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(Date of issue: March 2018, Version: 3)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on quetiapine use in pregnancy is available at


Quetiapine is an atypical antipsychotic used in the treatment of schizophrenia, bipolar disorder, other psychoses and major depressive disorder.

The considerable data regarding first trimester exposure to quetiapine does not suggest an overall increased risk of congenital malformation. More limited data does not support an association between quetiapine exposure and small for gestational age or preterm delivery. A single study has suggested an increased risk of spontaneous abortion, while no studies have investigated the risk of intrauterine death following in utero exposure to quetiapine specifically. Studies of antipsychotics as a class have presented conflicting findings for all of these outcomes.

Use of antipsychotics throughout pregnancy or near delivery has been associated with withdrawal symptoms in the neonate and/or poor neonatal adaptation syndrome (PNAS). These symptoms may vary in severity and duration but are likely to be more severe in infants exposed in utero to more than one CNS-acting drug. Three studies have reported higher rates of symptoms for quetiapine exposure in comparison to other antipsychotics. Delivery should be planned in a unit with facilities to monitor exposed neonates.

Metabolic effects have been reported with atypical antipsychotic use in the non-pregnant population, raising theoretical concerns regarding effects on maternal and fetal weight and glycaemic control in pregnancy. Meta-analyses have consistently found non-significant increased risks of large for gestational age among antipsychotic-exposed infants, therefore additional maternal, fetal and neonatal monitoring may be prudent until further data becomes available.

It is important to ensure that maternal mental health is treated appropriately. Where a patient is stabilised on quetiapine, either prior to conception or during pregnancy, the risk of discontinuing or changing medication, or reducing the dose, should be carefully weighed against the risk of relapse of the maternal condition. Where clinically appropriate, clinicians are encouraged to discuss the advantages and disadvantages of continued quetiapine use during pregnancy with the patient. Where the benefit of continued treatment is considered to outweigh any potential or known risks, quetiapine may be prescribed for use in pregnancy.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from or to ensure you are using the most up-to-date version.