scholarly journals Major Congenital Malformations Associated With Exposure to Second-Generation Antipsychotic Drugs During Pregnancy

2021 ◽  
Vol 82 (5) ◽  
Author(s):  
Chittaranjan Andrade
Keyword(s):  
Congenital Malformations ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Second Generation Antipsychotic ◽  
Major Congenital Malformations

scholarly journals Second-generation antipsychotic use during pregnancy and risk of congenital malformations

2021 ◽  
Author(s):  
Maria Ellfolk ◽  
Maarit K. Leinonen ◽  
Mika Gissler ◽  
Sonja Kiuru-Kuhlefelt ◽  
Leena Saastamoinen ◽  
...  
Keyword(s):  
Congenital Malformations ◽  
Second Generation ◽  
First Trimester ◽  
Population Based ◽  
Birth Cohort Study ◽  
Sampling Frame ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Second Generation Antipsychotic ◽  
Major Congenital Malformations

Abstract Purpose To study if second-generation antipsychotic (S-GA) use during the first trimester of pregnancy is associated with an increased risk of major congenital malformations (MCM). Methods A population-based birth cohort study using national register data extracted from the Drugs and Pregnancy database in Finland, years 1996–2017. The sampling frame included 1,273,987 pregnant women. We included singleton pregnancies ending in live or stillbirth or termination of pregnancy due to severe malformation. Pregnancies with exposure to known teratogens were excluded. Women were categorized into three groups: exposed to S-GAs (n = 3478), exposed to first-generation antipsychotics (F-GAs) (n = 1030), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 22,540). We excluded genetic conditions and compared the prevalence of MCMs in S-GA users to the two comparison groups using multiple logistic regression models. Results Use of S-GAs during early pregnancy was not associated with an increased risk of overall MCMs compared to unexposed (adjusted odds ratio, OR 0.92; 95% CI 0.72–1.19) or to F-GA users (OR 0.82; 95% CI 0.56–1.20). Of individual S-GAs, olanzapine use was associated with an increased risk of overall MCMs (OR 2.12; 95% CI 1.19–3.76), and specifically, an increased risk of musculoskeletal malformations (OR 3.71; 95% CI 1.35–10.1) when compared to unexposed, while comparisons to F-GA users did not show significant results. Conclusions Olanzapine use is associated with an increased risk of major congenital malformations and specifically, musculoskeletal malformations. Use during pregnancy should be restricted to situations where no safer alternatives exist.

scholarly journals Comparative effectiveness of depot and oral second generation antipsychotic drugs in schizophrenia: A nationwide study in Hungary

2013 ◽  
Vol 23 (11) ◽  
pp. 1383-1390 ◽  
Author(s):  
István Bitter ◽  
Lajos Katona ◽  
János Zámbori ◽  
Péter Takács ◽  
László Fehér ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Nationwide Study ◽  
Second Generation Antipsychotic

Differential Impairments in Incentive Learning Caused by First‐ and Second‐ Generation Antipsychotic Drugs

2016 ◽  
Author(s):  
Matthew Florczynski
Keyword(s):  
Neural Control ◽  
First Generation ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Operant Chamber ◽  
Incentive Learning ◽  
Dopamine Receptor Antagonists ◽  
Natural Response ◽  
Second Generation Antipsychotic ◽  
First And Second Generation

Schizophrenia is a neuropsychiatric disorder characterized by increased function of dopamine in the brain.  Dopamine release is a natural response to reward.  It promotes incentive learning (IL), a process by which neutral stimuli acquire the ability to elicit approach and other responses.  A recent model characterizes dopamine‐mediated IL as a progressive process with early and late stages accompanied by a shift in neural control from the nucleus accumbens (NAc) to the dorsolateral striatum (DLS).  A parallel can be drawn to differences in regionally specific neural responses generated by first‐ and second‐generation antipsychotic drugs (APDs) used to treat schizophrenia.  APDs are dopamine receptor antagonists, but first‐generation APDs affect the NAc and DLS while second‐generation APDs affect primarily the NAc.  We compared the effects of APDs on IL. Rats (N = 48) were trained to press a lever forfood pellets in an operant chamber.  Intraperitoneal injections (1 hr before testing) of the first‐generation APD haloperidol (0,0.05,0.10,0.20 mg/kg) or of the second‐generation APD risperidone (0,0.20,0.40,0.80 mg/kg) induced dose‐dependent suppression of lever pressing on days 1‐4, with the highest dose groups failing to demonstrate any evidence of previous learning on day 5 when tested drug‐free.  On days 16‐20 haloperidol induced a day‐to‐day suppression not seen with risperidone.  The results suggest that the effects of first‐ and second‐generation APDs on learning processes putatively mediated by the NAc and DLS can be differentiated experimentally.  The findings imply that APDs may differentially affect IL inpatients with schizophrenia.  

4.  Differential Impairments in Incentive Learning Caused by First‐ and Second‐ Generation Antipsychotic Drugs

2016 ◽  
Author(s):  
Matthew Florczynski
Keyword(s):  
Neural Control ◽  
First Generation ◽  
Antipsychotic Drugs ◽  
Second Generation ◽  
Operant Chamber ◽  
Incentive Learning ◽  
Dopamine Receptor Antagonists ◽  
Natural Response ◽  
Second Generation Antipsychotic ◽  
First And Second Generation

Schizophrenia is a neuropsychiatric disorder characterized by increased function of dopamine in the brain.  Dopamine release is a natural response to reward.  It promotes incentive learning (IL), a process by which neutral stimuli acquire the ability to elicit approach and other responses.  A recent model characterizes dopamine‐mediated IL as a progressive process with early and late stages accompanied by a shift in neural control from the nucleus accumbens (NAc) to the dorsolateral striatum (DLS).  A parallel can be drawn to differences in regionally specific neural responses generated by first‐ and second‐generation antipsychotic drugs (APDs) used to treat schizophrenia.  APDs are dopamine receptor antagonists, but first‐generation APDs affect the NAc and DLS while second‐generation APDs affect primarily the NAc.  We compared the effects of APDs on IL. Rats (N = 48) were trained to press a lever for food pellets in an operant chamber.  Intraperitoneal injections (1 hr before testing) of the first‐generation APD haloperidol (0,0.05,0.10,0.20 mg/kg) or of the second‐generation APD risperidone (0,0.20,0.40,0.80 mg/kg) induced dose‐dependent suppression of lever pressing on days 1‐4, with the highest dose groups failing to demonstrate any evidence of previous learning on day 5 when tested drug‐free.  On days 16‐20, haloperidol induced a day‐to‐day suppression not seen with risperidone.  The results suggest that the effects of first‐ and second‐generation APDs on learning processes putatively mediated by the NAc and DLS can be differentiated experimentally.  The findings imply that APDs may differentially affect IL inpatients with schizophrenia.

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