Dear Editor: With the introduction of atypical antipsychotics, it was predicted that the incidence of hyperprolactinemia-induced infertility problems would decrease. However, the use of atypical antipsychotics during pregnancy is an area with more questions than answers. We present a case wherein clozapine therapy was continued successfully over 2 consecutive pregnancies. case Report MK, aged 25 years and a housewife of rural background, was premorbidly well adjusted, with a family history of depression. She had an acute-onset 7-year continuous illness precipitated by the death of her father. The illness was characterized by auditory hallucinations (that is, commenting and commanding), tac tile hallucinations, passivity phenomenon, aggression, negative symptoms, and disturbed biofunctions. There was no history suggestive of depression or mania, substance abuse, or head injury. During this period, treatment tolerance or resistance was seen with various antipsychotics (that is, chlorpromazine, haloperidol, trifluperazine, and risperidone). Hence, clozapine was initiated after baseline investigations up to 400 mg daily. With 8 months of treatment, significant improvement in psychopathology and functioning occurred, with associated weight gain of 10 kg. Over the next 3 years, clozapine was gradually reduced to 200 mg daily with no reemergence of positive symptoms but persistence of negative symptoms. MK was married in early 2001 and continued to take clozapine. She was informed about the risk of congenital malformations with antipsychotics and was advised to use contraception. However, she conceived after 6 months of marriage and continued with the pregnancy and with clozapine. Venereal Disease Research Laboratory Slide Test (VDRL), HIV, and hepatitis B surface antigen titers were negative during the first trimester, and there was no evidence of congenital malformations during antenatal ultrasonography on repeat occasions. Hemoglobin was 9.6 gram percent at the 10th week of pregnancy; folic acid and iron supplements were initiated at 10 and 16 weeks, respectively. Pregnancy-induced hypertension (PIH) was detected at the 38th week and was monitored. At the beginning of the 39th week, a 3-kg boy was delivered by episiotomy, with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. The postnatal period was uneventful, with normal developmental growth until age 20 months. Eight months after the first delivery, the patient reconceived and continued the pregnancy while on clozapine 100 mg daily. PIH occurred at 30 weeks and was managed with methyldopate hydrochloride 1500 mg daily. At 39 weeks, a 2.8-kg girl in breech presentation was delivered by elective cesarean section. …