scholarly journals Psychotropic medication in pregnancy

2004 ◽  
Vol 10 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Dora Kohen
Keyword(s):  
Psychotropic Medication ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
First Trimester ◽  
Careful Consideration ◽  
Conventional Antipsychotics ◽  
Psychopharmacological Treatment ◽  
Essential Medication ◽  
In Pregnancy

The risks and benefits of psychopharmacological treatment in pregnancy need careful consideration. Conventional antipsychotics and tricyclic antidepressants are relatively safe for the foetus. Selective serotonin reuptake inhibitors appear to be safe, but mood stabilisers such as lithium, sodium valproate and carbamazepine are associated with increased foetal malformations. Benzodiazepines in the first trimester are teratogenic, and in high dosage can also cause withdrawal symptoms, hypotonia and agitation in the newborn. Women taking atypical antipsychotics should be switched to conventional antipsychotics before they conceive. In women with long-term mental illness necessitating psychotropic medication, effort should be made to stop polypharmacy and non-essential medication (e.g. benzodiazepines) and to decrease the dose of essential drugs, after full assessment. There is rarely a valid reason to stop essential drug treatment during pregnancy.

scholarly journals Should we stop using tricyclic antidepressants in pregnancy?

2010 ◽  
Vol 41 (1) ◽  
pp. 15-17 ◽  
Author(s):  
C. M. Pariante ◽  
G. Seneviratne ◽  
L. Howard
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Swedish Study ◽  
In Pregnancy

A new Swedish study by Reis & Källén describes approximately 15 000 women (and their babies) that, between 1995 and 2007, reported the use of antidepressants, or were prescribed such drugs, during pregnancy. In this study, pregnancy and teratogenic outcomes after exposure to tricyclic antidepressants are, for most measures, equal or worse than after exposure to selective serotonin reuptake inhibitors or other antidepressants. Based on this and on a review of the few other studies available (admittedly, a relatively small number of women on which conclusions can be based), the authors of this Editorial challenge the ‘perinatal myth’ that tricyclics are the safest choice in pregnancy.

scholarly journals Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands

2014 ◽  
Vol 112 (9) ◽  
pp. 1503-1509 ◽  
Author(s):  
Ary I. Savitri ◽  
Nasim Yadegari ◽  
Julia Bakker ◽  
Reyn J. G. van Ewijk ◽  
Diederick E. Grobbee ◽  
...  
Keyword(s):  
Birth Weight ◽  
The Netherlands ◽  
Medical Records ◽  
Muslim Women ◽  
First Trimester ◽  
Strict Adherence ◽  
Ramadan Fasting ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed that half of all the women adhered to Ramadan fasting. With strict adherence to Ramadan fasting in pregnancy, the birth weight of newborns tended to be lower than that of newborns of non-fasting mothers, although this was not statistically significant ( − 198 g, 95 % CI − 447, 51, P= 0·12). Children of mothers who fasted in the first trimester of pregnancy were lighter at birth than those whose mothers had not fasted ( − 272 g, 95 % CI − 547, 3, P= 0·05). There were no differences in birth weight between children whose mothers had or had not fasted if Ramadan fasting had taken place later in pregnancy. Ramadan fasting during early pregnancy may lead to lower birth weight of newborns. These findings call for further confirmation in larger studies that should also investigate potential implications for perinatal and long-term morbidity and mortality.

Previous and posterior psychopharmacological treatment in bariatric surgery patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S546-S546
Author(s):  
M. Angelats ◽  
P. Laia ◽  
R. Elena ◽  
M. Laura ◽  
E. Iciar ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Psychiatric Treatment ◽  
Descriptive Analysis ◽  
Previous Treatment ◽  
Psychopharmacological Treatment ◽  
Long Term Effect ◽  
Competing Interest ◽  
The Impact

IntroductionBariatric surgery is an effective treatment for obesity. It has been demonstrated that it improves the prognosis of vascular risk factors. However, the long term effect of surgery on psychiatric pathology, as depression, and the treatment adjustment needed is not clear.AimTo describe the previous and posterior psychopharmacological treatment of patients operated of bariatric surgery in Hospital del Mar.Material and methodsWe used a database of 292 bariatric surgery patients who have been operated in Hospital del Mar from January 2010 to November 2015. In this database, sociodemographic information, psychiatric antecedents, and anterior and posterior treatments among other data are included. We have made a descriptive analysis about more used treatments and their evolution.ResultsIn the sample, 27.1% of patients started with some psychiatric treatment the months before the bariatric surgery (16.4% had already a previous treatment prescribed). The medications the most frequently started before the surgery were selective serotonin reuptake inhibitors (SSRI, 11%), second were benzodiazepines and third a combination of the two previous treatments. Among antidepressants, Fluoxetine was the most prescribed (45.5%). Six months after surgery, 72.9% of patients were not taking any treatment.ConclusionThe large variety of psychiatric drugs used in our sample indicates that clearer guidelines are needed about the most appropriated treatments for those patients. Further studies on the impact of this surgery on pathologies and their psychopharmacological treatments are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effects of Preexisting Psychotropic Medication Use on a Cohort of Patients with Ischemic Stroke Outcome

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Adalia H. Jun-O’Connell ◽  
Dilip K. Jayaraman ◽  
Nils Henninger ◽  
Brian Silver ◽  
Majaz Moonis ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Psychotropic Medication ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Functional Disability ◽  
Medication Use ◽  
Control Group ◽  
Significant Difference ◽  
Comparison Groups

Background. Several studies investigated the use of selective serotonin reuptake inhibitors (SSRI) after ischemic stroke to improve motor recovery. However, little is known about the effects of preexisting psychotropic medication use (PPMU), such as antidepressants, on a long-term ischemic stroke functional disability. Objective. We sought to determine the prevalence of PPMU and whether PPMU relates to the long-term clinical outcome in a cohort of patients presenting with acute ischemic strokes. Methods. We retrospectively analyzed 323 consecutive patients who presented with an acute ischemic stroke in a single institution between January 2015 and December 2017. Baseline characteristics, functional disability as measured by the modified Rankin Scale (mRS), and major adverse cardiovascular complications (MACE) within 365 days were recorded. The comparison groups included a control group of ischemic stroke patients who were not on psychotropic medications before and after the index ischemic stroke and a second group of poststroke psychotropic medication use (PoMU), which consisted of patients started on psychotropic medication during the index admission. Results. The prevalence of PPMU in the studied cohort was 21.4% (69/323). There was a greater proportion of females in the PPMU than in the comparison groups (P<0.001), while vascular risk factors were similar in all groups, except for an increased presence of posterior circulation infarcts in the PPMU (37.4% vs. 18.8%, P<0.001). Among the patients with available 1-year follow-up data (n=246), we noted significantly greater improvement in stroke deficits, measured by National Institute of Health Stroke Scale (NIHSS) between PPMU and PoMU vs. control (3 (0-7) versus 1 (0-4), P=0.041). The 1-year mRS was worse in PPMU and PoMU compared to the control group (2 (IQ 1-3) vs. 2 (IQ 0-3) vs. 1 (IQ 0-2), respectively, P=0.013), but delta mRS reflecting the degree of mRS improvement showed no significant difference between any PMU and control patients (P=0.76). There was no statistically significant difference in MACE. Conclusion. PPMU in ischemic stroke is common; it can be beneficial in ischemic stroke in the long-term clinical outcome and is not associated with increased risks of MACE.

scholarly journals Gastrointestinal Stromal Tumor in Pregnancy: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
S. Scherjon ◽  
W. F. Lam ◽  
H. Gelderblom ◽  
F. W. Jansen
Keyword(s):  
Clinical Course ◽  
First Trimester ◽  
Optimal Management ◽  
Mesenchymal Tumors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
First Choice ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

Background. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract and are diagnosed relatively seldom in pregnancy.Case. We describe a remarkable clinical course and long-term outcome, now nine years after first diagnosis, of a massive and metastatic, with a high malignancy grade GIST case, found in and treated from the first trimester of pregnancy onwards.Conclusion. GIST occurring during pregnancy is extremely rare. However, early diagnosis is important for optimal management. The recent better understanding of oncogenesis, the use of immunohistochemistry for differential diagnosis of GISTs, and the use of imatinib mesylate as the treatment of first choice are—as shown in this case—important for care of pregnant women with this type of malignancy.

scholarly journals Safety of selective serotonin reuptake inhibitors in pregnancy

2007 ◽  
Vol 31 (5) ◽  
pp. 183-186 ◽  
Author(s):  
Allison Donnelly ◽  
Carol Paton
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Excellence ◽  
First Trimester ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Joint Decision ◽  
Increased Risk ◽  
Major Congenital Malformations ◽  
In Pregnancy

Aims and MethodSelective serotonin reuptake inhibitors (SSRIs) are recommended by the National Institute for Clinical Excellence as first-line drugs for the treatment of depression, but there is emerging evidence that they might not be entirely safe in pregnancy. We reviewed the literature in this area.ResultsSome data indicate an association between first-trimester SSRI exposure, particularly with paroxetine, and an increased risk of some major congenital malformations. Stronger evidence supports an association with small reductions in gestational age and neonatal withdrawal symptoms.Clinical ImplicationsRisks and benefits of using SSRIs during pregnancy should be discussed with the patient, and a joint decision made between prescriber and patient regarding treatment. Limited data suggest that other SSRIs are safer than paroxetine in pregnancy.

scholarly journals Prolactin and breast increase during pregnancy in PCOS: linked to long-term metabolic health?

2019 ◽  
Vol 180 (6) ◽  
pp. 373-380 ◽  
Author(s):  
Maria Othelie Underdal ◽  
Øyvind Salvesen ◽  
Anne Schmedes ◽  
Marianne Skovsager Andersen ◽  
Eszter Vanky
Keyword(s):  
Blood Pressure ◽  
Visceral Fat ◽  
First Trimester ◽  
Metabolic Health ◽  
Visceral Fat Area ◽  
Follow Up Study ◽  
Gestational Week ◽  
In Pregnancy

Objective To explore whether gestational prolactin and breast increase are markers of metabolic health in pregnancy and on long-term, in PCOS. Design Follow-up study. Women with PCOS, according to the Rotterdam criteria (n = 239), former participants of the randomized controlled trial (RCT) PregMet were invited, 131 participated in the current follow-up study, at mean 8 years after pregnancy. Methods Metformin 2000 mg/day or placebo from first trimester to delivery in the original RCT. No intervention in the current study. Prolactin was analyzed in the first trimester and at gestational week 32 and metabolic characteristics which are part of the metabolic syndrome and measures of glucose homeostasis were examined. Metabolic health was also evaluated according to breast increase versus lack of breast increase during pregnancy. Results Prolactin increase in pregnancy was negatively correlated to BMI (P = 0.007) and systolic blood pressure (P ≤ 0.001) in gestational week 32. Prolactin at gestational week 32 was negatively correlated to BMI (P = 0.044) and visceral fat area (P = 0.028) at 8-year follow-up in an unadjusted model. Prolactin at gestational week 32 showed no associations to metabolic health at follow-up when baseline BMI was adjusted for. Women who reported lack of breast increase during pregnancy, had higher BMI (P = 0.034), waist-hip ratio (P = 0.004), visceral fat area (P = 0.050), total cholesterol (P = 0.022), systolic (P = 0.027) and diastolic blood pressure (P = 0.011) at 8-year follow-up. Conclusion High prolactin levels and breast increase in pregnancy were associated with a more favorable long-term metabolic health in women with PCOS. Both prolactin and breast increase may be mediated by gestational BMI.

Metabolic abnormalities in patients with chronic psychiatric disorders receiving long-term psychopharmacological treatment

2005 ◽  
Vol 38 (05) ◽  
Author(s):  
B Reisinger ◽  
E Mueller ◽  
B Kropp-Hartmann ◽  
D Wölflick ◽  
C Zimmerer ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Metabolic Abnormalities ◽  
Psychopharmacological Treatment
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