Symptoms Of Schizophrenia And Bipolar Disorder

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Introduction & Background information:
Antipsychotics are primarily used to manage the symptoms of psychosis, particularly schizophrenia and bipolar disorder by blocking D2 receptors in the dopamine pathway of the brain. There are two main types of antipsychotics; typical antipsychotics, also known as the first generation antipsychotics (FGA) which were developed in 1950s, example of medicine in this category include Chloropromazine, Haloperidol, Flupenthixol, and Loxapine. Atypical antipsychotics, also referred as second generational antipsychotics (SGA) which acts as an antagonist for 5HT2A receptor aside from its blocking effect on D2 receptor, drugs in this class include Olanzapine, Quetiapine, Risperidone, Clozapine and Aripiprazole.
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Psychosis such as schizophrenia and bipolar disorder if left untreated during pregnancy is found to be associated with unfavourable pregnancy outcomes such as low birth weight, neonatal hypoglycemia, congenital defects, and adverse neurodevelopmental result.1 Furthermore, women with schizophrenia and bipolar disorder might suffer from antepartum hemorrhage during delivery and there are many other complications associated with these serious mental illnesses.1 Hence, after the assessment between risk and benefits associated with this condition, many patients are prescribed with either FGA or SGA during pregnancy. Survey found that 76% of the women with psychosis were exposed to SGAs throughout pregnancy, 7 and of the SGAs that were prescribed, Quetiapine was the most frequently given one with Risperidone, Piprazole and Ziprasidone appearing in declining order.3 It is found that SGA prescription has increased from 0% in 1990 to 78% in 2005, also, there are approximately 3-4000 pregnancies exposed to antipsychotics every year in United Kingdom.6 Due to the inclining number of atypical antipsychotic prescription to pregnant women, the effect of SGA on pregnancy outcome has been closely monitored and studied by number of research groups. It is found that antipsychotic use during pregnancy might lead to unfavourable pregnancy outcomes, such as Caesarian delivery, low & high birth weights, prematurity, preterm birth, neonatal withdrwal and abnormal muscle movement and
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