Does Taking Antipsychotic Medication During Pregnancy Affect Child Development?

What you need to know

• Taking antipsychotic medications during pregnancy does not appear to significantly increase children’s risk of developing ADHD or autism
• The underlying mental health conditions that require antipsychotic treatment are more strongly linked to children’s neurodevelopmental outcomes than the medications themselves
• Women who need antipsychotic medications during pregnancy can be reassured about their long-term safety for child development

The Growing Use of Antipsychotics During Pregnancy

When Sarah found out she was pregnant, one of her first concerns was about her bipolar medication. Like many expectant mothers managing serious mental health conditions, she worried about how her antipsychotic prescription might affect her baby’s development. This common concern has grown as antipsychotic medications are increasingly prescribed not just for conditions like schizophrenia and bipolar disorder, but also for anxiety, depression, insomnia and other conditions.

What the Research Shows

This groundbreaking study examined over 4 million births across five Nordic countries, following children for an average of 10 years. Among these children, about 15,500 were exposed to antipsychotic medications before birth. The researchers looked specifically at whether these children had higher rates of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).

Initially, the data showed slightly higher rates of these conditions in children exposed to antipsychotics. However, once the researchers accounted for other factors - particularly the mother’s underlying mental health conditions - they found little to no increased risk associated with the medications themselves.

Separating Medication Effects from Underlying Conditions

The study used several clever methods to tease apart the effects of the medications from the conditions they treat. For instance, they compared:

• Children exposed to antipsychotics during pregnancy versus those whose mothers stopped taking them before pregnancy
• Siblings where one was exposed to antipsychotics before birth and the other wasn’t
• Children whose mothers had conditions like schizophrenia or bipolar disorder but didn’t take antipsychotics

These comparisons consistently showed that the mother’s mental health condition was more strongly linked to neurodevelopmental outcomes than medication use.

Types and Timing of Medication

The researchers also examined whether different types of antipsychotics or timing of use during pregnancy made a difference. They found:

• Similar results whether medications were taken early or late in pregnancy
• No major differences between older (“typical”) and newer (“atypical”) antipsychotics
• Some suggestion of slightly higher risk with newer antipsychotics for autism, though this needs further study

What This Means for You

If you’re pregnant or planning pregnancy and take antipsychotic medication, these findings offer reassurance. The study suggests that:

• Continuing needed antipsychotic medication during pregnancy likely poses little risk to child neurodevelopment
• The benefits of treating serious mental health conditions during pregnancy may outweigh potential risks
• Decisions about medication should be individualized and made in consultation with healthcare providers
• Good mental health care during pregnancy remains important for both mother and child

Conclusions

• The study found no clear evidence that antipsychotic medications during pregnancy increase children’s risk of developing ADHD or autism
• A mother’s underlying mental health conditions appear more influential for child development than the medications used to treat them
• Women requiring antipsychotic medications during pregnancy can be reassured about their long-term safety for child development, while maintaining close consultation with their healthcare providers