Quetiapine and Pregnancy

Ms. A, a 38-year-old woman, had been treated for a diagnosis of schizophrenia (paranoid type) since 1998. After a period of outpatient treatment with zuclopenthixol, which resulted in insufficient response, her medication had been changed to quetiapine, 300 mg/day. She was not taking any other medications. After the change in medication, her symptom profile showed considerable improvement. Ms. A’s pregnancy was discovered at week 17, when she reported amenorrhea. A consultation with a gynecologist resulted in a diagnosis of an intact pregnancy, with no complications at that stage. She had been taking quetiapine when her child was conceived.

At the 20th week of pregnancy, Ms. A’s dose of quetiapine was reduced to 200 mg b.i.d.; from week 22, she was taking only 150 mg b.i.d. because her symptoms had improved significantly. She had no side effects from quetiapine during treatment. Ms. A was in remission during her pregnancy, and at week 38, she gave birth to a healthy boy. The newborn’s weight was 3120 g, his height was 48 cm, his Apgar score in the first minute was 9, and at 5 minutes it was 10. Because Ms. A continued taking her medication, breast-feeding was not introduced. Five days after delivery, Ms. A and her newborn were discharged from the hospital. Since that time both Ms. A and her son have been without any neuropsychiatric or perinatal complications. The son’s development was intact during the first 6 months of his life.