The goal of this observational study is to learn about how long-acting injectable antipsychotic (LAIA) medications are affected by the changes that take place in the body during pregnancy, and how much an unborn baby is exposed to. The investigators are also interested in the amount of these drugs that enters into breastmilk and taken by babies during breastfeeding. In addition to their regular clinic visits to receive long-acting mental health medicine injection, participants will be invited for up to four study visits between day 2 and 14 after the injection. This will happen only once during pregnancy, and once during the breastfeeding period to collect a few drops of blood on special filter paper card from the finger using safety lancet. A few drops of breastmilk will also be collected. Immediately after delivery, a few drops of blood will be collected from the mother, umbilical cord and the baby heel. The investigators will use these samples to determine the amount of the drug in the body during pregnancy and compare this to the amount during the breastfeeding period. Additionally, every month during the third trimester, and during the first 3 months postpartum, participants will complete a questionnaire (using the Liverpool University Neuroleptic Side Effect Scale) to document how they are feeling. Clinical improvement will be documented by the primary care provider using the Clinical Global Impressions Scale. Findings from this study are expected to help healthcare providers to understand these drugs better so that they can make informed decisions about if and how to use these drugs in women who become pregnant or are breastfeeding.
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Minimum plasma drug concentration (Cmin) during pregnancy and postpartum
Timeframe: During gestation weeks 33-36 and weeks 9-12 weeks postpartum
Minimum breastmilk drug concentration (Cmin)
Timeframe: During weeks 9-12 weeks postpartum
Maximum plasma drug concentration (Cmin) during pregnancy and postpartum
Timeframe: During gestation weeks 33-36 and weeks 9-12 weeks postpartum
Maximum breastmilk drug concentration (Cmin)
Timeframe: During weeks 9-12 weeks postpartum
Area under the plasma concentration-time curve (AUC)
Timeframe: During gestation weeks 33-36 and weeks 9-12 weeks postpartum
Area under the breastmilk concentration-time curve (AUC)
Timeframe: During weeks 9-12 weeks postpartum
Breastfed infant to maternal plasma LAIA concentration ratio
Timeframe: During weeks 9-12 weeks postpartum
Newborn to maternal plasma LAIA concentration ratio
Timeframe: As soon as possible after delivery