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Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period

INTRODUCTION: About 15% of women experience a depressive episode during pregnancy, and 19% during the postpartum. Studies on safety of Antidepressants use during pregnancy have given controversial results. Obstetric-gynecological changes of pregnancy determine modifications in the pharmacokinetics o...

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Autores principales: Cafaro, R., Giorgetti, F., Giacovelli, L., Vanzetto, S., Cerolini, L., Colombo, A., Dell’Osso, B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566247/
http://dx.doi.org/10.1192/j.eurpsy.2022.605
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author Cafaro, R.
Giorgetti, F.
Giacovelli, L.
Vanzetto, S.
Cerolini, L.
Colombo, A.
Dell’Osso, B.
author_facet Cafaro, R.
Giorgetti, F.
Giacovelli, L.
Vanzetto, S.
Cerolini, L.
Colombo, A.
Dell’Osso, B.
author_sort Cafaro, R.
collection PubMed
description INTRODUCTION: About 15% of women experience a depressive episode during pregnancy, and 19% during the postpartum. Studies on safety of Antidepressants use during pregnancy have given controversial results. Obstetric-gynecological changes of pregnancy determine modifications in the pharmacokinetics of medications, through an altered metabolism of the CYP enzymes. Patient’s therapeutic response might also be influenced by polymorphisms of the genes encoding CYP enzymes. OBJECTIVES: In this perspective, we evaluated the correlation between pharmacokinetics, pharmacogenetics and psychopathological measures, analyzing SSRIs or SNRIs concentrations during the three trimesters of pregnancy, at birth and at postpartum, in order to define efficacy, tolerability and safety of Antidepressants (ADs) in the treatment of affective and anxiety disorders during pregnancy. METHODS: 87 patients were enrolled at the Depressive Disorders Treatment Centre (CTDD) of the Department of Psychiatry of Sacco University Hospital (Milano, Italy). Plasma concentrations of ADs were measured during first (T1), second (T2), third (T3) trimester, at birth (T4) and at postpartum (T5). Psychometric assessments were carried out. The genotype of hepatic CYP isoforms were also analysed. RESULTS: ADs mainly metabolized by CYP2C19 (es. Sertraline) are less frequently below therapeutic range than ADs metabolized by CYP2D6. In fact, the metabolic activity of CYP2C19 is slowed down during pregnancy. The majority of ADs concentrations below therapeutic range were found in women with an accelerated metaboslism, carrier of a CYP polymorphism. CONCLUSIONS: Our results underline that the systematic use of pharmacokinetic and pharmacogenetic analyses during pregnancy could constitute a valid support in the management of therapy in the last phases of pregnancy. DISCLOSURE: No significant relationships.
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spelling pubmed-95662472022-10-17 Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period Cafaro, R. Giorgetti, F. Giacovelli, L. Vanzetto, S. Cerolini, L. Colombo, A. Dell’Osso, B. Eur Psychiatry Abstract INTRODUCTION: About 15% of women experience a depressive episode during pregnancy, and 19% during the postpartum. Studies on safety of Antidepressants use during pregnancy have given controversial results. Obstetric-gynecological changes of pregnancy determine modifications in the pharmacokinetics of medications, through an altered metabolism of the CYP enzymes. Patient’s therapeutic response might also be influenced by polymorphisms of the genes encoding CYP enzymes. OBJECTIVES: In this perspective, we evaluated the correlation between pharmacokinetics, pharmacogenetics and psychopathological measures, analyzing SSRIs or SNRIs concentrations during the three trimesters of pregnancy, at birth and at postpartum, in order to define efficacy, tolerability and safety of Antidepressants (ADs) in the treatment of affective and anxiety disorders during pregnancy. METHODS: 87 patients were enrolled at the Depressive Disorders Treatment Centre (CTDD) of the Department of Psychiatry of Sacco University Hospital (Milano, Italy). Plasma concentrations of ADs were measured during first (T1), second (T2), third (T3) trimester, at birth (T4) and at postpartum (T5). Psychometric assessments were carried out. The genotype of hepatic CYP isoforms were also analysed. RESULTS: ADs mainly metabolized by CYP2C19 (es. Sertraline) are less frequently below therapeutic range than ADs metabolized by CYP2D6. In fact, the metabolic activity of CYP2C19 is slowed down during pregnancy. The majority of ADs concentrations below therapeutic range were found in women with an accelerated metaboslism, carrier of a CYP polymorphism. CONCLUSIONS: Our results underline that the systematic use of pharmacokinetic and pharmacogenetic analyses during pregnancy could constitute a valid support in the management of therapy in the last phases of pregnancy. DISCLOSURE: No significant relationships. Cambridge University Press 2022-09-01 /pmc/articles/PMC9566247/ http://dx.doi.org/10.1192/j.eurpsy.2022.605 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Cafaro, R.
Giorgetti, F.
Giacovelli, L.
Vanzetto, S.
Cerolini, L.
Colombo, A.
Dell’Osso, B.
Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title_full Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title_fullStr Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title_full_unstemmed Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title_short Analyses of Pharmacokinetic, Pharmacogenetic and Psychometrics Correlates of Antidepressants Use during Pregnancy and the Post-Partum Period
title_sort analyses of pharmacokinetic, pharmacogenetic and psychometrics correlates of antidepressants use during pregnancy and the post-partum period
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566247/
http://dx.doi.org/10.1192/j.eurpsy.2022.605
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