Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence – an update

Fumeaux, Céline J. Fischer; Harari, Mathilde Morisod; Weisskopf, Etienne; Eap, Chin B.; Epiney, Manuella; Vial, Yvan; Csajka, Chantal; Graz, Myriam Bickle; Panchaud, Alice

doi:10.1080/14740338.2019.1658740

Cited by 58 publications

(35 citation statements)

References 134 publications

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“…Antidepressants such as SSRIs are only preferred in severe cases of depression. However, current practice shows that most of the time antidepressants are still used as the primary treatment [178][179][180]. The effect of SSRIs during pregnancy on an offspring's development has been examined frequently.…”

Section: Maternal Ssri Intake Is Associated With Neural Changes and Bmentioning

confidence: 99%

Gestational Factors throughout Fetal Neurodevelopment: The Serotonin Link

Hanswijk

Spoelder

Shan

et al. 2020

IJMS

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Serotonin (5-HT) is a critical player in brain development and neuropsychiatric disorders. Fetal 5-HT levels can be influenced by several gestational factors, such as maternal genotype, diet, stress, medication, and immune activation. In this review, addressing both human and animal studies, we discuss how these gestational factors affect placental and fetal brain 5-HT levels, leading to changes in brain structure and function and behavior. We conclude that gestational factors are able to interact and thereby amplify or counteract each other’s impact on the fetal 5-HT-ergic system. We, therefore, argue that beyond the understanding of how single gestational factors affect 5-HT-ergic brain development and behavior in offspring, it is critical to elucidate the consequences of interacting factors. Moreover, we describe how each gestational factor is able to alter the 5-HT-ergic influence on the thalamocortical- and prefrontal-limbic circuitry and the hypothalamo-pituitary-adrenocortical-axis. These alterations have been associated with risks to develop attention deficit hyperactivity disorder, autism spectrum disorders, depression, and/or anxiety. Consequently, the manipulation of gestational factors may be used to combat pregnancy-related risks for neuropsychiatric disorders.

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Section: Maternal Ssri Intake Is Associated With Neural Changes and Bmentioning

confidence: 99%

Gestational Factors throughout Fetal Neurodevelopment: The Serotonin Link

Hanswijk

Spoelder

Shan

et al. 2020

IJMS

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“…Especially it concerns SSRI as they are drugs of first choice for treatment depression in pregnant women. Among all SSRI fluoxetine and its active metabolite norfluoxetine having both long half-life 2-6 days could cause SS more likely [24,25].…”

Section: Serotonin Syndrome (Ss)mentioning

confidence: 99%

Fever as an Adverse Drug Reaction of Different Therapeutic Groups

Postnikov¹,

Teplova²,

Ermilin³

et al. 2020

AJP

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Fever (t>38°C) developed in association with drug usage is rare but sometimes severe side effect (SE). It could manifest as single symptom or as a part of such life-threatening syndromes like malignant hyperthermia (MH), serotonin syndrome (SS), neuroleptic malignant syndrome (NMS). Fever could be caused by different therapeutic groups of drugs but the leading positions are occupied by antibiotics (mainly beta-lactams), substances acting on central nervous system (CNS) and chemotherapeutic agents. Main mechanisms are allergic and receptive. Curative measures include discontinuation of the suspected drug, introduction of agents blocking the action of the trigger factor -dantrolene (МН), bromocriptine (NMS), cyproheptadine (SS). Purpose of this review: to present the global and Russian data concerning fever as a drug-induced side effect. To distinguish the groups of patients and drugs of the highest risk. To evaluate aid measures. Results: fever as monosymptom of drug allergy is a difficult condition to be diagnosed and there are only few things that could help to recognize it such as temporal association with the suspected drug use and manifestation of fever along with the following resolution after suspected drug discontinuation and recurrence fever after suspected drug re-challenge. Among four syndromes described in this review such as serum sickness-like reaction (SSLR), NMS, SS and MH just fever at MH is not only a sign like in case of three others but it is significant and life-threatening manifestation and therefore requires additional curative methods (in addition to pharmacological support with dantrolene) -rapid cooling measures: ice-water nasogastric and rectal lavage, infusion of crystalloid solutions cooled up to 4°C, ice packs placing on main blood vessels and liver area, ventilatory measurements.

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“…Antenatal depression is associated with both adverse maternal and neonatal outcomes. Women with depression during pregnancy have a higher likelihood of tobacco smoking, alcohol consumption, drug intake, poor antenatal care and poor nutrition which in themselves are also risk factors for complications during pregnancy and delivery (88). Depressed pregnant women both with antidepressant medication and without medication have a higher risk for operative delivery (i.e.…”

Section: Depression and Risks For Adverse Maternal And Neonatal Outcomesmentioning

confidence: 99%

Drug use during pregnancy with focus on antidepressants

Wolgast

2020

Linköping University Medical Dissertations

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Background: More than half of pregnant women use at least one prescribed medication during pregnancy, and almost all pregnant women use some kind of over-the-counter medication. Depression is one of the most common diseases in the world today, also during the peripartum period. The prevalence of pregnant women using antidepressant medication is increasing. General knowledge about the use of medication during pregnancy needs to improve. The overall aim of the studies on which this thesis is based is therefore to examine different aspects of medication use during pregnancy, with a focus on antidepressants. Material and methods:Study I was a questionnaire study where 850 pregnant women were asked about their perceptions on medication use during pregnancy. In Study II, plasma samples from 200 women were obtained at gestational weeks 10-12 and 25, and screened for drugs. The results of the analysis were compared with medication use noted in antenatal medical care records. Study III was a national register-based cohort study including 262,329 pregnant women, and their first child born in 2012-2015. Maternal obstetric and neonatal outcomes were studied in three groups: women diagnosed with depression and who had redeemed an antidepressant before becoming pregnant and women who were diagnosed with depression and who had redeemed an antidepressant both before and during pregnancy, were compared with each other and with women who had neither been diagnosed with depression nor been prescribed antidepressants. Study IV was a pharmacokinetic study that included 81 pregnant women with ongoing antidepressant medical treatment. Antidepressant drug and metabolite concentrations were measured throughout pregnancy. Participants were genotyped for enzymes involved in antidepressant drug metabolism, i.e. CYP2D6 and CYP2C19. Results and conclusions:The majority of pregnant women in our study considered the use of medication during pregnancy as either "probably harmful" or "harmful", and this perception was associated with non-use of medication. The women had high confidence in health care professionals when seeking advice about medication.

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Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence – an update

Cited by 58 publications

References 134 publications

Gestational Factors throughout Fetal Neurodevelopment: The Serotonin Link

Gestational Factors throughout Fetal Neurodevelopment: The Serotonin Link

Fever as an Adverse Drug Reaction of Different Therapeutic Groups

Drug use during pregnancy with focus on antidepressants

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