engleski

Influence of pharmacokinetic features of long acting injectable aripiprazole in pregnancy

Introduction: There is still not enough data about safety of aripiprazole in pregnancy and it should be used only if the potential benefit outweighs the potential risk for the fetus. Steady-state of long acting injectable (LAI) aripiprazole is reached after the fourth monthly injection of aripiprazole. Elimination half time of 400 mg aripiprazole after steady state is 46.5 days. Objectives: To evaluate the clinical outcomes of pregnant patient who was treated with 400 mg of LAI aripiprazole for one year until unplanned pregnancy happened and to emphasize the importance of atipical antipsychotics' pharmacokinetics with the intention to help clinicians facing complex treatment decisions in pregnancy. Methods: A case report and a review of literature. Results: Female patient with schizophrenia treated with LAI aripriprazole for over a year found out that she was pregnant one month after her last LAI application. The decision was to discontinue LAI treatment and switch it to clozapine. But, taking into account the pharmacokinetics of LAI aripiprazole, clozapine was initiated after three months, which is the time for elimination and effectiveness of LAI aripiprazole. During that period and after starting with clozapine no relapse of the disease was registered nor there were signs of fetal malformations so far. Also, according to available literature, this was the first reported case of treatment with LAI aripiprazole in pregnancy. Conclusions: In some cases, use of atipical antipsychotics cannot be avoided during pregnancy. To prevent polypragmasy which can harm fetus, it is necessary to know their pharmacodinamics and pharmacokinetics.

aripiprazole ; longinjectable antipsychotics ; pregnancy

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