Can you take Abilify while pregnant?

Abilify (aripiprazole) is an atypical antipsychotic used for schizophrenia, bipolar disorder, major depression, irritability in autism, and Tourette’s syndrome. If you become pregnant or plan to, discuss risks and benefits with your provider. Sudden discontinuation may worsen symptoms.

Miscarriage risk

Evidence is mixed. One small study suggested higher miscarriage rates, but larger studies have not shown a clear increase. Untreated mental illness itself can also raise miscarriage risk.

Birth defect risk

The baseline risk of birth defects is 3–5% in any pregnancy. Multiple studies of aripiprazole exposure during pregnancy found no significant rise in congenital malformations.

Other pregnancy complications

• Low birth weight or preterm delivery have been reported but may reflect underlying illness
• Possible higher rates of gestational diabetes, especially with weight‑gain–promoting antipsychotics
• Third‑trimester exposure can lead to newborn withdrawal signs (jitteriness, feeding or breathing difficulties), which are generally short‑lived

Pregnancy registry

There is a National Pregnancy Registry for Atypical Antipsychotics. Patients and providers are encouraged to enroll to track outcomes.

Breastfeeding

Aripiprazole appears in breast milk at low levels. Most breastfed infants tolerate it without issue, though milk supply may decrease. Monitor infants for sedation or feeding difficulties.

Fertility

Women on antipsychotics may have reduced fertility due to higher prolactin levels, but aripiprazole has a lower risk of prolactin elevation than many others.

Sources

• Galbally et al., J Affect Disord. 2018 Oct;238:593-596.
• Andrade C., J Clin Psychiatry. 2021;82(5).
• Habermann et al., J Clin Psychopharmacol. 2013;33(4):453-462.
• Freeman et al., Arch Womens Ment Health. 2021;24:659–667.
• Lutz et al., J Clin Psychopharmacol. 2010;30(2):205.