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Pregnancy and psychotropics

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https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#1
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28770276/a-comparative-study-of-qt-prolongation-with-serotonin-reuptake-inhibitors
#2
Ana Ojero-Senard, Justine Benevent, Emmanuelle Bondon-Guitton, Geneviève Durrieu, Leila Chebane, Melanie Araujo, Francois Montastruc, Jean-Louis Montastruc
BACKGROUND: QT interval prolongations were described with citalopram and escitalopram. However, the effects of the other serotonin reuptake inhibitors (SRIs) remained discussed. In order to identify a putative signal with other SRIs, the present study investigates the reports of QT interval prolongation with SRIs in two pharmacovigilance databases (PVDB). METHODS: Two kinds of investigations were performed: (1) a comparative study in VigiBase®, the WHO PVDB, where notifications of QT prolongation with six SRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) were selected...
August 3, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28769545/the-use-of-psychotropic-drugs-during-pregnancy
#3
Dengtang Liu, Peiwei Xu, Kaida Jiang
Patients with severe psychotic disorders face at least two challenges during pregnancy: the genetic risk of psychotic disorders and the risk of teratogenicity caused by psychotropic drugs. This paper reviewed the relevant literature regarding the issues surrounding use of antipsychotics, antidepressants in pregnant patients. The latest treatment guidelines and FDA recommendations are introduced.
February 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28768628/risk-of-neonatal-drug-withdrawal-after-intrauterine-co-exposure-to-opioids-and-psychotropic-medications-cohort-study
#4
Krista F Huybrechts, Brian T Bateman, Rishi J Desai, Sonia Hernandez-Diaz, Kathryn Rough, Helen Mogun, Leslie S Kerzner, Jonathan M Davis, Megan Stover, Devan Bartels, Jennifer Cottral, Elisabetta Patorno
Objectives To assess the impact of in utero co-exposure to psychotropic medications and opioids on the incidence and severity of neonatal drug withdrawal.Design Observational cohort study.Setting Nationwide sample of pregnancies in publicly insured women in the US, nested in the Medicaid Analytic eXtract (2000-10).Participants 201 275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.Interventions In utero exposure to psychotropic medications, in particular antidepressants, atypical antipsychotics, benzodiazepines, gabapentin, and non-benzodiazepine hypnotics (Z drugs), with prescriptions filled within the same time window as prescriptions for opioids...
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28768614/prescribing-opioids-and-psychotropic-drugs-in-pregnancy
#5
EDITORIAL
Stephen W Patrick, William O Cooper, Matthew M Davis
No abstract text is available yet for this article.
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28763925/-the-situation-of-social-support-and-its-relationship-with-antenatal-depression-among-1-075-zhejiang-primiparas-in-their-third-trimesters
#6
B D Zhang, Y C Shan, L W Xu, H Chen, X N Zhang, C Y Tong, Y L Mao, C Zhou
Objective: To investigate the situation of social support (SS), and explore its relationship with antenatal depression (AD) among Zhejiang primiparas in their third trimesters. Methods: From March to August 2016, a cross-sectional study was conducted and the questionnaire was used at the outpatient consulting room of one maternity hospital in Hangzhou. Inclusion criteria includes the primiparas over 18 years old, gestation from 30 to 36 weeks, been able to understand and complete the questionnaires independently, no family history and history of mental disorders and no use of psychotropic drugs, without serious illness and so on...
August 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28700807/association-of-antidepressant-medication-use-during-pregnancy-with-intellectual-disability-in-offspring
#7
Alexander Viktorin, Rudolf Uher, Alexander Kolevzon, Abraham Reichenberg, Stephen Z Levine, Sven Sandin
Importance: Maternal antidepressant medication use during pregnancy has previously been associated with adverse outcomes in offspring, but to our knowledge, the association with intellectual disability (ID) has not been investigated. Objectives: To examine the association of maternal antidepressant medication use during pregnancy with ID in offspring and investigate the importance of parental mental illness for such an association. Design, Setting, and Participants: A population-based cohort study of 179 007 children born from January 1, 2006, through December 31, 2007, with complete parental information from national registers who were followed up from birth throughout 2014...
July 12, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28665044/mood-symptoms-in-pregnant-and-postpartum-women-with-bipolar-disorder-a-naturalistic-study
#8
Kara E Driscoll, Dorothy K Y Sit, Eydie L Moses-Kolko, Emily Pinheiro, Amy Yang, Jody D Ciolino, Heather F Eng, James F Luther, Crystal T Clark, Stephen R Wisniewski, Katherine L Wisner
OBJECTIVE: We conducted a prospective naturalistic study of pregnant women with bipolar disorder (BD) to evaluate symptoms of BD across childbearing and assess whether pharmacotherapy reduced their severity. METHODS: Assessments were scheduled at 20, 30, and 36 weeks' gestation and 2, 12, 26, and 52 weeks postpartum. Symptoms were assessed using the Structured Interview Guide for the Hamilton Depression Rating Scale-Atypical Depression Supplement (SIGH-ADS) and Mania Rating Scale (MRS)...
June 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28663781/recent-advances-in-understanding-maternal-perinatal-mood-disorders
#9
REVIEW
Thalia Robakis, Eugenia Jernick, Katherine Williams
The study of perinatal mental health (mental health during pregnancy and postpartum) is a complex field of study that is of major importance both for the mental and physical health of new mothers and for the neurobehavioral development and long-term functioning of the children they bear. In this review, we cover the most recent additions to this rapidly evolving field. Notable advances include further illumination of the epidemiological patterns and clinical manifestations of perinatal mood disruption; new efficacy data on treatment and prevention; clarifications of the respective contributions of maternal mental illness and psychotropic medication to outcomes of pregnancy, birth, and child development; and updated expert guidelines for screening...
2017: F1000Research
https://www.readbyqxmd.com/read/28657488/the-risks-associated-with-the-use-of-lamotrigine-during-pregnancy
#10
Lingli Kong, Tiantian Zhou, Bailing Wang, Zhenbo Gao, Chunxia Wang
OBJECTIVE: This paper reviewed the relevant literature on the effects of lamotrigine on pregnancy outcomes to provide useful information regarding lamotrigine use in pregnant women with bipolar disorder. METHODS: A systematic search of electronic databases and other original sources was conducted that examined the effects of lamotrigine on pregnancy outcomes. RESULTS: It is not clear that foetuses of lamotrigine-exposed pregnant women are at higher risk of malformation or neurodevelopmental delay...
June 28, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28629296/atypical-antipsychotic-use-and-outcomes-in-an-urban-maternal-mental-health-service
#11
Susan Hatters Friedman, Charmian Moller-Olsen, Chandni Prakash, Abigail North
Objective Despite many women suffering from psychosis in their childbearing years, limited data exist about the use of atypical antipsychotic agents in pregnancy. Atypical antipsychotic agents are often used to treat bipolar disorder, instead of lithium or valproate because of the known teratogenicity of those agents. As well, atypical antipsychotics are often prescribed in anxiety disorders and depression. This study sought to describe pregnancy outcomes for women prescribed atypical antipsychotics during pregnancy...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28617210/antipsychotic-medication-use-among-publicly-insured-pregnant-women-in-the-united-states
#12
Yoonyoung Park, Krista F Huybrechts, Jacqueline M Cohen, Brian T Bateman, Rishi J Desai, Elisabetta Patorno, Helen Mogun, Lee S Cohen, Sonia Hernandez-Diaz
OBJECTIVE: Given the increasing use and broadening of indications for use of antipsychotic medications in the general population, as well as the paucity of information on the safety of this drug class during pregnancy, the study documented patterns of antipsychotic medication use among pregnant women. METHODS: Medicaid Analytic eXtract data (2001-2010) from pregnant women who delivered live-born infants were used. Antipsychotic use at both the class and the individual drug level was defined based on dispensed outpatient prescriptions...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28570796/neonatal-discontinuation-syndrome-in-serotonergic-antidepressant-exposed-neonates
#13
MULTICENTER STUDY
Amy Yang, Jody D Ciolino, Emily Pinheiro, Laura J Rasmussen-Torvik, Dorothy K Y Sit, Katherine L Wisner
OBJECTIVE: To determine whether infants exposed in utero to serotonin reuptake inhibitor (SRI) antidepressants or a DSM-IV-TR-defined mood disorder have significantly more neonatal discontinuation signs compared to an unexposed group of infants at 2-4 weeks after birth. METHODS: This secondary analysis was derived from 2 observational studies with enrollment from July 2000 to December 2011 in Cleveland, Ohio, and Pittsburgh, Pennsylvania. Mothers (n = 214) belonged to one of 3 groups based on exposure status during pregnancy: (1) Comparison-women who did not take psychotropics during pregnancy and had no major mood disorder; (2) SRI-exposed-women with a mood disorder who were taking an SRI but no benzodiazepines; and (3) Mood Disorder-women with depression or bipolar disorder who did not take psychotropic medications...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28545329/psychotropic-drug-use-before-during-and-after-pregnancy-a-population-based-study-in-a-canadian-cohort-2001-2013
#14
Christine Leong, Colette Raymond, Dan Château, Matthew Dahl, Silvia Alessi-Severini, Jamie Falk, Shawn Bugden, Alan Katz
OBJECTIVE: To describe the extent of increase in use and the rate of continuation versus discontinuation of psychotropic agents before, during, and after pregnancy. METHODS: Rates of psychotropic use (antidepressants, anxiolytic/sedative-hypnotics, antiepileptics, antipsychotics, lithium, stimulants) among women with a hospital-recorded pregnancy outcome were assessed using databases at the Manitoba Centre for Health Policy. Rate of use was defined as ≥1 prescription over the total number of pregnancies in the 3-12 months before pregnancy, 0-3 months before pregnancy, during pregnancy, or 3 months after pregnancy...
August 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28440103/british-association-for-psychopharmacology-consensus-guidance-on-the-use-of-psychotropic-medication-preconception-in-pregnancy-and-postpartum-2017
#15
R Hamish McAllister-Williams, David S Baldwin, Roch Cantwell, Abby Easter, Eilish Gilvarry, Vivette Glover, Lucian Green, Alain Gregoire, Louise M Howard, Ian Jones, Hind Khalifeh, Anne Lingford-Hughes, Elizabeth McDonald, Nadia Micali, Carmine M Pariante, Lesley Peters, Ann Roberts, Natalie C Smith, David Taylor, Angelika Wieck, Laura M Yates, Allan H Young
Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders...
May 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28386942/the-effects-of-gestational-use-of-antidepressants-and-antipsychotics-on-neonatal-outcomes-for-women-with-severe-mental-illness
#16
Jacqueline Frayne, Thinh Nguyen, Kellie Bennett, Suzanna Allen, Yvonne Hauck, Helena Liira
BACKGROUND: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. AIMS: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. METHODS: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type...
April 7, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28270105/economic-evaluation-of-a-behavioral-intervention-versus-brief-advice-for-substance-use-treatment-in-pregnant-women-results-from-a-randomized-controlled-trial
#17
Xiao Xu, Kimberly A Yonkers, Jennifer Prah Ruger
BACKGROUND: Substance use in pregnancy is associated with severe maternal and fetal morbidities and substantial economic costs. However, few studies have evaluated the cost-effectiveness of substance use treatment programs in pregnant women. The purpose of this study was to evaluate the economic impact of a behavioral intervention that integrated motivational enhancement therapy with cognitive behavioral therapy (MET-CBT) for treatment of substance use in pregnancy, in comparison with brief advice...
March 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28261117/psychotropic-medication-and-substance-use-during-pregnancy-by-women-with-severe-mental-illness
#18
Kate J Brameld, Assen Jablensky, Jenny Griffith, John Dean, Vera A Morgan
BACKGROUND: Sociodemographic factors, alcohol and drug intake, and maternal health are known to be associated with adverse outcomes in pregnancy for women with severe mental illness in addition to their use of psychotropic medication. In this study, we describe the demographic characteristics of women hospitalized for severe mental illness along with their use of medication and other drugs during the pregnancy period. METHODS: A clinical case note review of women with psychosis who were hospitalized at the State Psychiatric Hospital in Western Australia during 1966-1996, gave birth between 1980 and 1992, and received psychiatric treatment during the pregnancy period...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28202290/effect-of-psychotropic-drug-treatment-on-sterol-metabolism
#19
Željka Korade, Wei Liu, Emily B Warren, Kristan Armstrong, Ned A Porter, Christine Konradi
Cholesterol metabolism is vital for brain function. Previous work in cultured cells has shown that a number of psychotropic drugs inhibit the activity of 7-dehydrocholesterol reductase (DHCR7), an enzyme that catalyzes the final steps in cholesterol biosynthesis. This leads to the accumulation of 7-dehydrocholesterol (7DHC), a molecule that gives rise to oxysterols, vitamin D, and atypical neurosteroids. We examined levels of cholesterol and the cholesterol precursors desmosterol, lanosterol, 7DHC and its isomer 8-dehydrocholesterol (8DHC), in blood samples of 123 psychiatric patients on various antipsychotic and antidepressant drugs, and 85 healthy controls, to see if the observations in cell lines hold true for patients as well...
September 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28097730/exposure-to-reactive-intermediate-inducing-drugs-during-pregnancy-and-the-incident-use-of-psychotropic-medications-among-children
#20
Yen-Hao Tran, Henk Groen, Jorieke E H Bergman, Eelko Hak, Bob Wilffert
PURPOSE: Our study aimed to investigate the association between prenatal exposure to reactive intermediate (RI)-inducing drugs and the initiation of psychotropic medications among children. METHODS: We designed a cohort study using a pharmacy prescription database. Pregnant women were considered exposed when they received a prescription of RI-inducing drugs. These drugs could be either used alone (RI+/FAA-) or combined with drugs exhibiting folic acid antagonism (FAA, RI+/FAA+)...
January 18, 2017: Pharmacoepidemiology and Drug Safety
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