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Dopamine Partial Agonists in Pregnancy and Lactation: A Systematic Review
Alexia Koukopoulos1, Delfina Janiri2,3, Miriam Milintenda2,3
1Department of Life Science, Health, and Health Professions, Link Campus University, 00165 Rome, Italy.
Pharmaceuticals (Basel, Switzerland)
|July 30, 2025
Summary
Dopamine partial agonists like aripiprazole, brexpiprazole, and cariprazine appear safe for pregnant women. However, these antipsychotic medications should be avoided during breastfeeding due to potential risks to the infant.
Area of Science:
- Psychiatry
- Pharmacology
- Reproductive Health
Background:
- Dopamine partial agonists (aripiprazole, brexpiprazole, cariprazine) are used for schizophrenia and mood disorders.
- The decision to continue or discontinue antipsychotic treatment during pregnancy is complex.
- Maternal and infant safety during pregnancy and postpartum (including breastfeeding) is critical.
Purpose of the Study:
- To investigate the safety and use of dopamine partial agonists during pregnancy and lactation.
- To evaluate the risks versus benefits of treating psychiatric disorders during these sensitive periods.
Main Methods:
- Systematic review of literature published up to June 23, 2025.
- Searches conducted on PubMed, CINAHL, PsycInfo, Scopus, and ClinicalTrials.gov.
- Inclusion of case reports and clinical studies, adhering to PRISMA guidelines.
Main Results:
- 386 results were identified; 24 case reports/series and 15 studies were included.
- Most studies indicated no adverse pregnancy outcomes associated with dopamine partial agonists.
- Significant concerns were raised regarding the use of these agents during lactation.
Conclusions:
- Dopamine partial agonists seem safe for use during pregnancy.
- Avoidance of dopamine partial agonists during breastfeeding is recommended.
- Further research may be needed to clarify long-term effects and optimal management strategies.
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