Maternal Haloperidol Therapy Associated With Dyskinesia in a Newborn

Kristine O. Collins; Joyce B. Comer

Disclosures

Am J Health Syst Pharm. 2003;60(21) 

In This Article

Introduction

The use of antipsychotic medications in pregnancy poses a dilemma for patients and practitioners. The patient's need for the medication to maintain a stable psychiatric state during the pregnancy must be balanced with the paucity of data regarding the teratogenicity and fetal effects of the antipsychotic. Although children of schizophrenic mothers have a higher rate of perinatal death than matched subjects, there appears to be no association between the use of neuroleptic drugs and perinatal death.[1] The data are not conclusive but suggest a slight teratogenic risk from exposure to low-potency antipsychotics in the first trimester, although no specific organ malformation has been identified. The data for higher potency antipsychotics and atypical antipsychotics are limited and fail to show a conclusive trend.[1,2]

Case reports have shown adverse effects in near-term newborns who were exposed to neuroleptics, including rare cases of neonatal jaundice, functional bowel obstruction, and dyskinesias.[1] Extrapyramidal symptoms (EPS) in newborns may include tremor, difficulty in feeding, torticollis, abnormal movements, and increased muscle tone. Haloperidol, chlorpromazine, fluphenazine, and fluphenazine with chlorpromazine have been reported to cause dyskinesias in infants. The onset of these symptoms was reported from 24 hours to four weeks after delivery, raising the question of whether the symptoms may be attributable to withdrawal dyskinesia rather than EPS. These symptoms continued for eight days up to six months, and the patients received no treatment or were treated with diphenhydramine or phenobarbital.[3,4,5,6,7]

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