中国全科医学 ›› 2019, Vol. 22 ›› Issue (24): 2955-2961.DOI: 10.12114/j.issn.1007-9572.2019.00.182
所属专题: 精神卫生最新文章合集
翟倩1,2*,张国富1,2,丰雷1,2
出版日期:
2019-08-20
发布日期:
2019-08-20
基金资助:
ZHAI Qian1,2*,ZHANG Guofu1,2,FENG Lei1,2
Published:
2019-08-20
Online:
2019-08-20
摘要: 妊娠期用药的研究受医学伦理学等因素的影响,迄今为止仍是临床药理学和药物研究发展最缓慢和最受忽视的领域之一。由于妊娠期独特的母体生理学变化和胎儿发育的易损性,使得妊娠期妇女的合理用药问题被广泛关注。抑郁症是一种慢性精神疾病,具有患病率高、致残率高、复发率高和自杀率高等特点,因此抑郁症妇女妊娠期抗抑郁药物应用的安全性及必要性,成为临床治疗面临的一大难题。本文主要就妊娠期抗抑郁药物的合理应用进行 详述。
[1]HUYBRECHTS K F,PALMSTEN K,AVORN J,et al.Antidepressant use in pregnancy and the risk of cardiac defects[J].N Engl J Med,2014,370(25):2397-2407.DOI:10.1056/NEJMoa1312828. [2]JIMENEZ-SOLEM E,ANDERSEN J T,PETERSEN M,et al.Prevalence of antidepressant use during pregnancy in Denmark,a nation-wide cohort study[J].PLoS One,2013,8(4):e63034.DOI:10.1371/journal.pone.0063034. [3]MUZIK M,HAMILTON S E.Use of antidepressants during pregnancy:what to consider when weighing treatment with antidepressants against untreated depression?[J].Matern Child Health J,2016,20(11):2268-2279.DOI:10.1007/s10995-016-2038-5. [4]JAMESON J L,LONGO D L.Precision medicine——personalized,problematic,and promising[J].N Engl J Med,2015,372(23):2229-2234.DOI:10.1056/NEJMsb1503104. [5]DANCE A.Medical histories[J].Nature,2016,537(7619):S52-53.DOI:10.1038/537S52a. [6]WARD R M.Pharmacology of the maternal-placental-fetal-unit and fetal therapy[J].Progress in Pediatric Cardiology,1996,5(2):79-89.DOI:10.1016/1058-9813(96)00153-1. [7]KIM J H,SCIALLI A R.Thalidomide:the tragedy of birth defects and the effective treatment of disease[J].Toxicol Sci,2011,122(1):1-6.DOI:10.1093/toxsci/kfr088. [8]DAUD A N,BERGMAN J E,BAKKER M K,et al.Pharmacogenetics of drug-induced birth defects:the role of polymorphisms of placental transporter proteins[J].Pharmacogenomics,2014,15(7):1029-1041.DOI:10.2217/pgs.14.62. [9]EWING G,TATARCHUK Y,APPLEBY D,et al.Placental transfer of antidepressant medications:implications for postnatal adaptation syndrome[J].Clin Pharmacokinet,2015,54(4):359-370.DOI:10.1007/s40262-014-0233-3. [10]LAWLOR D A,TILLING K,DAVEY SMITH G.Triangulation in aetiological epidemiology[J].Int J Epidemiol,2016,45(6):1866-1886.DOI:10.1093/ije/dyw314. [11]NONACS R,COHEN L S.Assessment and treatment of depression during pregnancy:an update[J].Psychiatr Clin North Am,2003,26(3):547-562. [12]DEVLIN A M,BRAIN U,AUSTIN J,et al.Prenatal exposure to maternal depressed mood and the MTHFR C677T variant affect SLC6A4 methylation in infants at birth[J].PLoS One,2010,5(8):e12201.DOI:10.1371/journal.pone.0012201. [13]VIUFF A C,PEDERSEN L H,KYNG K,et al.Antidepressant medication during pregnancy and epigenetic changes in umbilical cord blood:a systematic review[J].Clin Epigenetics,2016,8(1):94.DOI:10.1186/s13148-016-0262-x. [14]TOH S,MITCHELL A A,LOUIK C,et al.Selective serotonin reuptake inhibitor use and risk of gestational hypertension[J].Am J Psychiatry,2009,166(3):320-328.DOI:10.1176/appi.ajp.2008.08060817. [15]DE VERA M A,BéRARD A.Antidepressant use during pregnancy and the risk of pregnancy-induced hypertension[J].Br J Clin Pharmacol,2012,74(2):362-369.DOI:10.1111/j.1365-2125.2012.04196.x. [16]PALMSTEN K,SETOGUCHI S,MARGULIS A V,et al.Elevated risk of preeclampsia in pregnant women with depression:depression or antidepressants?[J].American Journal of Epidemiology,2012,175(10):988-997.DOI:10.1093/aje/kwr394. [17]HUYBRECHTS K F,SANGHANI R S,AVORN J,et al.Preterm birth and antidepressant medication use during pregnancy:a systematic review and meta-analysis[J].PLoS One,2014,9(3):e92778.DOI:10.1371/journal.pone.0092778. [18]GRZESKOWIAK L E,MCBAIN R,DEKKER G A,et al.Antidepressant use in late gestation and risk of postpartum haemorrhage:a retrospective cohort study[J].BJOG,2016,123(12):1929-1936.DOI:10.1111/1471-0528.13612. [19]MCELHATTON P R,GARBIS H M,ELéFANT E,et al.The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants.A collaborative study of the European Network of Teratology Information Services (ENTIS)[J].Reprod Toxicol,1996,10(4):285-294. [20]MISRI S,SIVERTZ K.Tricyclic drugs in pregnancy and lactation:a preliminary report[J].Int J Psychiatry Med,1991,21(2):157-171.DOI:10.2190/JDTX-BYC3-K3VP-LWAH. [21]GENTILE S.Tricyclic antidepressants in pregnancy and puerperium[J].Expert Opin Drug Saf,2014,13(2):207-225.DOI:10.1517/14740338.2014.869582. [22]BéRARD A,ZHAO J P,SHEEHY O.Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women:an updated analysis of the Quebec Pregnancy Cohort[J].BMJ Open,2017,7(1):e013372.DOI:10.1136/bmjopen-2016-013372. [23]BROMIKER R,KAPLAN M.Apparent intrauterine fetal withdrawal from clomipramine hydrochloride[J].JAMA,1994,272(22):1722-1723. [24]KIEVIET N,DOLMAN K M,HONIG A.The use of psychotropic medication during pregnancy:how about the newborn?[J].Neuropsychiatr Dis Treat,2013,9:1257-1266.DOI:10.2147/NDT.S36394. [25]BYATT N,DELIGIANNIDIS K M,FREEMAN M P.Antidepressant use in pregnancy:a critical review focused on risks and controversies[J].Acta Psychiatr Scand,2013,127(2):94-114.DOI:10.1111/acps.12042. [26]ALI S F,BUELKE-SAM J,NEWPORT G D,et al.Early neurobehavioral and neurochemical alterations in rats prenatally exposed to imipramine[J].Neurotoxicology,1986,7(2):365-380. [27]NULMAN I,ROVET J,STEWART D E,et al.Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life:a prospective,controlled study[J].Am J Psychiatry,2002,159(11):1889-1895.DOI:10.1176/appi.ajp.159.11.1889. [28]SIMON G E,CUNNINGHAM M L,DAVIS R L.Outcomes of prenatal antidepressant exposure[J].Am J Psychiatry,2002,159(12):2055-2061.DOI:10.1176/appi.ajp.159.12.2055. [29]WEISSKOPF E,FISCHER C J,BICKLE GRAZ M,et al.Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence[J].Expert Opin Drug Saf,2015,14(3):413-427.DOI:10.1517/14740338.2015.997708. [30]BROY P,BéRARD A.Gestational exposure to antidepressants and the risk of spontaneous abortion:a review[J].Curr Drug Deliv,2010,7(1):76-92. [31]KJAERSGAARD M I,PARNER E T,VESTERGAARD M,et al.Prenatal antidepressant exposure and risk of spontaneous abortion —— a population-based study[J].PLoS One,2013,8(8):e72095.DOI:10.1371/journal.pone.0072095. [32]ANDERSEN J T,ANDERSEN N L,HORWITZ H,et al.Exposure to selective serotonin reuptake inhibitors in early pregnancy and the risk of miscarriage[J].Obstet Gynecol,2014,124(4):655-661.DOI:10.1097/AOG.0000000000000447. [33]GRZESKOWIAK L E,GILBERT A L,MORRISON J L.Exposed or not exposed? Exploring exposure classification in studies using administrative data to investigate outcomes following medication use during pregnancy[J].Eur J Clin Pharmacol,2012,68(5):459-467.DOI:10.1007/s00228-011-1154-9. [34]GRIGORIADIS S,VONDERPORTEN E H,MAMISASHVILI L,et al.Antidepressant exposure during pregnancy and congenital malformations:is there an association? A systematic review and meta-analysis of the best evidence[J].J Clin Psychiatry,2013,74(4):e293-308.DOI:10.4088/JCP.12r07966. [35]FURU K,KIELER H,HAGLUND B,et al.Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects:population based cohort study and sibling design[J].BMJ,2015,350:h1798.DOI:10.1136/bmj.h1798. [36]REEFHUIS J,DEVINE O,FRIEDMAN J M,et al.Specific SSRIs and birth defects:bayesian analysis to interpret new data in the context of previous reports[J].BMJ,2015,351:h3190.DOI:10.1136/bmj.h3190. [37]MALM H,KLAUKKA T,NEUVONEN P J.Risks associated with selective serotonin reuptake inhibitors in pregnancy[J].Obstet Gynecol,2005,106(6):1289-1296.DOI:10.1097/01.AOG.0000187302.61812.53. [38]YAZDY M M,MITCHELL A A,LOUIK C,et al.Use of selective serotonin-reuptake inhibitors during pregnancy and the risk of clubfoot[J].Epidemiology,2014,25(6):859-865.DOI:10.1097/EDE.0000000000000157. [39]KORNUM J B,NIELSEN R B,PEDERSEN L,et al.Use of selective serotonin-reuptake inhibitors during early pregnancy and risk of congenital malformations:updated analysis[J].Clin Epidemiol,2010,2:29-36. [40]BéRARD A,ZHAO J P,SHEEHY O.Sertraline use during pregnancy and the risk of major malformations[J].Am J Obstet Gynecol,2015,212(6):795.e1-12.DOI:10.1016/j.ajog.2015.01.034. [41]MALM H,ARTAMA M,GISSLER M,et al.Selective serotonin reuptake inhibitors and risk for major congenital anomalies[J].Obstet Gynecol,2011,118(1):111-120.DOI:10.1097/AOG.0b013e318220edcc. [42]PEDERSEN L H,PETERSEN O B,N?RGAARD M,et al.Linkage between the Danish National Health Service Prescription Database,the Danish Fetal Medicine Database,and other Danish registries as a tool for the study of drug safety in pregnancy[J].Clin Epidemiol,2016,8:91-95.DOI:10.2147/CLEP.S98139. [43]DAUD A N,BERGMAN J E,KERSTJENS-FREDERIKSE W S,et al.The risk of congenital heart anomalies following prenatal exposure to serotonin reuptake inhibitors-is pharmacogenetics the key?[J].Int J Mol Sci,2016,17(8):e1333.DOI:10.3390/ijms17081333. [44]NEMBHARD W N,TANG X Y,HU Z P,et al.Maternal and infant genetic variants,maternal periconceptional use of selective serotonin reuptake inhibitors,and risk of congenital heart defects in offspring:population based study[J].BMJ,2017,356:j832.DOI:10.1136/bmj.j832. [45]SANZ E J,DE-LAS-CUEVAS C,KIURU A,et al.Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome:a database analysis[J].Lancet,2005,365(9458):482-487.DOI:10.1016/S0140-6736(05)17865-9. [46]CHAMBERS C D,HERNANDEZ-DIAZ S,VAN MARTER L J,et al.Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn[J].N Engl J Med,2006,354(6):579-587.DOI:10.1056/NEJMoa052744. [47]Administration USFAD.FDA Drug Safety Communication:Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies[EB/OL].[2018-11-10].http://www.fda.gov/Drugs/DrugSafety/ucm283375.htm. [48]HUYBRECHTS K F,BATEMAN B T,PALMSTEN K,et al.Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn[J].JAMA,2015,313(21):2142-2151.DOI:10.1001/jama.2015.5605. [49]BROWN A S,GYLLENBERG D,MALM H,et al.Association of selective serotonin reuptake inhibitor exposure during pregnancy with speech,scholastic,and motor disorders in offspring[J].JAMA Psychiatry,2016,73(11):1163-1170.DOI:10.1001/jamapsychiatry.2016.2594. [50]PEDERSEN L H,HENRIKSEN T B,OLSEN J.Fetal exposure to antidepressants and normal milestone development at 6 and 19 months of age[J].Pediatrics,2010,125(3):e600-608.DOI:10.1542/peds.2008-3655. [51]CLEMENTS C,CASTRO M,BLUMENTHAL R,et al.Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system[J].Mol Psychiatry,2015,20(6):727-734.DOI:10.1038/mp.2014.90. [52]MALM H,BROWN A S,GISSLER M,et al.Gestational exposure to selective serotonin reuptake inhibitors and offspring psychiatric disorders:a national register-based study[J].J Am Acad Child Adolesc Psychiatry,2016,55(5):359-366.DOI:10.1016/j.jaac.2016.02.013. [53]CROEN L A,GRETHER J K,YOSHIDA C K,et al.Antidepressant use during pregnancy and childhood autism spectrum disorders[J].Arch Gen Psychiatry,2011,68(11):1104-1112.DOI:10.1001/archgenpsychiatry.2011.73. [54]RAI D,LEE B K,DALMAN C,et al.Parental depression,maternal antidepressant use during pregnancy,and risk of autism spectrum disorders:population based case-control study[J].BMJ,2013,346:f2059.DOI:10.1136/bmj.f2059. [55]OBERLANDER T F,GINGRICH J A,ANSORGE M S.Sustained neurobehavioral effects of exposure to SSRI antidepressants during development:molecular to clinical evidence[J].Clin Pharmacol Ther,2009,86(6):672-677.DOI:10.1038/clpt.2009.201. [56]GRZESKOWIAK L E,MORRISON J L,HENRIKSEN T B,et al.Prenatal antidepressant exposure and child behavioural outcomes at 7 years of age:a study within the Danish National Birth Cohort[J].BJOG,2016,123(12):1919-1928.DOI:10.1111/1471-0528.13611. [57]S?RENSEN M J,GR?NBORG T K,CHRISTENSEN J,et al.Antidepressant exposure in pregnancy and risk of autism spectrum disorders[J].Clin Epidemiol,2013,5:449-459.DOI:10.2147/CLEP.S53009. [58]HVIID A,MELBYE M,PASTERNAK B.Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism[J].N Engl J Med,2013,369(25):2406-2415.DOI:10.1056/NEJMoa1301449. [59]MAO Y Y,PEDERSEN L H,CHRISTENSEN J,et al.Prenatal exposure to antidepressants and risk of epilepsy in childhood[J].Pharmacoepidemiol Drug Saf,2016,25(11):1320-1330.DOI:10.1002/pds.4072. [60]PEDERSEN L H.Prenatal antidepressant exposure and childhood autism spectrum disorders:cause for concern?[J].Paediatr Drugs,2015,17(6):443-448.DOI:10.1007/s40272-015-0141-5. [61]GRZESKOWIAK L E,GILBERT A L,S?RENSEN T I,et al.Prenatal exposure to selective serotonin reuptake inhibitors and childhood overweight at 7 years of age[J].Ann Epidemiol,2013,23(11):681-687.DOI:10.1016/j.annepidem.2013.08.005. [62]LIND J N,TINKER S C,BROUSSARD C S,et al.Maternal medication and herbal use and risk for hypospadias:data from the National Birth Defects Prevention Study,1997—2007[J].Pharmacoepidemiol Drug Saf,2013,22(7):783-793.DOI:10.1002/pds.3448. [63]POLEN K N,RASMUSSEN S A,RIEHLE-COLARUSSO T,et al.Association between reported venlafaxine use in early pregnancy and birth defects,national birth defects prevention study,1997—2007[J].Birth Defects Res Part A Clin Mol Teratol,2013,97(1):28-35.DOI:10.1002/bdra.23096. [64]HOOG S L,CHENG Y K,ELPERS J,et al.Duloxetine and pregnancy outcomes:safety surveillance findings[J].Int J Med Sci,2013,10(4):413-419.DOI:10.7150/ijms.5213. [65]HEINONEN O P,SLONE D,SHAPIRO S.Birth defects and drugs in pregnancy[J].American Journal of Human Genetics,1980,29:(5). [66]RAMOS E,ST-ANDRé M,REY E,et al.Duration of antidepressant use during pregnancy and risk of major congenital malformations[J].Br J Psychiatry,2008,192(5):344-350.DOI:10.1192/bjp.bp.107.042523. [67]PEDERSEN L H.The risks associated with prenatal antidepressant exposure:time for a precision medicine approach[J].Expert Opin Drug Saf,2017,16(8):915-921.DOI:10.1080/14740338.2017.1341872. [68]KERNS L L.Treatment of mental disorders in pregnancy.A review of psychotropic drug risks and benefits[J].J Nerv Ment Dis,1986,174(11):652-659. [69]Use of psychoactive medication during pregnancy and possible effects on the fetus and newborn.Committee on drugs.American Academy of Pediatrics[J].Pediatrics,2000,105(4 Pt 1):880-887. [70]HANLEY G E,MINTZES B.Patterns of psychotropic medicine use in pregnancy in the United States from 2006 to 2011 among women with private insurance[J].BMC Pregnancy Childbirth,2014,14:242.DOI:10.1186/1471-2393-14-242. [71]MARGULIS A V,KANG E M,HAMMAD T A.Patterns of prescription of antidepressants and antipsychotics across and within pregnancies in a population-based UK cohort[J].Matern Child Health J,2014,18(7):1742-1752.DOI:10.1007/s10995-013-1419-2. [72]SABAHI A,SEPEHRI G,MOHSENBEIGI M,et al.Patterns of psychotropic medication prescriptions by psychiatrists for private clinic outpatients in kerman province,Iran[J].Sultan Qaboos Univ Med J,2014,14(3):e382-e387. [73]HANLEY G E,OBERLANDER T F.The effect of perinatal exposures on the infant:antidepressants and depression[J].Best Pract Res Clin Obstet Gynaecol,2014,28(1):37-48.DOI:10.1016/j.bpobgyn.2013.09.001. [74]MCDONAGH M S,MATTHEWS A,PHILLIPI C,et al.Depression drug treatment outcomes in pregnancy and the postpartum period:a systematic review and meta-analysis[J].Obstet Gynecol,2014,124(3):526-534.DOI:10.1097/AOG.0000000000000410. [75]WEISSKOPF E,FISCHER C J,BICKLE GRAZ M,et al.Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence[J].Expert Opin Drug Saf,2015,14(3):413-427.DOI:10.1517/14740338.2015.997708. [76]ROBINSON G E.Controversies about the use of antidepressants in pregnancy[J].J Nerv Ment Dis,2015,203(3):159-163.DOI:10.1097/NMD.0000000000000256. [77]JANICAK P G,DAVIS J M,PRESKORN S H,et al.Principles and practice of psychopharmacotherapy[M].Philadelphia:Lippincott,William and Wilkins,2001:156-162. [78]HOWLAND R H.Antidepressant medication and pregnancy:time for randomized controlled trials[J].J Psychosoc Nurs Ment Health Serv,2013,51(2):11-14.DOI:10.3928/02793695-20130109-01. [79]VIGOD S N,WILSON C A,HOWARD L M.Depression in pregnancy[J].BMJ,2016,352:i1547.DOI:10.1136/bmj.i1547. [80]RAY S,STOWE Z N.The use of antidepressant medication in pregnancy[J].Best Pract Res Clin Obstet Gynaecol,2014,28(1):71-83.DOI:10.1016/j.bpobgyn.2013.09.005. [81]GRIGORIADIS S,VONDERPORTEN E H,MAMISASHVILI L,et al.The impact of maternal depression during pregnancy on perinatal outcomes:a systematic review and meta-analysis[J].J Clin Psychiatry,2013,74(4):e321-e341.DOI:10.4088/JCP.12r07968. [82]HOWARD L M,MOLYNEAUX E,DENNIS C L,et al.Non-psychotic mental disorders in the perinatal period[J].Lancet,2014,384(9956):1775-1788.DOI:10.1016/S0140-6736(14)61276-9. [83]STEIN A,PEARSON R M,GOODMAN S H,et al.Effects of perinatal mental disorders on the fetus and child[J].Lancet,2014,384(9956):1800-1819.DOI:10.1016/S0140-6736(14)61277-0. [84]GJERE N A.Psychopharmacology in pregnancy[J].J Perinat Neonatal Nurs,2001,14(4):12-25. [85]DREW L.Pharmacogenetics:the right drug for you[J].Nature,2016,537(7619):S60-S62.DOI:10.1038/537S60a. [86]IQBAL M,AUDETTE M C,PETROPOULOS S,et al.Placental drug transporters and their role in fetal protection[J].Placenta,2012,33(3):137-142.DOI:10.1016/j.placenta.2012.01.008. [87]HICKS J K,BISHOP J R,SANGKUHL K,et al.Clinical pharmacogenetics implementation consortium(CPIC) guideline for CYP2D6 and CYP2C19 genotypes and dosing of selective serotonin reuptake inhibitors[J].Clin Pharmacol Ther,2012,98(2):127-134.DOI:10.1002/cpt.147. [88]HICKS J K,SWEN J J,THORN C F,et al.Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants[J].Clin Pharmacol Ther,2013,93(5):402-408.DOI:10.1038/clpt.2013.2. |
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