Antidepressants in Pregnancy: A Review of Commonly Prescribed Medications

Patil, Avinash; Kuller, Jeffrey A.; Rhee, Eleanor

doi:10.1097/ogx.0b013e31823e0cbf

Cited by 33 publications

(19 citation statements)

References 69 publications

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“…6 The presence of comorbid conditions during pregnancy often requires additional health care visits, and certain comorbidities, including obesity, type 2 diabetes, hypertension, osteoarthritis, and malignancies, increase the risk of neonatal death. [7][8][9][10][11] These conditions can also increase the average cost of prenatal care and lead to significantly more Caesarean deliveries. 12,13 The cost burden of comorbidities during pregnancy and childbirth has not been well documented.…”

Section: Introductionmentioning

confidence: 99%

The Additional Cost Burden of Preexisting Medical Conditions During Pregnancy and Childbirth

Law

McCoy

Lynen

et al. 2015

Journal of Women's Health

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Section: Introductionmentioning

confidence: 99%

The Additional Cost Burden of Preexisting Medical Conditions During Pregnancy and Childbirth

Law

McCoy

Lynen

et al. 2015

Journal of Women's Health

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“…El tratamiento adecuado de la depresión durante el embarazo es de gran importancia para la salud materna, fetal y neonatal. 2 El grupo de antidepresivos más recetado son los inhibidores selectivos de la recaptación de serotonina (ISRS), incluso en las embarazadas. 3 El uso de ISRS, en especial la paroxetina, la fluoxetina y la sertralina, durante el tercer trimestre del embarazo podría causar síndrome de abstinencia neonatal (SAN).…”

Section: Síndrome De Abstinencia Neonatal Debido a Exposición Prenataunclassified

Síndrome de abstinencia neonatal debido a exposición prenatal al citalopram: a propósito de un caso

Erol¹,

Ozean²,

Çelik³

et al. 2017

Arch Argent Pediat

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RESUMENEl síndrome de abstinencia neonatal (SAN) debido a la exposición prenatal al citalopram se desarrolla durante los primeros días de vida, incluso con una exposición al fármaco en dosis bajas. El tratamiento de apoyo es la primera opción, aunque puede usarse el fenobarbital en el tratamiento de este síndrome. No debe interrumpirse la lactancia. Debe hacerse un seguimiento de estos recién nacidos para establecer el desenlace del SAN y las consecuencias en el desarrollo neurológico. En este artículo presentamos el caso de un recién nacido con SAN debido a exposición al citalopram en una dosis más baja que lo informado previamente en la bibliografía durante los últimos seis meses del embarazo. Se utilizó el fenobarbital debido al fracaso del tratamiento no farmacológico. INTRODUCCIÓNLos trastornos psiquiátricos, como la depresión mayor, la ansiedad y el trastorno obsesivo compulsivo, son frecuentes durante el embarazo y después de este. En un estudio de importancia realizado en los Estados Unidos se mostró una prevalencia del 13% de trastornos de ansiedad y del estado de ánimo en las embarazadas o Síndrome de abstinencia neonatal debido a exposición prenatal al citalopram: a propósito de un casoNeonatal abstinence syndrome due to prenatally citalopram exposure: A case report puérperas.1 En general se usan antidepresivos para tratar estos trastornos. El tratamiento adecuado de la depresión durante el embarazo es de gran importancia para la salud materna, fetal y neonatal.2 El grupo de antidepresivos más recetado son los inhibidores selectivos de la recaptación de serotonina (ISRS), incluso en las embarazadas. 3El uso de ISRS, en especial la paroxetina, la fluoxetina y la sertralina, durante el tercer trimestre del embarazo podría causar síndrome de abstinencia neonatal (SAN). Este síndrome t a m b i é n s e d e n o m i n a m a l a a d a p t a c i ó n neonatal. 4 Entre sus síntomas se incluyen nerviosismo, convulsiones, llanto anormal, trastornos alimentarios, dificultad respiratoria e hipoglucemia.5 En este artículo presentamos el caso de un recién nacido con SAN debido a exposición al citalopram durante los últimos seis meses del embarazo. A propósito de un casoUn bebé de sexo masculino nació por cesárea a las 36 semanas de gestación, con un peso de 3010 gramos, una longitud de 50 cm y un perímetro cefálico de 33 cm. La madre tenía 40 años, había recibido atención prenatal adecuada y tenía antecedentes de depresión mayor. Había recibido citalopram 10 mg/día desde los últimos dos trimestres del embarazo en adelante. Al nacer, los puntajes de Apgar del recién nacido fueron 8, 9 y 10 en el minuto 1, 5 y 10. Se hospitalizó al paciente en la unidad de cuidados intensivos neonatales debido a dificultad respiratoria en la primera hora después del nacimiento. Al ingreso tenía taquipnea con una frecuencia respiratoria de 68 respiraciones por minuto con tiraje subcostal e intercostal. El hemograma completo, la gasometría, la glucemia y los electrolitos séricos, incluida la concentración de calcio y magnesio, y la radi...

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“…While extensive research related to teratogenesis and neonatal outcomes has been undertaken,1 there is relatively few data related to maternal obstetrical outcomes. Research from other specialties suggests that serotonin reuptake inhibitors (SSRIs) may be associated with increased risk of hospitalisation for bleeding and acute upper gastrointestinal bleeding 2 3.…”

Section: Contextmentioning

confidence: 99%

Late pregnancy use of selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors is associated with increased risk of postpartum haemorrhage

Ananth

Friedman

2013

Evid Based Nurs

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Late pregnancy use of selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors is associated with increased risk of postpartum haemorrhage Commentary on: Palmsten K, Hernández-Díaz S, Huybrechts KF, et al. Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the USA. BMJ 2013;347:f4877. Implications for research and practice▪ Use of antidepressant medication is associated with increased risk for postpartum haemorrhage (PPH).▪ Further research is needed to establish a causal role between antidepressant medication use and PPH.▪ Clinicians should be aware of possible increased risk of postpartum haemorrhage when treating depression during pregnancy. ContextAntidepressant medications are commonly used to manage psychiatric conditions in pregnancy. While extensive research related to teratogenesis and neonatal outcomes has been undertaken, 1 there is relatively few data related to maternal obstetrical outcomes. Research from other specialties suggests that serotonin reuptake inhibitors (SSRIs) may be associated with increased risk of hospitalisation for bleeding and acute upper gastrointestinal bleeding. 2 3 Prior research on antidepressants and obstetric haemorrhage is limited. 4 5 Palmsten and colleagues set out to determine whether antidepressant medication use is associated with increased risk for PPH. MethodsThis retrospective cohort evaluated 106 000 pregnant women from 2000 to 2007 with a diagnosis of mood or anxiety disorder. Using pharmacy dispensing data, women were classified based on whether they were prescribed antidepressant medications currently or had used them recently or in the past. Antidepressants were classified based on serotonin reuptake inhibition. Covariates included risk factors for PPH (the primary outcome, classified based on International Classification of Diseases (ICD)-9 coding), demographic factors and psychiatric diagnoses, among other factors. A number of sensitivity analyses were performed to assess the robustness of their conclusions. FindingsIn this cohort, the use of SSRIs or non-SSRIs was associated with an approximate 40% increased risk of PPH in an analysis adjusted for risk factors. Risk for PPH was 2.8% for women with mood and/or anxiety diagnoses on no medications compared to 4% for women currently using SSRIs and 3.8% for women currently using non-SSRIs. The risk for recent users (up to 30 days before delivery date) was 3.2% for SSRIs and 3.1% for non-SSRIs. CommentaryObstetric haemorrhage is a leading cause of maternal mortality and severe morbidity in the USA. 6 Identification of further clinical risk factors for PPH could lead to novel clinical interventions and research initiatives to reduce adverse outcomes from this complication. This study demonstrates an association between PPH and medication that is relatively commonly prescribed in pregnancy. Several aspects of the methodology in this study enhance the validity of the findings: first, the control population is composed of wo...

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Antidepressants in Pregnancy: A Review of Commonly Prescribed Medications

Cited by 33 publications

References 69 publications

The Additional Cost Burden of Preexisting Medical Conditions During Pregnancy and Childbirth

The Additional Cost Burden of Preexisting Medical Conditions During Pregnancy and Childbirth

Síndrome de abstinencia neonatal debido a exposición prenatal al citalopram: a propósito de un caso

Late pregnancy use of selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors is associated with increased risk of postpartum haemorrhage

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