Assessing the Effects of Antipsychotics on Parenting

Context: Mental health professionals interact with substantial numbers of parents, mainly mothers, who suffer from severe mental disorders and who are treated, acutely or chronically, with antipsychotic medication. The behavior of these clients is affected by their primary illness but also by many other factors, including their drug regimen. The treating team, however, does not always recognize that a drug can profoundly impact cognition and behavior. The aim of this paper is to inform non-medical mental health workers how antipsychotic medication (AP) can influence client cognition and behavior, and thereby impact the safety of the client’s children. Indirectly, APs can also affect the immediate and longer-term behavior of the children.
Evidence Acquisition: This article qualitatively reviews the very sparse literature on antipsychotic effects on cognition and behavior in populations of mentally ill mothers of young children. This narrative review includes case illustrations taken from a clinic for women with psychotic disorders. Also included are references to studies of rodent maternal behavior, as influenced by antipsychotic drugs.
Animal studies have shown that maternal behavior in rodents is impaired by antipsychotic drugs. In humans, drug effects such as sedation, dizziness, indicated thinking, tardive dyskinesia, increased appetite, and sleepwalking, as well as client beliefs about and attitudes toward their drugs, can affect their problem solving, decision-making, and behavior and, thus, play a critical role in child custody determinations. Behavior induced by drugs includes issues of tolerance, withdrawal, and sensitization. Importantly, there are major safety concerns related to APs.
Listening attentively when clients speak about their drugs and understanding potential drug effects help mental health professionals increase their therapeutic efficacy and make sound decisions about clients and their children.