Sex, pregnancy & antipsychotics

Taking antipsychotics can affect sexual activity. It is also important to be aware of effects if you are pregnant or breastfeeding.

Sex

Antipsychotics can lower sex drive and may increase prolactin levels, causing periods to stop in women, and a lack of libido, breast enlargement and the production of breast milk in both men and women. You may find it harder to get aroused and men may have particular problems with erection and ejaculation.

If you are experiencing any of the above problems you should contact your doctor. They may reduce the dose or stop the drug in question.

People with psychosis are less able to develop good psychosexual relationships and, for some, treatment with an antipsychotic can improve sexual functioning. However, sexual dysfunction has been reported as a side-effect of all antipsychotics, and up to 45% of people taking typical antipsychotics experience sexual dysfunction. Whether you will be affected varies with the individual and all the effects are reversible.

Pregnancy

Although the data is patchy it is assumed that there is only a small risk of complications if you take typical drugs during pregnancy. Data relating to atypical antipsychotics are now appearing. The use of clozapine and olanzapine appear not to increase the risk of malformation to the child, although gestational diabetes (and neonatal seizures with clozapine) may be more likely to occur. Very limited data suggest neither quetiapine nor risperidone are associated with malformations in the foetus.

Women wishing to get pregnant who take antipsychotic medication are advised to discuss a planned pregnancy as soon as possible. Such women, particularly if they have suffered repeated relapses, are best maintained on antipsychotics during and after pregnancy. Research has found that newborn babies may experience withdrawal symptoms from antipsychotic drugs including crying, agitation, and increased suckling.
Pregnancy & mental illness

Breastfeeding

There are no published controlled studies on the safety of psychotropic medication during breast feeding. The Maudsley (medication experts) recommends that as far as possible, the same medication used during pregnancy should be continued during breast feeding, at the lowest effective dose. More than one antipsychotic should not be taken at a time. The Maudsley recommend sulpiride for the least effect on the baby while breast feeding.