Quick Hits: Antipsychotics & Pregnancy + Preemies & Antibiotics

Antipsychotics & Pregnancy + Preemies & Antibiotics
Antipsychotics & Pregnancy + Preemies & Antibiotics
Last updated:

Women Prescribed Antipsychotics During Pregnancy May Have an Increased Risk of Developing Gestational Diabetes

Women prescribed certain antipsychotics during pregnancy may have an increased risk of developing gestational diabetes, according to a study published in The American Journal of Psychiatry. Researchers looked at 1,543,334 nondiabetic pregnant women who were enrolled in Medicaid between 2000 and 2010. These women received at least one antipsychotic medication during the 3 months before pregnancy. Among the 1.5 million pregnancies, 1,924 were taking aripiprazole (Abilify), 673 ziprasidone (Geodon, Zeldox, Zipwell), 4,533 quetiapine (Seroquel), 1,824 risperidone (Risperdal) and 1,425 olanzapine (Zyprexa). The results, which were presented at the Annual Meeting of the American Psychiatric Association in May, indicated that 2 of the 5 antipsychotic medications were associated with an increased risk for gestational diabetes. Women continuing to take quetiapine had a 28% increased risk, while the continuation of olanzapine led to a 61% increased risk of the disease. The other antipsychotics analyzed — aripiprazole, ziprasidone and risperidone — did not elevate the risk of gestational diabetes. Those who continued the medication had a wider absolute risk range for the condition (4.2%-12.0%) compared to those who stopped using the medication altogether (3.8%-4.7%). Posted May 8, 2018. Via The American Journal of Psychiatry.

Novel Enzyme Therapy to Treat PKU (Phenylketonuria)

The FDA has approved a novel enzyme therapy to treat PKU. Patients suffering from PKU (phenylketonuria), a rare but serious genetic disease, are unable to break down an amino acid known as phenylalanine (Phe). Phe is found in protein-containing foods and sweeteners. This disorder affects around 1 in 10,000 to 15,000 people in the US, and can lead to serious intellectual, developmental and psychiatric disabilities if left untreated. Palynziq (pegvaliase-pqpz) is an enzyme substitution therapy to help break down Phe. After evaluating the safety and efficacy of Palynziq in clinical trials, researchers identified the most common side effects, which include injection site reactions, joint pain, nausea, dizziness, abdominal pain and hypersensitivity reactions, just to name a few. A black-box warning was also added to the drug’s label, indicating that it was associated with anaphylaxis — which frequently occurred “during upward titration of the dose within the first year of treatment.” Posted May 24, 2018. Via FDA.

Preemies Being Exposed to Antibiotics Can Potentially Increase the Risk of Death

The vast majority of preemies are being exposed to antibiotics without showing clear signs of an infection, which can potentially increase the risk of death, according to a new study published in JAMA Network Open. Despite concerns that early administration of antibiotics can lead to poor outcomes, many doctors continue to give preemies antibiotics shortly after birth, before testing whether an infection is present. Approximately 1 in 90 very-low-birth weight (VLBW) infants develop early-onset sepsis, which is a life-threatening infection — up to 50% of infected babies born between 22 and 24 weeks die from it. However, doctors may be administering antibiotics for too long without detection of sepsis. Researchers analyzed more than 40,000 VLBW infants who survived for at least 1 day, including 12,947 extremely-low-birth-rate (ELBW) infants, between 2009 and 2015. Of those, almost 80% of VLBW infants were exposed to early antibiotic treatment, while 87% of ELBW infants possibly received unnecessary exposure. There was a “statistically significant” decrease in the rate of prolonged antibiotic duration over time for VLBW infants, but not for ELBW infants. Posted May 25, 2018. Via JAMA Network Open.