Antipsychotics

Antipsychotics during pregnancy and breastfeeding 

This page covers: 

• What are the risks and benefits of taking antipsychotics while pregnant or breastfeeding?
• What can I do to feel more in control? 
• Further support during pregnancy and breastfeeding

What are the risks and benefits of taking antipsychotics while pregnant or breastfeeding? 

There is not much evidence about exactly how safe it is to take antipsychotics during pregnancy or while breastfeeding. But there are some known risks to taking antipsychotics during this time: 

• Risks to your developing baby in the first three months of your pregnancy (first trimester). All drugs carry higher risks during this period, when your developing baby is most vulnerable. 
• Possible effects on your baby in the final three months of your pregnancy (third trimester). For example, there’s a risk that your baby may experience a temporary muscle disorder if you take antipsychotics in the third trimester. All risks become higher in the last few weeks of pregnancy, when your baby becomes more vulnerable again. 
• Gestational diabetes and excessive weight gain. Some research suggests that taking antipsychotics can make you more likely to put on weight and to develop diabetes. Gestational diabetes is a type of diabetes that starts during pregnancy. Your healthcare team should monitor for any signs of gestational diabetes while you are pregnant. 
• If you are breastfeeding, antipsychotics can be passed to your baby through your breast milk. Your baby could experience some side effects from the medication because of this. 
• Speak to your doctor or psychiatrist if you want to breastfeed and stay on your medication. They can let you know how serious the risks are with the antipsychotic you are taking. If the risk is low, you might feel that the advantages of breastfeeding whilst taking your medication outweigh any risks. But with certain antipsychotics, for example clozapine, they are likely to advise that you do not breastfeed. 
• Drugs are not usually clinically tested on anyone who is pregnant. There is not much evidence about how safe it is to take antipsychotics during pregnancy. Newer drugs carry a  higher ‘unknown’ risk than drugs that have been around longer. This is because scientists have had less time to gather evidence about them. 

There can also be benefits to taking antipsychotics during this time: 

• You might already be taking antipsychotics when you become pregnant. You may feel concerned about becoming unwell or unable to cope if you stop taking antipsychotics. This may mean you decide that the best thing for you and your baby is to continue taking them, so you are well enough to care for your baby. 
• Or you may be offered antipsychotics to help treat a problem you develop during or shortly after pregnancy, such as postpartum psychosis. 

Your doctor or psychiatrist can help you balance the possible risks to your baby against any potential harm in not taking your medication. This is to help you come to your own decision about what’s best for you. But it is understandable to feel unsure about this, and you might find it helpful to seek further support during this time.

What can I do to feel more in control? 

Being pregnant can sometimes feel like you’re giving up control of your own body. This can be stressful, but there are lots of positive steps you can take: 

• Planning your pregnancy gives you more options early on. But it is also a common experience to find out you’re pregnant without planning it. Whatever your situation is, it’s important to remember that you have the same rights as everyone else. This includes your right to choose whether or not to take medication, and to have your say in decisions about your treatment. 
• Talk to a healthcare professional as early on as you can. This could be with your doctor or obstetrician/midwife, or a mental health specialist such as a psychiatrist. The earlier you start talking to someone about your options, the more in control you’re likely to feel. For planned pregnancies, you should do this as soon as you decide you want to start trying to get pregnant. For unplanned pregnancies, you should speak to them as soon as you think you might be pregnant. 
• Seek extra support, to talk through your options and decide what’s right for you. 
• If you decide to stay on your medication, ask your doctor or psychiatrist how you can reduce potential risks. For example, you may be able to manage your symptoms more effectively on a  reduced dose. 
• If you decide to come off your medication, make sure you do it safely. See our pages on coming off medication for more information. And see our page on alternatives to antipsychotics for information about other treatment and support options for your mental health. 

Further support during pregnancy and breastfeeding 

Coming to a decision you feel comfortable with about what’s right for you and your baby can be difficult. It’s understandable if you feel conflicted or unsure about what to do. 

As well as talking to your doctor or psychiatrist, you might find these support options helpful: 

• Talk to someone you trust. it can help to talk through your feelings with someone like a partner or close friend.
• Obstetrician/Midwife appointments. You can talk to your obstetrician/midwife about how you’re feeling throughout your pregnancy. They can also help make sure you receive plenty of support from your health visitor after you give birth. 
• Perinatal mental health services. These services offer support to help you stay well during your pregnancy. You can be referred to these services by other professionals involved in  your care, such as your doctor
• Online peer support. It can be helpful to talk to other people who’ve had similar experiences to yours.
• Specialist websites. (UK-based) websites such as Action on Postpartum Psychosis, NCT and the Breastfeeding Network can provide information and support on pregnancy, breastfeeding and mental health. 

You might also find it helpful to read our pages on parenting with a mental health problem. These pages include information on taking care of yourself, looking after your children, and other kinds of support available to parents. Our information on perinatal mental health problems may also help.