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CLASStime: Balancing emotions: Antidepressant use in pregnancy and breastfeeding
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CLASStime: Balancing emotions: Antidepressant use in pregnancy and breastfeeding
Wednesday 1 November 2023, 12:40 AM
[Image: Fraser Williamson]
Perinatal depression is common and carries considerable risks, yet patients often receive contradictory information regarding the safety of antidepressant use during pregnancy and breastfeeding. In this article, Lucy Broughton sets the record straight and explains how pharmacists can support this important treatment decision
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References
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- Stewart AL, Payne JL. Perinatal depression: A review and an update. Psychiatr Clin North Am 2023;46(3):447–61.
- Perinatal and Maternal Mortality Review Committee. Te Pūrongo ā-Tau Tekau mā Toru o te Komiti Arotake Mate Pēpi, Mate Whaea Hokihe | Thirteenth Annual Report of the Perinatal and Maternal Mortality Review Committee. Wellington, NZ: Health Quality and Safety Commission; 2019.
- Svardal CA, Waldie K, Milne B, et al. Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women. Aust N Z J Psychiatry 2022;56(5):489–99.
- Broughton LC, Hughes-Medlicott N, Zeng J, Smith A. Perinatal psychotropic dispensing: A descriptive population-based study in New Zealand. Asia Pac Psychiatry 2023;15(2–3):e12539.
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- BPACnz. Diagnosing and managing perinatal depression in primary care. November 2019.
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- Venkatesh KK, Riley L, Castro VM, et al. Association of antenatal depression symptoms and antidepressant treatment with preterm birth. Obstet Gynecol 2016;127(5):926–33.
- Malm H, Sourander A, Gissler M, et al. Pregnancy complications following prenatal exposure to SSRIs or maternal psychiatric disorders: Results from population-based national register data. Am J Psychiatry 2015;172(12):1224–32.
- Raffi ER, Nonacs R, Cohen LS. Safety of psychotropic medications during pregnancy. Clin Perinatol 2019;46(2):215–34.
- Desaunay P, Eude L-G, Dreyfus M, et al. Benefits and risks of antidepressant drugs during pregnancy: A systematic review of meta-analyses. Paediatr Drugs 2023;25(3):247–65.
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- Nulman I, Rovet J, Stewart DE, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: A prospective, controlled study. Am J Psychiatry 2002;159(11):1889–95.
- Medsafe. Small increased risk of postpartum haemorrhage with use of serotonergic antidepressants close to delivery. Prescriber Update 2021;42(2):23–24.
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- Briggs GG, Freeman RK, Tower CV, et al. Brigg's Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 12th edition. Lippincott Williams & Wilkins, US; 2021.
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