• As a general principle, exposure to pharmaceutical products during pregnancy should be kept to the strict minimum necessary |
• Aripiprazole should only be initiated or maintained in women planning a pregnancy, or who find themselves pregnant, after a careful evaluation of the benefits and risks of treatment |
• This evaluation should be multidisciplinary, including the psychiatrist, obstetrician, midwife, general practitioner, and involving the patient herself and any carers or peer support persons |
• Treatment during pregnancy may be envisaged if the patient is well-controlled with aripiprazole, or has responded to this antipsychotic during a previous episode, or if there is an important identified risk of side effects with alternative treatment options |
• In women who are currently well-controlled on an appropriate dose of aripiprazole and who are planning a pregnancy or find themselves pregnant, and in the absence of any identified risks, treatment can be continued |
• In patients treated with the depot formulation of aripiprazole, a switch to the oral formulation is not generally necessary |
• In a well-controlled patient, dose adjustment is not generally justified |
• With appropriate monitoring, treatment can be continued right up to delivery |
• The new-born infant should be assessed carefully for any residual drug effects after delivery |
• Given the long elimination half-life of aripiprazole (75 to 146 h), there is a risk of accumulation in breast-fed infants; for this reason, breast-feeding with aripiprazole is not recommended |