Drugs in pregnancy and schizophrenia

Title: Drugs in pregnancy and schizophrenia.


The risk of developing schizophrenia is known to be connected to a family history of the condition. However, some studies have also shown that, if the mother had flu during pregnancy, the risk of the child later suffering from schizophrenia may be increased.


But this raises the question: is it caused by the infection or the medicine she might have taken to help with the symptoms? In Copenhagen, a group of over 8000 children has been followed-up, and their mothers asked about medication taken in pregnancy. This study looked at analgesics (pain-relieving drugs) which, like aspirin, are also used to bring down fever, and are sometimes used in combination with other drugs such a phenacetin.1 The study showed that taking analgesics in the second trimester (at three to six months into pregnancy) was associated with an increased risk of schizophrenia – in fact, a fourfold greater risk. This persisted even after they allowed for other risk factors, such as a family history of the illness. The second period is the time when the immature brain is particularly sensitive. Earlier information from the same study has shown that malformation of the fetus is more common when women have taken analgesics in pregnancy. However, the group of mothers who took analgesics was also more likely to have taken mood-changing drugs, so this might suggest that they were more likely to have psychiatric problems. This study did not find a significant association between viral infections in pregnancy and schizophrenia risk in children, but it does not exclude a possible association because, as a study, it is too small. Only 15 mothers had had viral infections and taken analgesics. When mothers took diuretics (agents that increase the flow of urine) in the final three months of pregnancy, this was also associated with an increased risk of schizophrenia developing later in the child.

The highest apparent risk of all was seen with children whose mothers were treated with morphine or opioid analgesics, but there were so few of these that it was more likely to be a chance finding. These were usually mothers who had undergone surgery during pregnancy.

AIMS comments
This is an important study. We don’t know a single mother who doesn’t worry about taking medicines during pregnancy and, often, the professionals they ask for advice are woefully ignorant or – even worse – don’t bother to check before handing out prescriptions. We have been carefully watching a succession of studies showing an association between viral infections in pregnancy (particularly flu) and schizophrenia risk. However, because once a mother has caught the flu there’s little that can be done about it, worrying isn’t going to help. Nevertheless, if it is the painkillers they take rather than the flu itself, then we do have a choice – and mothers need to know.

Reference: Holger J et al. Association between prenatal exposure to analgesics and risk of schizophrenia. Br J Psychiatry, 2004; 185: 366-718




Any views or opinions expressed are solely those of the author and do not represent those of The Federation of Antenatal Educators (FEDANT) unless specifically stated.

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