clozapine and Puerperal-Disorders

This article reviews the literature on the use of psychotropic drugs in pregnancy and lactation.. Medline search yielded more than five hundred titles. Articles were reviewed and ninety-one were selected for reference.. Fetal physiology and teratogenicity are discussed and the effects of specific drugs on the fetus and newborn are presented. When possible, recommendations for use or non-use are presented.. Though no controlled studies have ever been done in pregnant women to truly prove their safety, it appears that most, but not all, current psychotropic drugs appear fairly safe for use in pregnancy.

Topics: Clozapine; Embryonic and Fetal Development; Female; Fluoxetine; Humans; Lactation; Lithium; Mental Disorders; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Psychotropic Drugs; Puerperal Disorders

Three schizophrenic patients and one schizophreniform patient, all experiencing puerperal psychosis, required a drug-induced delactation (bromocriptine) simultaneously to neuroleptic treatment. Taking into account the pharmacodynamic effects, an exacerbation of symptoms following bromocriptine (a D-2 receptor agonist) and an impairment of delactation following neuroleptic treatment (bringing about the blockade of D-2 receptors) are to be expected. In three cases, we carried out a combined bromocriptine-haloperidol treatment and, in one case, a bromocriptine-clozapine treatment. The above mentioned complications were not observed in any of the cases. The problems which may result from using clozapine during the puerperal period are also discussed.

Topics: Adult; Antipsychotic Agents; Bromocriptine; Chronic Disease; Clozapine; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Haloperidol; Humans; Lactation; Psychotic Disorders; Puerperal Disorders; Schizophrenia; Schizophrenic Psychology

Clozapine is an atypical neuroleptic drug characterised by specific pharmacological properties and clinical side effects, which are different from those observed with conventional neuroleptics such as drugs of the phenothiazine or butyrophenone classes. This report suggests a new clinical indication for clozapine, based on its negligible influence on plasma prolactin levels: the pharmacotherapy of schizophrenic psychoses in the post-partum period and in patients suffering from acute mastitis.

Topics: Adult; Clozapine; Dose-Response Relationship, Drug; Female; Humans; Mastitis; Puerperal Disorders; Schizophrenia; Schizophrenia, Paranoid; Schizophrenic Psychology

Topics: Adult; Clozapine; Female; Humans; Lactation; Mastitis; Paranoid Disorders; Puerperal Disorders

Topics: Adult; Clozapine; Dibenzazepines; Drug Therapy, Combination; Female; Humans; Neuroleptic Malignant Syndrome; Puerperal Disorders; Referral and Consultation; Respiratory Insufficiency; Schizophrenia, Catatonic