Psychopharmaka in der Schwangerschaft

Da viele psychiatrische Erkrankungen im jungen Erwachsenenalter manifest werden, gibt es auch immer mehr Frauen im gebärfähigen Alter bzw. mit Kinderwunsch, die bereits Psychopharmaka einnehmen. Und andere Frauen erkranken erstmalig psychisch, während sie schwanger sind. Daher ist die Frage nach Psychopharmaka in der Schwangerschaft ein Problem, mit dem man im klinischen Alltag immer häufiger konfrontiert wird.

• Literatur

• 1 Herba CM, Glover V, Ramchandani PG. et al. Maternal depression and mental health in early childhood: an examination of underlying mechanisms in low-income and middle-income countries. Lancet Psychiatry 2016; 3: 983-992 doi:10.1016/S2215-0366(16)30148-1
• 2 Andrade C. Major Congenital Malformations Associated With Exposure to Antiepileptic Drugs During Pregnancy. J Clin Psychiatry 2018; 79 doi:10.4088/JCP.18f12449
• 3 Tomson T, Battino D, Bonizzoni E. et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol 2018; 17: 530-538 doi:10.1016/S1474-4422(18)30107-8
• 4 Diav-Citrin O, Shechtman S, Tahover E. et al. Pregnancy outcome following in utero exposure to lithium: a prospective, comparative, observational study. Am J Psychiatry 2014; 171: 785-794 doi:10.1176/appi.ajp.2014.12111402
• 5 Patorno E, Huybrechts KF, Bateman BT. et al. Lithium Use in Pregnancy and the Risk of Cardiac Malformations. N Engl J Med 2017; 376: 2245-2254 doi:10.1056/NEJMoa1612222
• 6 Dolk H, Wang H, Loane M. et al. Lamotrigine use in pregnancy and risk of orofacial cleft and other congenital anomalies. Neurology 2016; 86: 1716-1725 doi:10.1212/WNL.0000000000002540
• 7 Veroniki AA, Rios P, Cogo E. et al. Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: a systematic review and network meta-analysis. BMJ Open 2017; 7: e017248 doi:10.1136/bmjopen-2017-017248
• 8 Clark CT, Klein AM, Perel JM. et al. Lamotrigine dosing for pregnant patients with bipolar disorder. Am J Psychiatry 2013; 170: 1240-1247 doi:10.1176/appi.ajp.2013.13010006
• 9 Patorno E, Bateman BT, Huybrechts KF. et al. Pregabalin use early in pregnancy and the risk of major congenital malformations. Neurology 2017; 88: 2020-2025 doi:10.1212/WNL.0000000000003959
• 10 Winterfeld U, Merlob P, Baud D. et al. Pregnancy outcome following maternal exposure to pregabalin may call for concern. Neurology 2016; 86: 2251-2257 doi:10.1212/WNL.0000000000002767
• 11 Huybrechts KF, Hernandez-Diaz S, Patorno E. et al. Antipsychotic Use in Pregnancy and the Risk for Congenital Malformations. JAMA Psychiatry 2016; 73: 938-946 doi:10.1001/jamapsychiatry.2016.1520
• 12 Wikner BN, Kallen B. Are hypnotic benzodiazepine receptor agonists teratogenic in humans?. J Clin Psychopharmacol 2011; 31: 356-359 doi:10.1097/JCP.0b013e3182197055
• 13 Enato E, Moretti M, Koren G. The fetal safety of benzodiazepines: an updated meta-analysis. J Obstet Gynaecol Can 2011; 33: 46-48
• 14 Ban L, West J, Gibson JE. et al. First trimester exposure to anxiolytic and hypnotic drugs and the risks of major congenital anomalies: a United Kingdom population-based cohort study. PLoS One 2014; 9: e100996 doi:10.1371/journal.pone.0100996
• 15 Okun ML, Ebert R, Saini B. A review of sleep-promoting medications used in pregnancy. Am J Obstet Gynecol 2015; 212: 428-441 doi:10.1016/j.ajog.2014.10.1106
• 16 Uzun S, Kozumplik O, Jakovljevic M. et al. Side effects of treatment with benzodiazepines. Psychiatr Danub 2010; 22: 90-93
• 17 Cohen LS, Goez-Mogollon L, Sosinsky AZ. et al. Risk of Major Malformations in Infants Following First-Trimester Exposure to Quetiapine. Am J Psychiatry 2018;
• 18 Uguz F. Prophylactic use of olanzapine and quetiapine from pregnancy to the postpartum period in women with bipolar disorder: a case series. J Matern Fetal Neonatal Med 2017; 30: 2569-2571 doi:10.1080/14767058.2016.1256991
• 19 Damkier P, Videbech P. The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review. CNS Drugs 2018; 32: 351-366 doi:10.1007/s40263-018-0517-5
• 20 Norby U, Winbladh B, Kallen K. Perinatal Outcomes After Treatment With ADHD Medication During Pregnancy. Pediatrics 2017;
• 21 Diav-Citrin O, Shechtman S, Arnon J. et al. Methylphenidate in Pregnancy: A Multicenter, Prospective, Comparative, Observational Study. J Clin Psychiatry 2016; 77: 1176-1181 doi:10.4088/JCP.15m10083
• 22 Dideriksen D, Pottegard A, Hallas J. et al. First trimester in utero exposure to methylphenidate. Basic Clin Pharmacol Toxicol 2013; 112: 73-76 doi:10.1111/bcpt.12034
• 23 Huybrechts KF, Hernandez-Diaz S, Avorn J. Antidepressant use in pregnancy and the risk of cardiac defects. N Engl J Med 2014; 371: 1168-1169 doi:10.1056/NEJMc1409203
• 24 Womersley K, Ripullone K, Agius M. What are the risks associated with different Selective Serotonin Re-uptake Inhibitors (SSRIs) to treat depression and anxiety in pregnancy? An evaluation of current evidence. Psychiatr Danub 2017; 29: 629-644
• 25 Gentile S. Tricyclic antidepressants in pregnancy and puerperium. Expert Opin Drug Saf 2014; 13: 207-225 doi:10.1517/14740338.2014.869582
• 26 Smit M, Dolman KM, Honig A. Mirtazapine in pregnancy and lactation – A systematic review. Eur Neuropsychopharmacol 2016; 26: 126-135 doi:10.1016/j.euroneuro.2015.06.014
• 27 Winterfeld U, Klinger G, Panchaud A. et al. Pregnancy outcome following maternal exposure to mirtazapine: a multicenter, prospective study. J Clin Psychopharmacol 2015; 35: 250-259 doi:10.1097/JCP.0000000000000309
• 28 Nanovskaya TN, Oncken C, Fokina VM. et al. Bupropion sustained release for pregnant smokers: a randomized, placebo-controlled trial. Am J Obstet Gynecol 2017; 216: 420.e421-422.e429 doi:10.1016/j.ajog.2016.11.1036
• 29 Kolding L, Pedersen LH, Henriksen TB. et al. Hypericum perforatum use during pregnancy and pregnancy outcome. Reprod Toxicol 2015; 58: 234-237 doi:10.1016/j.reprotox.2015.10.003
• 30 Huybrechts KF, Bateman BT, Palmsten K. et al. Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA 2015; 313: 2142-2151 doi:10.1001/jama.2015.5605
• 31 Ross LE, Grigoriadis S, Mamisashvili L. et al. Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis. JAMA Psychiatry 2013; 70: 436-443 doi:10.1001/jamapsychiatry.2013.684
• 32 Cantarutti A, Merlino L, Monzani E. et al. Is the Risk of Preterm Birth and Low Birth Weight Affected by the Use of Antidepressant Agents during Pregnancy? A Population-Based Investigation. PLoS One 2016; 11: e0168115 doi:10.1371/journal.pone.0168115
• 33 Jarde A, Morais M, Kingston D. et al. Neonatal Outcomes in Women With Untreated Antenatal Depression Compared With Women Without Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry 2016; 73: 826-837 doi:10.1001/jamapsychiatry.2016.0934
• 34 Salisbury AL, OʼGrady KE, Battle CL. et al. The Roles of Maternal Depression, Serotonin Reuptake Inhibitor Treatment, and Concomitant Benzodiazepine Use on Infant Neurobehavioral Functioning Over the First Postnatal Month. Am J Psychiatry 2016; 173: 147-157 doi:10.1176/appi.ajp.2015.14080989
• 35 El Marroun H, White TJ, van der Knaap NJ. et al. Prenatal exposure to selective serotonin reuptake inhibitors and social responsiveness symptoms of autism: population-based study of young children. Br J Psychiatry 2014; 205: 95-102 doi:10.1192/bjp.bp.113.127746
• 36 Boukhris T, Sheehy O, Mottron L. et al. Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children. JAMA Pediatr 2016; 170: 117-124 doi:10.1001/jamapediatrics.2015.3356
• 37 Brown HK, Hussain-Shamsy N, Lunsky Y. et al. The Association Between Antenatal Exposure to Selective Serotonin Reuptake Inhibitors and Autism: A Systematic Review and Meta-Analysis. J Clin Psychiatry 2017; 78: e48-e58 doi:10.4088/JCP.15r10194
• 38 Kieviet N, van Keulen V, van de Ven PM. et al. Serotonin and poor neonatal adaptation after antidepressant exposure in utero. Acta Neuropsychiatr 2017; 29: 43-53 doi:10.1017/neu.2016.30
• 39 Forsberg L, Naver L, Gustafsson LL. et al. Neonatal adaptation in infants prenatally exposed to antidepressants-clinical monitoring using Neonatal Abstinence Score. PLoS One 2014; 9: e111327 doi:10.1371/journal.pone.0111327
• 40 Smit M, Wennink H, Heres M. et al. Mirtazapine in pregnancy and lactation: data from a case series. J Clin Psychopharmacol 2015; 35: 163-167 doi:10.1097/JCP.0000000000000279