Can I take quetiapine while pregnant or breastfeeding?

8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to atypical antipsychotics, including quetiapine, during pregnancy. Healthcare providers are encouraged to register patients by contacting the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or online at http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/. Risk Summary Neonates exposed to antipsychotic drugs (including quetiapine) during the third trimester are at risk for extrapyramidal and/or withdrawal symptoms following delivery (see CLINICAL CONSIDERATIONS ). Overall available data from published epidemiologic studies of pregnant women exposed to quetiapine have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes (see Data). There are risks to the mother associated with untreated schizophrenia, bipolar I, or major depressive disorder, and with exposure to antipsychotics, including quetiapine, during pregnancy ( see CLINICAL CONSIDERATIONS ) .

Prescribing label, section “8.1 Pregnancy” (opening excerpt): Quetiapine fumarate (oral), Preferred Pharmaceuticals Inc. Read the full section on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.

Maternal quetiapine doses of up to 400 mg daily produce doses in milk that are less than 1% of the maternal weight-adjusted dosage. Limited long-term follow-up of infants exposed to quetiapine indicates that infants generally developed normally. A safety scoring system finds quetiapine to be possible to use during breastfeeding.[1] Systematic reviews of second-generation antipsychotics concluded that quetiapine seemed to be the first- or second-choice agent during breastfeeding.[2-4] Monitor the infant for drowsiness and developmental milestones, especially if other antipsychotics are used concurrently. Cases of galactorrhea and milk ejection in non-nursing women have been reported rarely.

“Summary of Use during Lactation”, LactMed record “Quetiapine” (LM233), quoted verbatim. Everything LactMed reports about Quetiapine while breastfeeding.

8.2 Lactation Risk Summary Limited data from published literature report the presence of quetiapine in human breast milk at relative infant dose of <1% of the maternal weight-adjusted dosage. There are no consistent adverse events that have been reported in infants exposed to quetiapine through breast milk. There is no information on the effects of quetiapine on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for quetiapine and any potential adverse effects on the breastfed child from quetiapine or from the mother's underlying condition.

Prescribing label, section “8.2 Lactation”: Quetiapine fumarate (oral), Preferred Pharmaceuticals Inc. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.