Patterns of antidepressant use during pregnancy: a nationwide population-based cohort study.
Br J Clin Pharmacol
; 84(8): 1764-1775, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29665098
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Padrões de Prática Médica
/
Depressão
/
Uso de Medicamentos
/
Antidepressivos
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Pregnancy
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article