While a 2016 study found that antipsychotic medications taken during pregnancy do not necessarily lead to birth defects, a new study by the same researcher has discovered that expectant mothers who take opioid painkillers on top of antipsychotic prescription drugs run a moderate to high risk of giving birth to babies going through withdrawal.
According to the findings, babies born to women taking opioids while on prescriptions for depression are up to 60 percent more likely to suffer from neonatal drug withdrawal than those whose mothers took only anti-depressants.
This recent study, published in the current British Medical Journal, builds on earlier research published in the April 2015 issue of Pediatrics, linking prescription opioid use with neonatal abstinence syndrome (NAS), a set of conditions that can cause tremors, convulsions, fever, lack of appetite and diarrhea. The risk can be twice as high when a pregnant woman is taking two or more antipsychotic medications.
In 2012 (the most recent year for which data is available), an opioid-addicted baby was born in the U.S. an average of every 25 minutes according to data from DrugAbuse.gov – a 400% increase from just over a decade earlier. That problem has only gotten worse.
Dr. Krista Huybrechts of the Harvard Medical School, author of the current study, blames the medical profession for part of the problem. “These findings indicate that clinicians should be cautious in prescribing these medications together in late pregnancy and in prescribing psychotropic medications to women with known or suspected illicit opioid use,” she says.
One of Huybrecht's colleagues, pediatrician Dr. Stephen Patrick of Vanderbilt University, notes the dramatic increase in opioid use across the nation. He said, “that expansion has included an increase in prescribing to pregnant women.” That includes not only antipsychotics and opioid analgesics, but antibiotics and other prescription medications as well. “We have to make sure that when we prescribe medications that they are necessary and appropriate for what we are treating,” he said.
One problem is the fact that in many cases, patients who suffer from mental health issues also experience physical pain. Huybrechts says in such cases, infant exposure to these kinds of drug combinations may be unavoidable. She adds that in such cases, “the findings may help to assess the level of risk among exposed infants and to rethink treatment for infants born to women who were prescribed multiple drugs during their pregnancy.”
Significantly, the highest risk of NAS was not found among women who had been prescribed atypical antipsychotics such as Abilify and Haldol, but rather more commonly-prescribed medications such as Valium – which are far more likely to be prescribed in combination with other drugs. Nonetheless, Dr. Paul Jarris, chief medical officer for the March of Dimes, advises his colleagues to be vigilant, recommending that all expectant mothers be screened regularly for narcotic use. In particular, he stresses the “need to focus on opioids and other medicines that are often prescribed at the same time.”