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Praxis der Pharmakotherapie der Depression in Schwangerschaft und Stillzeit

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Therapie der Depression

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Zusammenfassung

Bei der Behandlung von Frauen im gebärfähigen Alter tauchen nicht selten Fragen zu Risiken und Nutzen einer Psychopharmakotherapie bei Schwangerschaftswunsch, in Schwangerschaft und Stillzeit auf. Bei der Behandlung depressiver Erkrankungen in Schwangerschaft und Stillzeit muss die Option einer medikamentösen Behandlung nicht prinzipiell ausgeschlossen werden. Vielmehr bedarf es einer individuellen Nutzen-Risiko-Abwägung zwischen der Gefährdung von Mutter und Kind durch eine unbehandelte Depression ohne Medikamenteneinnahme und einer gut behandelten Depression unter einer Medikation. Bei einer Medikation muss die potenzielle Gefährdung des Kindes durch fetotoxische Medikamenteneffekte, Schwangerschafts- oder peripartale Komplikationen und mögliche Langzeitfolgen beachtet werden. Es liegen heute Daten für Antidepressiva vor, die eine gute Einschätzung über ihre Eignung in Schwangerschaft und Stillzeit erlauben. Unter Beachtung einiger Regeln und bei geeigneter Auswahl der Antidepressiva kann das Risiko für das Neugeborene in Schwangerschaft und Stillzeit minimiert werden. In der Stillzeit besteht prinzipiell die Möglichkeit des Abstillens. Therapeutisches Drug Monitoring erhöht die Arzneimittelsicherheit für Mutter und Kind

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Literatur

  • Abramowitz JS, Meltzer-Brody S, Leserman J, Killenberg S, Rinaldi K, Mahaffey BL, Pedersen C (2010) Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Arch Womens Ment Health 13:523–530

    Article  PubMed  Google Scholar 

  • Adab N (2006) Therapeutic monitoring of antiepileptic drugs during pregnancy and the postpartum period. Is it useful? CNS Drugs 20:791–800

    Article  CAS  PubMed  Google Scholar 

  • Ahokas AJ, Turtiainen S, Aito M (1998) Sublingual oestrogen treatment of postnatal depression. Lancet 351:109

    Article  CAS  PubMed  Google Scholar 

  • Altshuler LL, Cohen L, Szuba MP, Burt VK, Gitlin M, Mintz J (1996) Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry 153:592–606

    Article  CAS  PubMed  Google Scholar 

  • Andersen JT, Andersen NL, Horwitz H, Poulsen HE, Jimenez-Solem E (2014) Exposure to selective serotonin reuptake inhibitors in early pregnancy and the risk of miscarriage. Obstet Gynecol 124:655–661

    Article  CAS  PubMed  Google Scholar 

  • Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159:872–881

    Article  PubMed  Google Scholar 

  • Andrade C (2014) The safety of duloxetine during pregnancy and lactation. J Clin Psychiatry 75(12):e1423–1427

    Article  Google Scholar 

  • Andrade SE, Raebel MA, Brown J, Lane K, Livingston J, Boudreau D, Rolnick SJ, Roblin D, Smith DH, Willy ME, Staffa JA, Platt R (2008) Use of antidepressant medications during pregnancy: a multisite study. Am J Obstet Gynecol 198:194.e1–194.e5

    Article  CAS  Google Scholar 

  • Austin MP, Karatas JC, Mishra P, Christl B, Kennedy D, Oei J (2013) Infant neurodevelopment following in utero exposure to antidepressant medication. Acta Paediatr 102:1054–1059

    CAS  PubMed  Google Scholar 

  • Bäckström T, Bixo M, Hammarbäck S (1985) Ovarian steroid hormones. Effects and mood, behaviour and brain excitability. Acta Obstet Gynecol Scand 130:19–24

    Article  Google Scholar 

  • Ban L, Gibson JE, West J, Fiaschi L, Sokal R, Smeeth L, Doyle P, Hubbard RB, Tata LJ (2014) Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. BJOG 121:1471–1481

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bar-Oz B, Einarson T, Einarson A, Boskovic R, O′Brien L, Malm H, Bérard A, Koren G (2007) Paroxetine and congenital malformations: meta-analysis and consideration of potential confounding factors. Clin Ther 29:918–926

    Article  CAS  PubMed  Google Scholar 

  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709

    Article  PubMed  Google Scholar 

  • Bergemann N (2001) Psychotrope Effekte der Hormonsubstitutionstherapie. In: Riecher-Rössler A, Rohde A (Hrsg) Psychische Erkrankungen bei Frauen – Für eine geschlechtersensible Psychiatrie und Psychotherapie. Karger, Basel, S 138–164

    Google Scholar 

  • Bergemann N (2007) Antidepressive Therapie: Besonderheiten in Schwangerschaft und Stillzeit. Der Neurologe & Psychiater DNP 8(12):34–41

    Google Scholar 

  • Bergemann N (2009) Antidepressiva in der Schwangerschaft. Neurol Neurochir Psychiatr 10:41–47

    Google Scholar 

  • Bergemann N (2015) Mood Stabilizer in der Schwangerschaft. Psychopharmakotherapie 22:286–297

    Google Scholar 

  • Bergemann N, Rommel F (2010) Junge Frau mit affektiver Erkrankung – was tun, wenn sie schwanger wird? InFo Neurologie & Psychiatrie 12:30–39

    Google Scholar 

  • Bergemann N, Riecher-Rössler A (2005) Introduction and overview. In: Bergemann N, Riecher-Rössler A (Hrsg) Estrogen effects in psychiatric disorders. Springer, Wien, S 1–5

    Chapter  Google Scholar 

  • Bergemann N, Rommel F, Conca A (2009) Therapeutisches Drug-Monitoring von Psychopharmaka in der Schwangerschaft. Neurol Neurochir Psychiatr 10:38–40

    Google Scholar 

  • Bergink V, Kushner SA (2014) Lithium during pregnancy. Am J Psychiatry 171:712–715

    Article  PubMed  Google Scholar 

  • Bloch M, Schmidt PJ, Danaceau M, Murphy J, Nieman L, Rubinow DR (2000) Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatry 157:924–930

    Article  CAS  PubMed  Google Scholar 

  • Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49:726–735

    Article  PubMed  Google Scholar 

  • Brand SR, Brennan PA (2009) Impact of antenatal and postpartum maternal mental illness: how are the children? Clin Obstet Gynecol 52:441–455

    Article  PubMed  Google Scholar 

  • Briggs G, Freeman S, Yaffe S (1994) Drugs in pregnancy and lactation. Williams & Williams, Baltimore MD

    Google Scholar 

  • Brockington IF, Macdonald E, Wainscott G (2006) Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium. Arch Womens Ment Health 9:253–263

    Article  CAS  PubMed  Google Scholar 

  • Broich K, Greiner C, Paeschke N, Huber M (2015) Antidpressiva in der Schwangerschaft. Psychopharmakotherapie 22:268–277

    Google Scholar 

  • Buist A, Norman TR, Dennerstein L (1990) Breastfeeding and the use of psychotropic medication: a review. J Affect Disord 19:197–206

    Article  CAS  PubMed  Google Scholar 

  • Buttner MM, Mott SL, Pearlstein T, Stuart S, Zlotnick C, O’Hara MW (2013) Examination of premenstrual symptoms as a risk factor for depression in postpartum women. Arch Womens Ment Health 16:219–225

    Article  PubMed  PubMed Central  Google Scholar 

  • Byatt N, Deligiannidis KM, Freemann MP (2013) Antidepressant use in pregnancy: a critical review focused on risks and controversies. Acta Psychiatr Scand 127:94–114

    Article  CAS  PubMed  Google Scholar 

  • Campbell E, Kennedy F, Russell A, Smithson WH, Parsons L, Morrison PJ, Liggan B, Irwin B, Delanty N, Hunt SJ, Craig J, Morrow J (2014) Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. J Neurol Neurosurg Psychiatry 85:1029–1034

    Article  CAS  PubMed  Google Scholar 

  • Casper RC, Fleisher BE, Lee-Ancaja JC, Gilles A, Gaylor E, DeBattista A, Hoyme HE (2003) Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr 142:402–408

    Article  CAS  PubMed  Google Scholar 

  • Chan J, Natekar A, Einarson A, Koren G (2014) Risks of untreated depression in pregnancy. Can Fam Physician 60:242–243

    PubMed  PubMed Central  Google Scholar 

  • Chen H, Yang K, Choi S, Fischer JH, Jeong H (2009) Up-regulation of UDP-glucuronosyltransferase (UGT) 1A4 by 17β-estradiol: a potential mechanism of increased lamotrigine elimination in pregnancy. Drug Metab Dispos 37:1841–1847

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Clements CC, Castro VM, Blumenthal SR, Rosenfield HR, Murphy SN, Fava M, Erb JL, Churchill SE, Kaimal AJ, Doyle AE, Robinson EB, Smoller JW, Kohane IS, Perlis RH (2015) Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. Mol Psychiatr 20:272–734

    Article  CAS  Google Scholar 

  • Cohen LS, Friedman JM, Jefferson JW, Johnson EM, Weiner ML (1994) A reevaluation of risk of in utero exposure to lithium. JAMA 271:146–150

    Article  CAS  PubMed  Google Scholar 

  • Cohen LS, Nonacs RM, Bailey JW, Viguera AC, Reminick AM, Altshuler LL, Stowe ZN, Faraone SV (2004) Relapse of depression during pregnancy following antidepressant discontinuation: a preliminary prospective study. Arch Womens Ment Health 7:217–221

    Article  CAS  PubMed  Google Scholar 

  • Cohen LS, Altshuler LL, Harlow BL, Nonacs R, Newport DJ, Viguera AC, Suri R, Burt VK, Hendrick V, Reminick AM, Loughead A, Vitonis AF, Stowe ZN (2006) Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 295:499–507 (Erratum in: JAMA 2006, 296:170)

    Article  CAS  PubMed  Google Scholar 

  • Cole JA, Ephross SA, Cosmatos, Walker AM (2007) Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf 16:1075–1085

    Article  PubMed  Google Scholar 

  • Cooper WO, Pont ME, Ray WA (2007) Increasing use of antidepressants in pregnancy. Am J Obstet Gynecol196:544.e1-5

    Article  CAS  Google Scholar 

  • Cox JL, Connor Y, Kendell RE (1982) Prospective study of the psychiatric disorders of childbirth. Br J Psychiatry 140:111–117

    Article  CAS  PubMed  Google Scholar 

  • Czeizel A, Rácz J (1990) Evaluation of drug intake during pregnancy in the Hungarian Case-Control Surveillance of Congenital Anomalies. Teratology 42:505–512

    Article  CAS  PubMed  Google Scholar 

  • Deligiannidis KM, Byatt N, Freeman MP (2014) Pharmacotherapy for mood disorders in pregnancy. A review of pharmacokinetic changes and clinical recommendations for therapeutic drug monitoring. J Clin Psychopharamcol 2:244–255

    Article  CAS  Google Scholar 

  • DeVane CL, Stowe ZN, Donovan JL, Newport DJ, Pennell PB, Ritchie JC, Owens MJ, Wang JS (2006) Therapeutic drug monitoring of psychoactive drugs during pregnancy in the genomic era: challenges and opportunities. J Psychopharmacol 20:54–59

    Article  PubMed  Google Scholar 

  • DeVries NKS, Van der Veere CN, Reijneveld SA, Bos AF (2013) Early neurological outcome of young infants exposed to selective serotonin reuptake inhibitors during pregnancy: results from the observational SMOK study. PLoS ONE 8:e64654

    Article  CAS  Google Scholar 

  • Diav-Citrin O, Shechtman S, Weinbaum D, Arnon J, Di Gianantonio E, Clementi M, Ornoy A (2005) Paroxetine and fluoxetine in pregnancy: controlled study. Reprod Toxicol 220:459

    Google Scholar 

  • Diav-Citrin O, Shechtman S, Tahover E, Finkel-Pekarsky V, Arnon J, Kennedy D, Erebara A, Einarson A, Ornoy A (2014) Pregnancy outcome following in utero exposure to lithium: a prospective, comparative, observational study. Am J Psychiatry 171:785–794

    Article  PubMed  Google Scholar 

  • di Scalea TL, Wisner KL (2009) Pharmacotherapy of postpartum depression. Expert Opin Pharmacother 10:2593–2607

    Article  PubMed  CAS  Google Scholar 

  • Do T, Hu Z, Otto J, Rohrbeck P (2013) Depression and suicidality during the postpartum period after first time deliveries, active component service women and dependent spouses, U.S. armed forces, 2007–2012. MSMR 20:2–7

    PubMed  Google Scholar 

  • Einarson A, Pistelli A, DeSantis M, Malm H, Paulus WD, Panchaud A, Kennedy D, Einarson TR, Koren G (2008) Evaluation of the risk of congenital cardiovascular defects associated with use of paroxetine during pregnancy. Am J Psychiatry 165:749–752

    Article  PubMed  Google Scholar 

  • El Marroun H, White T, Verhulst FC, Tiemeier H (2014) Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: a systematic review. Eur Child Adolesc Psychiatry 23:973–992

    Article  PubMed  Google Scholar 

  • Ellfolk M, Malm H (2010) Risks associated with in utero and lactation exposure to selective serotonin reuptake inhibitors (SSRIs). Reprod Toxicol 30:249–260

    Article  CAS  PubMed  Google Scholar 

  • Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Farr SL, Dietz PM, O’Hara MW, Burley K, Ko JY (2014) Postpartum anxiety and comorbid depression in a population-based sample of women. J Womens Health (Larchmt) 23:120–128

    Article  Google Scholar 

  • Figuerosa R (2010) Use of antidepressants during pregnancy and risk of attention-deficit/hyperactivity disorder in the offspring. J Dev Behav Pediatr 31:641–648

    Article  Google Scholar 

  • Frick A, Reck C, Fuchs T, Aderjan R, Grimm D, Bergemann N (2005) Fluvoxamininduzierte epileptische Anfälle bei einem 7 Wochen alten, gestillten Säugling. Fortschr Neurol Psychiatr 73:629

    Article  Google Scholar 

  • Furu K, Kieler H., Haglund B, Engeland A, Engeland A, Selmer R, Stephansson O, Valdimarsdottir UA, Zoega H, Artama M, Gissler M, Malm H, Nørgaard M (2015) Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ 350:h1798

    Article  Google Scholar 

  • Garbis H, McElhatton PR (2007) Psychotropic drugs. In: Schaefer C, Peters P, Miller RK (Hrsg) Drugs during pregnancy and lactation. Treatment options and risk assessment, 2. Aufl. Academic Press/Elsevier, Amsterdam NL, S 288–320

    Chapter  Google Scholar 

  • Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083

    Article  PubMed  Google Scholar 

  • Gentile S (2005) The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf 28:137–152

    Article  CAS  PubMed  Google Scholar 

  • Gentile S (2011) Drug treatment for mood disorders in pregnancy. Curr Opin Psychiatry 24:34–40

    Article  PubMed  Google Scholar 

  • Gentile S (2012) Lithium in pregnancy: the need to treat, the duty to ensure safety. Expert Opin Drug Saf 11:425–437

    Article  CAS  PubMed  Google Scholar 

  • Gentile S (2015) Early pregnancy exposure to selective serotonin reuptake inhibitors, risks of major structural malformations, and hypothesized teratogenic mechanisms. Expert Opin Drug Metab Toxicol 11:1585–1597

    Article  CAS  PubMed  Google Scholar 

  • Gentile S, Galbally M (2010) Prenatal exposure to antidepressant medications and neurodevelopmental outcomes: a systematic review. J Affect Disord 128:1–9

    Article  PubMed  CAS  Google Scholar 

  • GlaxoSmithKline (2007) The Bupropion Pregnancy Registry – Interim Report, 1 September 1997 through 28 February 2007

    Google Scholar 

  • Glynn LM, Davis EP, Sandman CA (2013) New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides 47:363–370

    Article  CAS  PubMed  Google Scholar 

  • Grandjean EM, Aubry JM (2009) Lithium: updated human knowledge using an evidence-based approach. Part III: clinical safety. CNS Drugs 23:397–418

    Article  CAS  PubMed  Google Scholar 

  • Gregoire AJP, Kumar R, Everitt B (1996) Transdermal oestrogen for treatment of severe postnatal depression. Lancet 347:930–933

    Article  CAS  PubMed  Google Scholar 

  • Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, Steiner M, Mousmanis P, Cheung A, Ross LE (2014) Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis. BMJ 348:f6932

    Article  CAS  Google Scholar 

  • Guclu S, Gol M, Dogan E, Savgili U (2005) Mirtazapine use in resistant hyperemesis gravidarum: report of three cases and review of the literature. Arch Gynecol Obstet 272:298–300

    Article  PubMed  Google Scholar 

  • Hadjikhani N (2010) Serotonin, pregnancy and increased autism prevalence: is there a link? Med Hypotheses 74:880–883

    Article  CAS  PubMed  Google Scholar 

  • Hägg S, Spigset O (2000) Anticonvulsant use during lactation. Drug Saf 22:425–440

    Article  PubMed  Google Scholar 

  • Hale TW (2003) Medications in breastfeeding mothers of preterm infants. Pediatr Ann 32:337–347

    Article  PubMed  Google Scholar 

  • Hale TW (2004) Maternal medications during breastfeeding. Clin Obstet Gynecol 47:696–711

    Article  PubMed  Google Scholar 

  • Hanley GE, Oberlander TF (2012) Neurodevelopmental outcomes following prenatal exposure to serotonin reuptake inhibitor antidepressants: a “social teratogen” or moderator of developmental risk? Birth Defects Res A Clin Mol Teratol 94:651–659

    Article  CAS  PubMed  Google Scholar 

  • Harrington RA, Lee LC, Crum RM, Zimmermann AW, Hertz-Picciotto (2014) Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics 133:e1241-1248

    Article  Google Scholar 

  • Harris B, Lovett L, Newcombe RG, Read GF, Walker R, Riad-Fahmy D (1994) Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II. BMJ 308:949–953

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthøj B, Gattaz WF, Thibaut F, Möller HJ; WFSBP Task Force on Treatment Guidelines for Schizophrenia (2015) World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. Part 3: Update 2015 Management of special circumstances: Depression, suicidality, substance use disorders and pregnancy and lactation. World J Biol Psychiatry 16:142–170

    Article  PubMed  Google Scholar 

  • Hemels ME, Einarson A, Koren G, Lanctôt KL, Einarson TR (2005) Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother 39:803–809

    Article  PubMed  Google Scholar 

  • Hermansen TK, Melinder A (2015) Prenatal SSRI exposure: effects on later child development. Child Neuropsychol 21:543–569

    Article  PubMed  Google Scholar 

  • Hiemke C, Baumann P, Bergemann N, Conca A, Dietmaier O, Egberts K, Fric M, Gerlach M, Greiner C, Gründer G, Haen E, Havemann-Reinecke U, Jaquenoud Sirot E, Kirchherr H, Laux G, Lutz UC, Messer T, Müller MJ, Pfuhlmann B, Rambeck B, Riederer P, Schoppek B, Stingl J, Uhr M, Ulrich S, Waschgler R, Zernig G (2011) AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Psychiatry: Update 2011. Pharmacopsychiatry 44(6):195–235)

    Article  Google Scholar 

  • Huybrechts KF, Hernandez-Diaz S, Avorn J. (2014) Antidepressant use in pregnancy and the risk of cardiac defects. N Engl J Med 371:1168–1169

    PubMed  Google Scholar 

  • Huybrechts KF, Bateman BT, Palmsten K, Desai RJ, Patorno E, Gopalakrishnan C, Levin R, Mogun H, Hernandez-Diaz S (2015) Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA 313:2142–2151

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jacobson SJ, Jones K, Johnson K, Ceolin L, Kaur P, Sahn D, Donnenfeld AE, Rieder M, Santelli R, Smythe J (1992) Prospective multicenter study of pregnancy outcome after lithium exposure during first trimester. Lancet 339:530–533

    Article  CAS  PubMed  Google Scholar 

  • Jones I, McDonald L (2014) Living with uncertainty: antidepressants and pregnancy. Br J Psychiatry 205:103–104

    Article  PubMed  Google Scholar 

  • Jones I, Chandra PS, Dazzan P, Howard LM (2014) Bipolar disorder, affective psychosis and schizophrenia in pregnancy and the post-partum period. Lancet 384:1789–1799

    Article  PubMed  Google Scholar 

  • Källén BA (2007) The safety of antidepressant drugs during pregnancy. Expert Opin Drug Saf 6:357–370

    Article  PubMed  Google Scholar 

  • Källén BA, Otterblad Olausson P (2007) Maternal use of selective serotonin re-uptake inhibitors in early pregnancy and infant congenital malformations. Birth Defects Res A Clin Mol Teratol 79:301–308

    Article  PubMed  CAS  Google Scholar 

  • Kieler H, Artama M, Engeland A, Ericsson O, Furu K, Gissler M, Nielsen RB, Nørgaard M, Stephansson O, Valdimarsdottir U, Zoega H, Haglund B (2012) Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ 344:d8012

    Article  PubMed  CAS  Google Scholar 

  • Kim DR, Epperson CN, Weiss AR, Wisner KL (2014) Pharmacotherapy of postpartum depression: an update. Expert Opin Pharmacother 15:1223–1234

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kinsella MT, Monk C (2009) Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 52:425–440

    Article  PubMed  PubMed Central  Google Scholar 

  • Kissling W, Hamann J (2010) Partizipation, Integrierte Versorgung. In: Riederer PF, Laux G (Hrsg) Grundlagen der Neuro-Psychopharmakologie. Ein Therapiehandbuch. Springer, Wien, S 199–213

    Google Scholar 

  • Kjaersgaard MI, Parner ET, Vestergaard M, Sorensen MJ, Olsen J, Christensen J, Bech BH, Pedersen LH (2013) Prenatal antidepressant exposure and risk of spontaneous abortion – a population-based study. PLoS One 8:e72095

    Article  CAS  Google Scholar 

  • Klinger G, Merlob P (2008) Selective serotonin reuptake inhibitor induced neonatal abstinence syndrome. Isr J Psychiatriy Relat Sci 45:107–113

    Google Scholar 

  • Knoppert DC, Nimkar R, Principi T, Yuen D (2006) Paroxetine toxicity in a newborn after in utero exposure: clinical symptoms correlate with serum levels.Ther Drug Monit 28(1):5–7

    Article  PubMed  Google Scholar 

  • Knutti R, Rothweiler H, Schlatter C (1982) The effect of pregnancy on the pharmacokinetics of caffeine. Arch Toxicol (Suppl.) 5:187–192

    Article  CAS  Google Scholar 

  • Koren G (2006) A new indication for therapeutic drug monitoring in the neonate. Ther Drug Monit 28:1

    Article  PubMed  Google Scholar 

  • Kozma C (2005) Neonatal toxicity and transient neurodevelopmental deficits following prenatal exposure to lithium: Another clinical report and a review of the literature. Am J Med Genet 132 A:441–444

    Article  Google Scholar 

  • Kuhl H (2002) Einfluss von Psychopharmaka auf Reproduktion und Kontrazeption. In: Kuhl H (Hrsg) Sexualhormone und Psyche. Thieme, Stuttgart, S 48–56

    Google Scholar 

  • Laugesen K, Olsen MS, Andersen ABT, Frøslev T, Sørensen HT (2013) In utero exposure to antidepressant drugs and risk of attention deficit hyperactivity disorder: a nationwide Danish cohort study. BMJ Open 3:e003507

    Article  PubMed  PubMed Central  Google Scholar 

  • Lakshminrusimha S, Steinhorn RH (1999) Pulmonary vascular biology during neonatal transition. Clin Perinatol 26:601–619

    CAS  PubMed  Google Scholar 

  • Lamberg L (2005) Risks and benefits key to psychotropic use during pregnancy and postpartum period. JAMA 294:1604–1608

    Article  CAS  PubMed  Google Scholar 

  • Lanczik M, Knoche M, Fritze J (1998a) Psychopharmakotherapie während Gravidität und Laktation. Teil 1: Gravidität. Nervenarzt 69:1–9

    Article  CAS  PubMed  Google Scholar 

  • Lanczik M, Knoche M, Fritze J (1998b) Psychopharmakotherapie während Gravidität und Laktation. Teil 2: Laktation. Nervenarzt 69:10–14

    Article  CAS  PubMed  Google Scholar 

  • Lassen D, Ennis ZN, Damkier P (2016) First-trimester pregnancy exposure to venlafaxine or duloxetine and risk of major congenital malformations: a systematic review. Basic Clin Pharmacol Toxicol 118:32–36

    Article  CAS  PubMed  Google Scholar 

  • Leung AK, Sauve RS (2005) Breast is best for babies. J Natl Med Assoc 97:1010–1019

    PubMed  PubMed Central  Google Scholar 

  • Loebstein R, Koren G (2002) Clinical relevance of therapeutic drug monitoring during pregnancy. Ther Drug Monit 24:15–22

    Article  CAS  PubMed  Google Scholar 

  • Lorenzo L, Einarson A (2014) Antidepressant use in pregnancy: An evaluation of adverse outcomes excluding malformations. Isr J Psychiatry Relat Sci 51:94–105

    PubMed  Google Scholar 

  • Malm H, Sourander A, Gissler M, Gyllenberg D, Hinkka-Yli-Salomäki S, McKeague IW, Artama M, Brown AS (2016) Pregnancy complications following prenatal exposure to SSRIs or maternal psychiatric disorders: results from population-based national register data. Am J Psychiatry 172:1224–1232

    Article  Google Scholar 

  • Margulis AV, Kang EM, Hammad TA (2014) Patterns of prescription of antidepressants and antipsychotics across and within pregnancies in a population-based UK cohort. Matern Child Health J 18:1742–1752

    Article  PubMed  Google Scholar 

  • McKnight RF, Marc A, Budge K, Stockton S, Goddwin GM, Geddes JR (2012) Lithium toxicity profile: a systematic review and meta-analysis. Lancet 379:721–728

    Article  CAS  PubMed  Google Scholar 

  • Mortola JF (1989) The use of psychotropic agents in pregnancy and lactation. Psychiatr Clin North Am 12:69–87

    CAS  PubMed  Google Scholar 

  • Moses-Kolko EL, Bogen D, Perel J, Bregar A, Uhl K, Levin B, Wisner KL (2005) Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 293:2372–2383

    Article  CAS  PubMed  Google Scholar 

  • Moses-Kolko EL, Berga SL, Kalro B, Sit DKY, Wisner KL (2009) Transdermal estradiol for postpartum depression: a promising treatment option. Clin Obstet Gynecol 52:516–529

    Article  PubMed  PubMed Central  Google Scholar 

  • Munk-Olsen T, Laursen TM, Mendelson T, et al. (2009) Risks and predictors of readmission for a mental disorder during the postpartum period. Arch Gen Psychiatry 66:189–195

    Article  PubMed  Google Scholar 

  • Musenga A, Saracino MA, Sani G, Raggi MA (2009) Antipsychotic and antiepileptic drugs in bipolar disorder: the importance of therapeutic drug monitoring. Curr Med Chem 16:1463–1481

    Article  CAS  PubMed  Google Scholar 

  • Myles N, Newall H, Ward H, Large M (2013) Systematic meta-analysis of individual selective serotonin reuptake inhibitor medications and congenital malformations. Aust N Z J Psychiatry 47:1002–1002

    Article  PubMed  Google Scholar 

  • Nomura J, Okano T (1992) Endocrine function and hormonal treatment of postpartum psychosis. In: Hamilton JA, Harberger PN (Hrsg) Postpartum psychiatric illness – a picture puzzle. University of Pennsylvania Press, Philadelphia PA, S 176–190

    Google Scholar 

  • Nordeng H, Gelder M, Spigset O, Koren G, Einarson A, Eberhard-Gran M (2011) Antidepressant exposure, maternal depression and pregnancy outcome – results from the Norwegian mother and child cohort study. Reprod Toxicol 31:263

    Article  CAS  Google Scholar 

  • Nulman I, Rovet J, Stewart DE, Wolpin J, Gardner HA, Theis JGW, Kulin N, Koren G (1997) Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 336:258–262

    Article  CAS  PubMed  Google Scholar 

  • Nulman I, Rovet J, Stewart DE, Wolpin J, Pace-Asciak P, Shuhaiber S, Koren G (2002) Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry 159:1889–1895

    Article  PubMed  Google Scholar 

  • Nulman I, Koren G, Rovet J, Barrera M, Pulver A, Streiner D, Feldman B (2012) Neurodevelopment of children following prenatal exposure to venlafaxine, selective serotonin reuptake inhibitors, or untreated maternal depression. Am J Psychiatry 169:1165–1174

    Article  PubMed  Google Scholar 

  • Nulman I, Koren G, Rovet J, Barrera M, Streiner DL, Feldman BM (2015) Neurodevelopment of children prenatally exposed to selective reuptake inhibitor antidepressants: Toronto sibling study. J Clin Psychiatry 76:e842–847

    Article  Google Scholar 

  • Occhiogrosso M, Omran SS, Altemus M (2012) Persistent pulmonary hypertension of the newborn and selelctive serotonin reuptake inhibitors: lessons from clinical and translational studies. Am J Psychiatry 169:134–140

    Article  PubMed  Google Scholar 

  • Ogburn PL Jr, Hurt RD, Croghan IT, Schroeder DR, Ramin KD, Offord KP, Moyer TP (1999) Nicotine patch use in pregnant smokers: nicotine and cotinine levels and fetal effects. Am J Obstet Gynecol 181:736–743

    Article  CAS  PubMed  Google Scholar 

  • O’Hara MW (1986) Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry 43:569–573

    Article  PubMed  Google Scholar 

  • O’Hara MW, McCabe JE (2013) Postpartum depression: current status and future directions. Annu Rev Clin Psychol 9:379–407

    Article  PubMed  Google Scholar 

  • O’Hara MW, Schlechte JA, Lewis DA, Wright EJ (1991) Prospective study of postpartum blues. Biological and psychosocial factors. Arch Gen Psychiatry 48:801–806

    Article  PubMed  Google Scholar 

  • O’Keane V, Marsh MS (2007) Pregnancy Plus: Depression during pregnancy. BMJ 334:1003–1005

    Article  PubMed  PubMed Central  Google Scholar 

  • Oncken CA, Hatsukami DK, Lupo VR, Lando HA, Gibeau LM, Hansen RJ (1996) Effects of short-term use of nicotine gum in pregnant smokers. Clin Pharmacol Ther 59:654–661

    Article  CAS  PubMed  Google Scholar 

  • Pavek P, Ceckova M, Staud F (2009) Variation of drug kinetics in pregnancy. Curr Drug Metab 10:520–529

    Article  CAS  PubMed  Google Scholar 

  • Paykel ES, Emms EM, Fletcher J, Rassaby ES (1980) Life events and social support in puerperal depression. Br J Psychiatry 136:339–346

    Article  CAS  PubMed  Google Scholar 

  • Pedersen LH, Henriksen TB, Vestergaard N, Olsen J, Bech BH (2009) Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study. BMJ 339:b3569

    Article  Google Scholar 

  • Pedersen LH, Henriksen TB, Bech BH, Licht RW, Kjaer D, Olsen J (2013) Prenatal antidepressant exposure and behavioral problems in early childhood – a cohort study. Acta Psychiatr Scand 127:125–135

    Article  Google Scholar 

  • Petersen I, Evans S, Nazareth I (2014) Prenatal exposure to selective serotonin reuptake inhibitors and autistic symptoms in young children: another red herring? Br J Psychiatry 205:105–106

    Article  PubMed  Google Scholar 

  • Pinsonneault JK, Sullivan D, Sadee W, Soares CN, Hampson E, Steiner M (2013) Association study of the estrogen receptor gene ESR1 with postpartum depression-a pilot study. Arch Womens Ment Health 16:499–509

    Article  PubMed  Google Scholar 

  • Pond SM, Kreek MJ, Tong TG, Raghunath J, Benowitz NL (1985) Altered methadone pharmacokinetics in methadone-maintained pregnant women. Pharmacol Exp Ther 233:1–6

    CAS  Google Scholar 

  • Queißer-Luft A, Spranger J (2006) Fehlbildungen bei Neugeborenen. Dtsch Aerztebl 103:A2464–2471

    Google Scholar 

  • Rahman A, Iqbal Z, Harrington R (2003) Life events, social support and depression in childbirth: perspectives from a rural community in the developing world. Psychol Med 33:1161–1167

    Article  CAS  PubMed  Google Scholar 

  • Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R (2004) Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry 61:946–952

    Article  PubMed  Google Scholar 

  • Rahman A, Bunn J, Lovel H, Creed F (2007) Association between antenatal depression and low birthweight in a developing country. Acta Psychiatr Scand 115:481–486

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C (2013) Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ 19:346:f2059

    Google Scholar 

  • Reis M, Källén B (2010) Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med 40:1723–1733

    Article  CAS  PubMed  Google Scholar 

  • Righetti-Veltema M, Conne-Perréard E, Bousquet A, Manzano J (1998) Risk factors and predictive signs of postpartum depression. J Affect Disord 49:167–180

    Article  CAS  PubMed  Google Scholar 

  • Robinson GE (2015) Controversies about the use of antidepressants in pregnancy. J Nerv Ment Dis 203:159–163

    Article  PubMed  Google Scholar 

  • Roca A, Imaz ML, Torres A, Plaza A, Subirà S, Valdés M, Martin-Santos R, Garcia-Esteve L (2013) Unplanned pregnancy and discontinuation of SSRIs in pregnant women with previously treated affective disorder. J Affect Disord 150:807–813

    Article  CAS  PubMed  Google Scholar 

  • Ross LE, Grigoriadis S, Mamisashvili L, Vonderporten EH, Roerecke M, Rehm J, Dennis CL, Koren G, Steiner M, Mousmanis P, Cheung A (2013) Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis. JAMA Psychiatry 70:436–443

    Article  PubMed  Google Scholar 

  • Sacher J, Wilson AA, Houle S, Rusjan P, Hassan S, Bloomfield PM, Stewart DE, Meyer JH (2010) Elevated brain monoamine oxidase A binding in the early postpartum period. Arch Gen Psychiatry 67:468–474

    Article  PubMed  Google Scholar 

  • Sanz EJ, De-las-Cuevas C, Kiuru A, Bate A, Edwards R (2005) Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 365(9458):482–487

    Article  CAS  PubMed  Google Scholar 

  • Schaefer C, Spielmann H, Vetter K, Weber-Schöndorf C (Hrsg) (2012) Arzneimittel in Schwangerschaft und Stillzeit, 8. Aufl. Elsevier, München

    Google Scholar 

  • Schwabe U, Paffrath D (Hrsg) (2015) Arzneiverordnungs-Report 2015. Aktuelle Zahlen, Kosten, Trends und Kommentare. Springer, Heidelberg

    Google Scholar 

  • Sharma V, Burt VK, Ritchie HL (2009) Bipolar II postpartum depression: detection, diagnosis, and treatment. Am J Psychiatry 166:1217–1221

    Article  PubMed  Google Scholar 

  • Shechtman S, Sabbah U, Diav-Citrin O et al (2011) Lack of teratogenic effect of citalopram/escitalopram after in-utero exposure. Reprod Toxicol 31:265

    Article  CAS  Google Scholar 

  • Simon GE, Cunningham ML, Davis RL (2002) Outcomes of prenatal antidepressant exposure. Am J Psychiatry 159:2055–2061

    Article  PubMed  Google Scholar 

  • Skurtveit S, Selmer R, Roth C, Hernandez-Diaz S, Handal M (2014) Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway. BJOG 121:1621–1631

    Article  CAS  PubMed  Google Scholar 

  • Smith A, Cubis J, Brinsmead M, Lewin T, Singh B, Owens P, Chan EC, Hall C, Adler R, Lovelock M (1990) Mood changes, obstetric experience and alteration in plasma cortisol, beta-endorphin and corticotrophin releasing hormone during pregnancy and the puerperium. J Psychosom Res 34:53–69

    Article  CAS  PubMed  Google Scholar 

  • Steinhorn RH (2010) Neonatal pulmonary hypertension. Pediatr Crit Care Med 11(Suppl):79–84

    Article  Google Scholar 

  • Stowe ZN, Llewellyn A, Hostetter A, Nemeroff CB (2000) The use of psychiatric medications during breast-feeding. In: Steiner M, Yonkers KA, Eriksson E (Hrsg) Mood disorders in women. Dunitz, London GB, S 329–351

    Google Scholar 

  • Studd JW (2011) A guide to the treatment of depression in women by estrogens. Climacteric 14:637–642

    Article  CAS  PubMed  Google Scholar 

  • Taylor D, Paton C, Kerwin R (Hrsg) (2005) The Maudsley Prescribing Guidelines 2005. Taylor & Francis, London GB

    Google Scholar 

  • Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Sabers A, Perucca E, Vajda F; EURAP study group (2011) Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol 10:609–617

    Article  CAS  PubMed  Google Scholar 

  • Tomson T, Xue H, Battino D (2015) Major congenital malformations in children of women with epilepsy. Seizure 28:46–50

    Article  PubMed  Google Scholar 

  • Troyer WA, Pereila GR, Lannon RA, Belik J, Yoder MC (1993) Association of maternal lithium exposure and premature delivery. J Perinatol 13:123–127

    CAS  PubMed  Google Scholar 

  • Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, Zurick A, Cohen LS (2007) Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry 164:1817–1824

    Article  PubMed  Google Scholar 

  • Wadhawa PD, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, Wiglesworth AK, Sandman CA (2002) Behavioral perinatology: biobehavioral processes in human fetal development. Regul Pept 108:149–157

    Article  Google Scholar 

  • Warner JP (2000) Evidence-based psychopharmacology 3. Assessing evidence of harm: what are the teratogenic effects of lithium carbonate? Psychopharmacol 14:77–80

    Article  CAS  Google Scholar 

  • Wegner I, Edelbroek P, de Haan GJ, Lindhout D, Sander JW (2010) Drug monitoring of lamotrigine and oxcarbazepine combination during pregnancy. Epilepsia 51:2500–2502

    Article  PubMed  Google Scholar 

  • Weinberg MK, Tronick EZ (1998) The impact of maternal psychiatric illness on infant development. J Clin Psychiatry 59 (Suppl 2):53–61

    PubMed  Google Scholar 

  • Weinstein MR, Goldfield M (1975) Cardiovascular malformations with lithium use during pregnancy. Am J Psychiatry 132:529–531

    Article  CAS  PubMed  Google Scholar 

  • Weissman AM, Levy BT, Hartz AJ, Bentler S, Donohue M, Ellingrod VL, Wisner KL (2004) Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry 161:1066–1078

    Article  PubMed  Google Scholar 

  • Wichman CL, Moore KM, Lang TR, St Sauver JL, Heise RH Jr, Watson WJ (2009) Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc 84:23–27

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilson KL, Zelig CM, Harvey JP, Cunningham BS, Dolinsky BM, Napolitano PG (2011) Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol 28:19–24

    Article  PubMed  Google Scholar 

  • Wirz-Justice A, Bader A, Frisch U, Stieglitz RD, Alder J, Bitzer J, Hösli I, Jazbec S, Benedetti F, Terman M, Wisner KL, Riecher-Rössler A (2011) A randomized, double-blind, placebo-controlled study of light therapy for antepartum depression. J Clin Psychiatry 72:986–993

    Article  PubMed  Google Scholar 

  • Wisner KL, Gelenberg AJ, Leonard H, Zarin D, Frank E (1999) Pharmacologic treatment of depression during pregnancy. JAMA 282:1264–1269

    Article  CAS  PubMed  Google Scholar 

  • Wisner KL, Sit DK, McShea MC Rizzo DM, Zoretich RA, Hughes CL, Eng HF, Luther JF, Wisniewski SR, Costantino ML, Confer AL, Moses-Kolko EL, Famy CS, Hanusa BH (2013) Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry 70:490–498

    Article  PubMed  PubMed Central  Google Scholar 

  • Wurst KE, Poole C, Ephross SA, Olshan AF (2010) First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies. Birth Defects Res A Clin Mol Teratol 88:159–170

    Article  CAS  PubMed  Google Scholar 

  • Yacobi S, Ornoy A (2008) Is lithium a real teratogen? What can we conclude from the prospective versus retrospective studies? A review. Isr J Psychiatry Relat Sci 45:95–106

    PubMed  Google Scholar 

  • Yankowitz J, Niebyl JR (2001) Folic acid supplementation for prevention of birth defects. In: Yankowitz J, Niebyl JR (Hrsg) Drug Therapy in Pregnancy, 3. Aufl. Lippincott Williams & Wilkins, Philadelphia PA, S 187–193

    Google Scholar 

  • Yonkers KA, Blackwell KA, Glover J, Forray A (2014) Antidepressant use in pregnant and postpartum women. Annu Rev Clin Psychol 10:369–392

    Article  PubMed  Google Scholar 

  • Zegers B, Andriessen P (2003) Maternal lithium therapy and neonatal morbidity. Eur J Pediatr 162:348–349

    Article  PubMed  Google Scholar 

  • Zelkowitz P, Milet TH (1996) Postpartum psychiatric disorders: their relationship to psychological adjustment and marital satisfaction in the spouses. J Abnorm Psychol 105:281–285

    Article  CAS  PubMed  Google Scholar 

  • Zeskind PS, Stephens LE (2004) Maternal selective serotonin reuptake inhibitor use during pregnancy and newborn neurobehavior. Pediatrics 113:368–375

    Article  PubMed  Google Scholar 

  • Zhang H, Cui D, Wang B, Han Y-H, Balimane P, Yang Z, Sinz M,Rodrigues AD (2007) Pharmacokinetic drug interactions involving 17α-ethinylestradiol – a new look at an old drug. Clin Pharmacokinet 46:133–157

    Article  CAS  PubMed  Google Scholar 

  • Zuckerman B, Amaro H, Bauchner H, Cabral H (1989) Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol 160:1107–1111

    Article  CAS  PubMed  Google Scholar 

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    Niels Bergemann

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    Carsten Konrad

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Bergemann, N. (2017). Praxis der Pharmakotherapie der Depression in Schwangerschaft und Stillzeit. In: Konrad, C. (eds) Therapie der Depression. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-50347-8_15

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