Treatment of schizophrenia during pregnancy and breastfeeding, as well as treatment of schizophrenia in children, may encounter special difficulties and requires a lot of knowledge and a consideration of the benefits and losses resulting from it each time. It should be remembered that the treatment of schizophrenia is important because thanks to it it is possible to free the patient from experienced psychotic symptoms, but also to improve his functioning in everyday life. What are the general principles of treating schizophrenia in pregnancy? Is it safe? And how should the treatment of children with schizophrenia look like?

  • Treatment of schizophrenia in pregnant women
  • Treatment of schizophrenia in lactating women
  • Treatment of schizophrenia in children and adolescents
  • Treatment of schizophrenia in pregnancy and in children: the role of psychotherapy

Treatment of schizophrenia in pregnancyandwhile breastfeedingas well astreatment of schizophrenia in childrenrequires special attention. In general, the treatment of schizophrenia is a rather complex aspect and often associated with various problems, in some specific groups of patients, the treatment of this chronic mental disorder is associated with additional difficulties. These groups of patients with schizophrenia include pregnant patients and children.

Treatment of schizophrenia in pregnant women

Patients diagnosed with schizophrenia - like women who do not suffer from this mental illness - may simply want to have children. However, in the case of women suffering from schizophrenia, it is also noted that in this group, unplanned conception of a child occurs more often than in he althy people.

A mother suffering from schizophrenia has the opportunity to get pregnant and give birth to a he althy child - however, treatment of schizophrenia in pregnancy involves many different dilemmas and difficulties.

Pregnancy is the period in which future mothers are given various medications only when necessary.

Doctors advising pregnant women to choose any pharmacological treatment very carefully - after all, they must take into account the potential risks for the fetus associated with taking medications by the mother.

In the case of basic drugs used in the treatment of schizophrenia - drugsantipsychotics - none of them belongs to the category A according to the FDA, i.e. the one in which there are preparations with the lowest risk of adversely affecting the developing child.

In pregnant patients with schizophrenia, the management depends on, inter alia, on their current mental state and the course of the disease - the treatment of schizophrenia in pregnancy is different in a patient who has been struggling with this disease for many years, and differently in the case of a new diagnosis of psychotic disorders.

In a situation where schizophrenia in a woman has been treated for many years, and the mental state of the patient is normalized, it is possible to consider even a complete discontinuation of drugs. However, it should be clearly emphasized here that in such a situation there is always a risk that the psychotic symptoms will recur.

Therefore, it is necessary to analyze all the benefits of discontinuing pharmacotherapy (such as the elimination of the risk of damage to the fetus), as well as the associated risks (recurrence of schizophrenia symptoms may, for example, lead to the fact that the mother neglects both herself and herself). and necessary visits to the gynecologist during pregnancy).

When the symptoms of schizophrenia appear in a patient for the first time during pregnancy, it also becomes necessary to carefully consider what treatment to offer to such a patient.

It should be analyzed whether it would be possible to improve the patient's mental state by means of methods of treating schizophrenia other than pharmacotherapy (we are talking here primarily about psychotherapeutic interactions).

Due to the risk of recurrence of schizophrenia, some specialists believe that pregnant women should still use antipsychotics. However, this therapy should be carried out in accordance with certain assumptions:

  • in the first trimester of pregnancy - if there is such a possibility (e.g. in the case of low intensity of psychotic symptoms) - the administration of antipsychotic drugs should be avoided at all
  • in patients who used chronic neuroleptics before pregnancy, the dose of drugs should be adjusted to the lowest that will be effective
  • Antipsychotics should be administered in divided doses during pregnancy, it is not recommended to use depot preparations (prolonged-release agents allow you to reduce the frequency of taking medications, however, it is not possible to quickly change their dosage - for this reason pregnancy, they should not be used)
  • the patient should be under the constant care of a psychiatrist -there are various changes during pregnancy (such as a change in body weight or changes in metabolic rate), which may lead to the need to modify the doses of drugs
  • in the postpartum period, the patient's condition should be closely monitored - due to the relatively high risk of psychosis recurrence after childbirth, it may be necessary to increase the dose of psychotropic drugs immediately after delivery

Treatment of schizophrenia in lactating women

Problems with treating schizophrenia in pregnancy also appear after its resolution. We are talking about breastfeeding by women taking antipsychotic drugs, as well as the need for special care for a newborn whose mother used neuroleptics during pregnancy.

These measures to a different degree, but still get into the breast milk. For this reason, it is necessary to consult a doctor whether natural breastfeeding will be possible with the use of neuroleptics.

It depends to a large extent on what specific antipsychotic drug the woman is taking - in some cases, breastfeeding will be strongly discouraged, while in others it may turn out that the child can be breastfed, but it is necessary then it will be very careful to observe their condition (e.g. whether the child is becoming excessively sleepy).

In the case of pregnancies during which mothers took antipsychotic drugs, newborns require vigilant observation afterwards.

This is due to the fact that the consequence of the use of neuroleptics by a pregnant woman are various problems, among which there are e.g.

  • sucking reflex disorder
  • increased tearfulness
  • increased muscle tension
  • breathing disorders

In the literature, you can also find information that the result of the mother taking neuroleptics during pregnancy is sometimes a low birth weight of the child.

Treatment of schizophrenia in children and adolescents

Schizophrenia is a chronic disease in which many years of treatment are often required. This unit, although much less frequently than in adulthood, may also begin in the early years of life.

Schizophrenia in children is associated with various problems - they concern, for example, educational aspects and the relationship of a sick child with other people, but also these problems are related to the treatment of schizophrenia in children.

In general, the treatment of schizophrenia in patients from a younger age group does not differ from that which is implemented in adults - the mainstay of treatmentfor schizophrenia in children and adolescents is the use of antipsychotic drugs.

Pharmacotherapy, however, is usually required for a very long time, putting patients at increased risk of developing neuroleptic side effects.

These can be, for example, weight gain or disturbances in carbohydrate metabolism, but also cardiological problems (e.g. arrhythmias) or a significant reduction in the amount of one of the white blood cells (a condition called granulocytopenia).

Long-term therapy with antipsychotics also increases the risk of extrapyramidal symptoms - examples include restlessness, excessive muscle stiffness or the appearance of uncontrolled muscle contractions.

Due to the above-mentioned risks, children treated for schizophrenia require regular visits not only to psychiatrists, but also to paediatricians - they require regular blood tests.

However, before the treatment of schizophrenia in a child is started, the specialist first carefully analyzes which specific antipsychotic drug to recommend to the patient - it is important to choose the agent that will be the safest for a given patient (for example, an obese child will not be prescribed a neuroleptic that can lead to for weight gain).

Treatment of schizophrenia in pregnancy and in children: the role of psychotherapy

Just as pharmacotherapy of schizophrenia can lead to various problems, the same is true of psychotherapy. This is why a large aspect of the treatment of schizophrenia, whether in pregnant or children, is directed towards psychotherapeutic interactions.

These will not harm the developing fetus in the womb, they will not lead to metabolic disorders in the child, and at the same time may significantly improve the mental state of a person suffering from schizophrenia.

Read also:

  • Schizophrenia: causes, symptoms, treatment
  • Schizophrenia in children: symptoms, causes, treatment and prognosis
  • Inheriting schizophrenia - are genes related to schizophrenia?
  • Catatonic Schizophrenia: Causes, Symptoms, and Treatment
  • Paranoid Schizophrenia: Causes, Symptoms, and Treatment

Category:

Psychiatry