemiology and Drug Safety (in press).

The use of psychotropic medications during pregnancy has the potential of causing birth defects or other adverse pregnancy outcomes. Across a range of diagnoses, pregnant women in the Tennessee State Medicaid (TennCare) database were treated with atypical (newer) antipsychotics and anticonvulsants with increasing frequency from 1985 to 2005. The use of lithium and typical (older) antipsychotics declined.

The changes in prescribing patterns for pregnant women are reviewed, showing that certain medications have increased in use, including some like anticonvulsants that are linked to birth defects. This paper may increase awareness about prescribing patterns for pregnant women.

Highlighted is an issue of increasing use of certain drugs like the anticonvulsants that are associated with birth defects and others (atypical antipsychotics) that are associated with out adverse outcomes for pregnant women. Ideally, this paper will impact psychiatric practice by sensitizing clinicians to prescribing patterns.