More than 50% of pregnancies in the United States are unplanned (10), and many women become pregnant while taking medications. Clinicians working with chronically mentally ill women should keep in mind their relatively high incidence of unprotected sex and inadequate use of contraception (11). For women who do not wish to conceive, it is wise to provide education about methods of contraception and to inquire about recent missed menstrual periods. Adequate contraception has become particularly important following the widespread use of the "atypical" antipsychotic medications (e.g., olanzapine, quetiapine) that, unlike the older antipsychotic agents, do not raise prolactin levels and therefore do not interfere with women's ability to conceive.
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