Pregnancy and postpartum period (perinatal period) are not protective in terms of schizophrenia, contrarily perinatal period may lead to an exacerbation of symptoms of a patient in remission. Cessation of existing treatment or attempt to replace a currently effective antipsychotic drug during pregnancy increases exacerbation risk even more. Patients who stopped their antipsychotic drug treatment have 2–three-fold increased possible recurrence risk compared to continuation of treatment and in sudden drug withdrawals have increased risk of recurrence compared to gradual withdrawals. According to our current knowledge, psychotic relapse ratio of patients with schizophrenia is higher during early postpartum period (mostly seen at first 3 months after birth) rather than pregnancy. Acute psychotic exacerbation of schizophrenia related to leaving the pharmacological treatment or stress factors at the postpartum period has a risk of harm to the baby. Choosing an antipsychotic drug for the treatment of a woman diagnosed with schizophrenia during the perinatal period requires a holistic approach in order to maximize both the maternal and child’s physical and mental well-being. Each treatment option should therefore be thoroughly discussed and the decision should be based on balancing the benefits and risks, with considerations for patient preference and other patient factors.