Atypical antipsychotic (clozapine) self‐poisoning in late pregnancy presenting with absent fetal heart rate variability without acidosis and delayed peristalsis in the newborn baby: A case report

Novikova, Natalya; Chitnis, Meenali M.; Linder, Verena; Hofmeyr, G Justus

doi:10.1111/j.1479-828x.2009.01017.x

Cited by 11 publications

(4 citation statements)

References 4 publications

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“…We must point out that our mean plasma neonatal concentration of clozapine was lower than that estimated by Moreno-Bruna et al ( 2012 ). In the literature there are two cases of neonatal delayed peristalsis after maternal acute clozapine intoxication in late pregnancy in two women that were not receiving regular clozapine treatment (Kłys et al, 2007 ; Novikova et al, 2009 ). In the first case, the baby died after 3 h and the woman was saved.…”

Section: Discussionmentioning

confidence: 99%

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

et al. 2018

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The current prescription of clozapine in psychotic women of reproductive age makes it crucial to understand its pharmacokinetics during pregnancy and lactation as well as its risk profile for neonatal outcome. The aim of this case series was to provide new evidence on the pharmacokinetic features of clozapine that determine its passage through the placenta and amniotic fluid, as well as the neonatal clozapine elimination half-life (t1/2). This case series demonstrates for the first time that clozapine might show partial placental passage similar to other atypical antipsychotics. Clozapine levels decreased during the first few days in nursing infants. The half-life of clozapine in neonates was slightly higher than previously estimated. Clozapine use in pregnancy may be associated with diabetes mellitus, especially if there is a family history of this disease. Although no acute toxicological effects were observed in the intrauterine exposed newborn, close follow-up of pregnancy is recommended. However, these results must be taken with caution being a case series with small sample size

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Section: Discussionmentioning

confidence: 99%

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

et al. 2018

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“…Yogev et al [1] rapportent un cas dans lequel ceci était mis en évidence seulement pendant le travail avec une surveillance foetale par SBM, et évaluation néonatale sans particularité. Novikova et al [6] relatent le cas d'une patiente présentant des troubles hémodynamiques suite à une intoxication volontaire à la clozapine, césarisée en urgence pour suspicion d'asphyxie foetale devant l'absence de variabilité du RCF, avec pH de naissance à 7,19 et score d'Apgar à 7 à 5 min, suggérant une acidose minime alors que le RCF était de type pré-mortem. A posteriori, ce phénomène était imputé à l'effet de la clozapine sur le système nerveux autonome (SNA) foetal plutôt que sur une acidose secondaire à l'hypo-perfusion placentaire.…”

Section: Discussionunclassified

Absence de variabilité du rythme cardiaque fœtal chez les fœtus exposés in utero à la clozapine

Coston

Hoffmann

Equy

et al. 2012

Gynécologie Obstétrique & Fertilité

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“…Clozapine overdose during pregnancy has also been shown to lead to fatal poisoning in the newborn[ 200 ] and to be associated with absent fetal heart rate variability and delayed peristalsis in the newborn. [ 201 ]…”

Section: Effects Of Psychotropics: Pregnancy and Lactationmentioning

confidence: 99%

Mood stabilizers in pregnancy and lactation

Grover

2015

Indian J Psychiatry

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Management of bipolar during pregnancy and postpartum is very challenging. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. The choice of drug should depend on the balance between safety and efficacy profile. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. During lactation, use of valproate and LTG is reported to be safe. Use of typical and/atypical antipsychotic is a good option during pregnancy in women with bipolar disorder.

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Atypical antipsychotic (clozapine) self‐poisoning in late pregnancy presenting with absent fetal heart rate variability without acidosis and delayed peristalsis in the newborn baby: A case report

Cited by 11 publications

References 4 publications

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

Clozapine Use During Pregnancy and Lactation: A Case-Series Report

Absence de variabilité du rythme cardiaque fœtal chez les fœtus exposés in utero à la clozapine

Mood stabilizers in pregnancy and lactation

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