Antipsychotics Safe During Pregnancy, After Corrective Algorithm

Rob Wipond
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Women taking antipsychotic medications have a “much higher” likelihood than other women of experiencing many different types of adverse events during pregnancy, according to a study in the British Medical Journal. However, after the researchers applied a “high dimensional propensity score” (HDPS) algorithm to their data, many of those differences disappeared and news media subsequently reported that antipsychotics are “safe” during pregnancy.

The researchers from Women’s College Hospital in Toronto examined data from several large health databases in Ontario, Canada, and searched for a number of possible adverse effects among pregnant women who’d taken antipsychotics between 2003-12. “The maternal and perinatal medical risks associated with antipsychotic drug use itself during pregnancy appear to be minimal,” said lead author Simone Vigod in a press release. Vigod described the findings to The Globe and Mail as “reassuring.”

In the study itself, the researchers wrote that, “Antipsychotic drug use in pregnancy did not substantially worsen maternal medical or short term perinatal outcomes in a cohort of women closely matched on baseline characteristics using a HDPS algorithm. The only exceptions were a slightly higher risk of labour induction and vaginal delivery among exposed pregnancies.”

They then added: “However, antipsychotic users had outcome event rates that were much higher than in the general population. This was true for the main maternal outcomes of the hypertensive disorders of pregnancy and venous thromboembolism, and for the main perinatal outcomes, including almost a 14% rate of preterm birth, about twice that in the general population. Although there were few events, the observed neonatal mortality rate of 1% was twice that of the general population.”

The researchers suggested that there must have been some other “factors” at work — other than antipsychotics — making antipsychotic users have consistently worse outcomes on every measure. The researchers did not suggest what those other “factors” might be. But in their use of the “high dimensional propensity score” algorithm, the authors explained that they tried to more closely match the antipsychotic users and controls, such as by trying to ensure that they matched for use of other psychotropics, and for pre-pregnancy use of psychotropics. The authors acknowledged that this may have affected their results since other psychotropics are believed to also have negative effects on pregnant women.

The study did not look specifically at possible negative short or long-term impacts on infants.

Vigod, Simone N., Tara Gomes, Andrew S. Wilton, Valerie H. Taylor, and Joel G. Ray. “Antipsychotic Drug Use in Pregnancy: High Dimensional, Propensity Matched, Population Based Cohort Study.” BMJ 350 (May 13, 2015): h2298. doi:10.1136/bmj.h2298. (Full text)

Antipsychotic drug use in pregnant women appears to pose minimal risk, new study suggests (Women’s College Hospital press release on MedicalXPress, May 13, 2015)

Antipsychotics shown safe for pregnant women and their babies (The Globe and Mail, May 13, 2015)

9 COMMENTS

  1. The psychiatric profession will do anything, it seems, to protect the reputation of their precious antipsychotics / neuroleptics – their “gold standard” treatment for their crown jewel of the fictitious DSM “mental illnesses,” schizophrenia.

    The neuroleptics, which actually cause the atrophy of the brain, previously thought to be proof schizophrenia was a “real” disease.

    https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=8&cad=rja&uact=8&ved=0CF8QFjAH&url=https%3A%2F%2Fwww.psychologytoday.com%2Fblog%2Fmad-in-america%2F201102%2Fandreasen-drops-bombshell-antipsychotics-shrink-the-brain&ei=49BdVbrZLMaCyQTh-YGoDQ&usg=AFQjCNE112ugbi4zF4c_6mJ5mWavxSg9kA&sig2=FfeA4WXS-y9Uf1hbWWQFTg&bvm=bv.93756505,d.aWw

    The neuroleptics, which actually cause both the positive and negative symptoms of schizophrenia, as well, via both the central symptoms of neuroleptic induced anticholinergic intoxication syndrome and neuroleptic induced deficit syndrome.

    “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to ‘improve’ what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”

    The “gold standard” treatment for schizophrenia is likely the cause of most schizophrenia.

  2. “Antipsychotics Safe During Pregnancy, After Corrective Algorithm”

    Here is a list of other things that are now safe after the corrective algorithm:

    1. sky-diving without a parachute
    2. driving a car at top speed going the opposite way on the highway
    3. putting your face in front of the pitching machine in batting cages
    4. befriending members of ISIS
    5. challenging Krav Maga experts to a fight
    6. taste testing different flavors of anthrax
    7. flying with Andreas Lubitz

  3. You have got to be kidding me.

    I just don’t even.

    How are people so irresponsible ? Taking that stuff while pregnant. I’m not a doctor but personally it blows my mind to even think people don’t attempt to get off that stuff for at least 2 years before getting pregnant.

  4. Wow, talk about manipulating the data! You have twice the prematurity rate and twice the neonatal death rate, but they are “safe” because other people exposed to different psychotropics at different times in their lives or pregnancies did just as badly? It is hard to imagine a more warped form of “logic!”

    I also thought it odd that they mentioned an increase “risk” of vaginal birth. Is a vaginal birth now considered a bad outcome?

    This is a marriage of the two most unscientific and corrupt disciplines in medicine: psychiatry and obstetrics. Both are expert at taking normal human processes and pathologizing them, and both chronically insist on intervening in situations in ways that predictably lead to worse outcomes. It is no surprise that they teamed up to come up with something sleazy and dishonest, but even I am shocked at the disingenuousness of this ridiculous approach!

    —- Steve

    • “VHT receives funding from Bristol-Myers Squibb for an investigator initiated study and has been a speaker for Astra-Zeneca, Bristol-Myers Squibb, Eli Lilly, and Lundbeck.”
      VHT = Valerie H Taylor, psychiatrist-in-chief; associate professor

      Btw, this journal seems to have a response section, maybe someone wants to contribute?