Nonpharmacological intervention for schizophrenia

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Maxwell Discussion Post-Interventions for Schizophrenia in Pregnant Women

The use of antipsychotics for a pregnant woman involves balancing the potential risks to the fetus with the benefit of decreased psychotic symptoms. Antipsychotic medications are becoming more frequently prescribed to women who are pregnant and there is a growing body of research on their effects on pregnancy and infant outcomes (Betcher et al., 2019). Currently, the FDA approved drug Olanzapine (Zyprexa), has not been associated with any increased congenital malformation if taken during pregnancy (Betcher et al., 2019). However, some studies on Olanzapine have suggested an increased chance of preterm delivery or gestational diabetes, but it is unknown whether this is due to the medication or pregnancy complications from mental illness (Mother To Baby, 2024). The benefits of Olanzapine during pregnancy appear to outweigh its risks, however, as untreated psychotic symptoms are a risk factor and may harm the fetus due to disorganized behavior and poor self-care (Jenkins, 2013).

An off-label drug, Lurasidone (Latuda), is a favorable choice during pregnancy due to its lower metabolic side effect profile. Lurasidone is considered a weight-neutral medication and is not expected to increase the risk of gestational diabetes when compared to Olanzapine (Betcher et al., 2019). Studies have also found no specific patterns of increased congenital malformation when the mother is taking Latuda during pregnancy (Mother To Baby, 2024). However, there have been no studies on the risks of preterm delivery or other pregnancy-related problems. In addition, there is an increased risk of temporary withdrawal symptoms in the newborn that manifest as excessive somnolence, alterations in muscle tone, and difficulty feeding (Mother To Baby, 2024). In most cases, it is recommended that women who have been taking an antipsychotic continue their current regimen during pregnancy to prevent symptom remission. Only one second generation antipsychotic, Risperidone (Risperdal), is not a first-line choice during pregnancy due to studies showing possible, increased risk of congenital malformations (Betcher et al., 2019).

One nonpharmacological intervention for schizophrenia in pregnant women is cognitive behavioral therapy (CBT). CBT is non-invasive and has low risk during pregnancy as it involves psychological interventions. CBT has been shown to reduce stress, increase coping skills, and decrease both positive and negative symptoms of schizophrenia (Kart et al., 2021). CBT is a useful, adjunct therapy with pharmacological interventions in the treatment and management of psychotic symptoms.

Reference no: EM133873601

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