Abilify During Pregnancy & Breastfeeding
Mental illness is a sensitive subject. In many cases, the patient finds a drug regimen that works for them, and they go on about their lives. Other times, taking a second look at the patient's medication list becomes necessary, such as when a patient on psychotropic drugs becomes pregnant. When this occurs, physicians use a benefit to risk ratio to determine which course of action will be safest for mother and child.
Aripiprazole has been ranked in the pregnancy category C by the Food and Drug Administration, meaning sufficient studies have not been done to determine the extent of damage the medication may cause to an unborn fetus.
Pregnant mothers should only use Abilify during pregnancy if the benefits of the medication to the mother greatly outweigh any potential risk to the unborn baby. Physicians will often result to other, safer means of treating pregnant women during pregnancy and fall back to Abilify after the baby has been born. Aripiprazole has been proven to pass into breast milk; nursing mothers should either stop breastfeeding during treatment or discuss different medications with their doctors.
The official patient prescription safety information issued by Abilify's maker, Bristol-Myers Squibb, states the drug is in Pregnancy Category 3, meaning animal studies in rabbits and rats were positive for potential toxicity. In these animal offspring, there were instances of decreased body weight, undescended testicles, delay in fetal development, hernia and reproductive problems in the affected offspring. There was no effect on the survival rate of the offspring. Rats treated with 30 times the recommended human dose did show slightly higher rates of stillbirth. These findings mean it just isn't clear whether Abilify is safe for use in pregnancy. The company website emphatically states, "Do not use Abilify if you are pregnant." Most doctors advise using the drug only if the potential benefit justifies the potential risk to the fetus.
In the same patient prescription safety information, the company states that the drug could be passed to the baby through breastfeeding. They recommend women on Abilify not breastfeed.
According to several authoritative reports, OB/GYN doctors have said that the risk of complications for the fetus exist primarily during the third trimester and should be avoided at that time. There are several other sites that purport OB/GYNs are most opposed to Abilify use in the first trimester, due to the risk of malformation in the unborn child during developmentally sensitive periods of growth. All sources familiar with the issue seem to agree that women on Abilify should not breastfeed, stating the two are absolutely contraindicated.
In the case of certain mental illnesses, such as Schizophrenia, oftentimes the benefit will exceed the risk to the baby. Schizophrenic pregnant women who decide to cease taking medication for their condition often pose other risks to their pregnancy, and therefore are advised to continue taking their prescription. In other cases where Abilify is utilized as a booster for other drugs, such as those for depression, the condition most likely would not worsen by stopping the drug, making the risk not worth the benefit.
The only way to ensure the safest course of treatment in pregnancy is by having a frank conversation with an OB/GYN about treatment goals. Together, the patient and her doctor can map out the path that is safest for both mother and child.