A 30-year-old woman is 9 weeks pregnant. She has schizophrenia and has remained well for 3 years while taking oral aripiprazole monotherapy. On two

Question

A 30-year-old woman is 9 weeks pregnant. She has schizophrenia and has remained well for 3 years while taking oral aripiprazole monotherapy. On two previous occasions, stopping antipsychotic medication was followed by a severe psychotic relapse requiring admission. She wishes to continue the pregnancy and asks about her medication. Which management plan best accords with current NICE guidance?

Accepted Answer

Continue aripiprazole after shared risk–benefit discussion, with perinatal input, weight monitoring and gestational-diabetes screening including an oral glucose tolerance test

Answer

Continue aripiprazole after shared risk–benefit discussion, but omit additional gestational-diabetes screening unless hyperglycaemic symptoms develop

Answer

Cross-taper to quetiapine because it has more pregnancy exposure data, with perinatal input, weight monitoring and an oral glucose tolerance test

Answer

Cross-taper to lithium because it has more pregnancy exposure data, with perinatal input, serum-level monitoring and fetal cardiac assessment

Answer

Gradually discontinue aripiprazole, offer psychological treatment, and restart medication only if psychotic symptoms recur

Antipsychotics in Pregnancy — MRCPsych Paper B MCQ