Selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors in pregnancy: Infant and childhood outcomes.

This position statement provides guidance for the monitoring, care, and follow-up of newborns exposed to selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) in utero. Depression and anxiety are common during pregnancy and postpartum. While there are risks to taking medications during pregnancy, untreated or incompletely managed depression and anxiety also carry risks for the newborn. Poor neonatal adaptation syndrome (PNAS) occurs in one-third of newborns exposed to SSRIs or SNRIs in utero, and is generally mild and self-limiting. The low levels of SSRIs and SNRIs excreted in breast milk are compatible with breastfeeding. Persistent pulmonary hypertension of the newborn and congenital heart defects are rare associations of exposure to SSRIs or SNRIs in utero. There are inconsistencies in the literature regarding neurodevelopmental outcomes, specifically autism spectrum disorder and attention-deficit hyperactivity disorder. The inconsistencies likely relate to other factors (i.e., genetics, maternal depression, lifestyle, and comorbidities), rather than exposure to SSRIs or SNRIs in utero. Health care providers and parents should be reassured that PNAS is generally treatable with nonpharmacological measures, and that the risk of serious adverse effects from exposure to SSRIs or SNRIs in utero is low.

Definite peak identification of (R)-and (S)-methadone and (R)- and (S)-EDDP using established HPLC and CE methods.

Methadone is widely used for the treatment of opioid dependence. HPLC and CE are widespread methods for drug monitoring and metabolism studies. Although the methods are widely used for methadone and its main metabolite EDDP [1, 2], a definite direct peak identification for EDDP enantiomers is not described. This study describes a method for specific identification of each peak in the chromatogram and electropherogram of methadone analysis. The result of the study demonstrates differences in the elution order of the enantiomers of methadone and EDDP due to the technique used for analysis. The elution order of EDDP using HPLC is interchanged with respect to the order of the peaks in the electropherogram.