Neonatal Withdrawal Reaction Following Maternal Antipsychotic Therapy During Pregnancy

Patient selection: neonate of a mother treated with haloperidol or other antipsychotic agent during the third trimester

Clinical features:

(1) onset of clinical findings shortly after birth

(2) subside within a few hours, or relief by administration of the antipsychotic agent given to the mother

(3) exclusion of other diagnoses that could explain the findings

Usually the diagnosis is simple if the maternal history is known, but it may be difficult if the woman presents in labor without prenatal care.

Clinical findings:

(1) extrapyramidal symptoms (dystonia, tremor, dyskinesia, etc)

(2) agitation

(3) somnolence

(4) respiratory distress

(5) feeding disorder

(6) hypotonia

Hair testing of the neonate may help to support the diagnosis.