Anne Bénard-Laribière1, Elodie Pambrun1, Anne-Laure Sutter-Dallay1,2, Sophie Gautier3, Caroline Hurault-Delarue4, Christine Damase-Michel4, Isabelle Lacroix4, Bernard Bégaud1,5, Antoine Pariente1,5. 1. team PHARMACOEPIDEMIOLOGY, Univ. Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, F-33000, Bordeaux, France. 2. Charles Perrens Hospital, F-33000, Bordeaux, France. 3. Clinical Pharmacology Department, U 1171 University Hospital of Lille, University of Lille, F-59000, Lille, France. 4. Clinical Pharmacology Department, Inserm UMR 1027, CIC Inserm 1436, Faculty of Medicine, University Hospital of Toulouse, F-31000, Toulouse, France. 5. Clinical Pharmacology, University Hospital of Bordeaux, F-33000, Bordeaux, France.
Abstract
AIMS: We explored the patterns of antidepressant use during pregnancy. METHODS: A cohort of women who started a pregnancy in 2014 was identified using data from the French reimbursement healthcare system (covering approximately 99% of the population). Antidepressant usage (initiated before or during pregnancy) was assessed. Explored changes in antidepressant treatment were: associations, switches, discontinuation and resumption of antidepressants during pregnancy. RESULTS: The cohort included 766 508 pregnancies (755 519 women). Antidepressant use during pregnancy was 25.7 per 1000 [95% CI: 25.3-26.0]. New use concerned 3.9 per 1000 [95% CI: 3.7-4.0]; the most initiated class during pregnancy was selective serotonin reuptake inhibitors (SSRIs), while the most prescribed individual drug in second and third trimesters was amitriptyline, a tricyclic. Most changes were observed before pregnancy and during the first trimester: 63% of ongoing treatments in the year before pregnancy were discontinued before conception; 68% of treatments maintained after conception were discontinued during the first trimester; switches or antidepressant associations mostly occurred during the periconceptional period or during the first trimester. Regardless of initial antidepressant, switches to sertraline were the most frequent. Associations mainly consisted of a prescription of tri-/tetracyclic or mirtazapine/mianserin in addition to an SSRI. Discontinuation during pregnancy led to treatment resumption in 22% of pregnancies. CONCLUSIONS: These results suggest that pregnancy was planned or the treatment especially adapted in accordance with existing recommendations in a large proportion of women under antidepressants or in whom such treatments have been initiated after starting a pregnancy.
AIMS: We explored the patterns of antidepressant use during pregnancy. METHODS: A cohort of women who started a pregnancy in 2014 was identified using data from the French reimbursement healthcare system (covering approximately 99% of the population). Antidepressant usage (initiated before or during pregnancy) was assessed. Explored changes in antidepressant treatment were: associations, switches, discontinuation and resumption of antidepressants during pregnancy. RESULTS: The cohort included 766 508 pregnancies (755 519 women). Antidepressant use during pregnancy was 25.7 per 1000 [95% CI: 25.3-26.0]. New use concerned 3.9 per 1000 [95% CI: 3.7-4.0]; the most initiated class during pregnancy was selective serotonin reuptake inhibitors (SSRIs), while the most prescribed individual drug in second and third trimesters was amitriptyline, a tricyclic. Most changes were observed before pregnancy and during the first trimester: 63% of ongoing treatments in the year before pregnancy were discontinued before conception; 68% of treatments maintained after conception were discontinued during the first trimester; switches or antidepressant associations mostly occurred during the periconceptional period or during the first trimester. Regardless of initial antidepressant, switches to sertraline were the most frequent. Associations mainly consisted of a prescription of tri-/tetracyclic or mirtazapine/mianserin in addition to an SSRI. Discontinuation during pregnancy led to treatment resumption in 22% of pregnancies. CONCLUSIONS: These results suggest that pregnancy was planned or the treatment especially adapted in accordance with existing recommendations in a large proportion of women under antidepressants or in whom such treatments have been initiated after starting a pregnancy.
Authors: Lee S Cohen; Lori L Altshuler; Bernard L Harlow; Ruta Nonacs; D Jeffrey Newport; Adele C Viguera; Rita Suri; Vivien K Burt; Victoria Hendrick; Alison M Reminick; Ada Loughead; Allison F Vitonis; Zachary N Stowe Journal: JAMA Date: 2006-02-01 Impact factor: 56.272
Authors: Sheena Mathew; Sumahitha Bichenapally; Vahe Khachatryan; Asmaa Muazzam; Chandani Hamal; Lakshmi Sai Deepak Reddy Velugoti; Godfrey Tabowei; Greeshma N Gaddipati; Maria Mukhtar; Mohammed J Alzubaidee; Raga Sruthi Dwarampudi; Michael Alfonso Journal: Cureus Date: 2022-08-28