TY  - JOUR
A1  - Leutritz, Anna Linda
A1  - van Braam, Lara
A1  - Preis, Katharina
A1  - Gehrmann, Andrea
A1  - Scherf-Clavel, Maike
A1  - Fiedler, Katrin
A1  - Unterecker, Stefan
A1  - Kittel-Schneider, Sarah
T1  - Psychotropic medication in pregnancy and lactation and early development of exposed children
T2  - British Journal of Clinical Pharmacology
N2  - There is still limited knowledge about alterations of blood concentrations of psychotropic drugs during pregnancy, the transfer of psychotropic drugs into breastmilk and the effects on exposed children. We investigated changes in concentrations of psychopharmacological medication during pregnancy and lactation in serum and breastmilk at different time points in a naturalistic sample of 60 mothers and observed the development of the exposed children in the first 12 months. We found a decrease in serum concentrations from the first to the second trimester of amitriptyline, duloxetine, escitalopram, quetiapine and sertraline. Citalopram stayed rather stable during pregnancy, sertraline levels interestingly increased again from the second to the third trimester. High concentration-by-dose ratios in breastmilk were found for venlafaxine as well as lamotrigine, low for quetiapine and clomipramine. Similarly, clomipramine and quetiapine showed low milk/serum–penetration ratios. Regarding the birth outcome measures in children, we found no significant differences between in utero exposed compared to nonexposed newborns. There were no significant differences in the development in the first 12 months. Psychotropic medication in the peripartum needs a balancing of risks and benefits and a continuous therapeutic drug monitoring can be a guidance for clinicians to monitor drug alteration patterns, which are likely to occur due to physiological pregnancy-associated changes in pharmacokinetics. Accordingly, therapeutic drug monitoring can optimize a medication in pregnancy and lactation with the lowest effective dose.
KW  - antidepressants
KW  - psychotropic medication
KW  - pregnancy
KW  - peripartum
KW  - mental disorders
KW  - lactation
KW  - child development
Y1  - 2023
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/31895
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-318954
VL  - 89
IS  - 2
SP  - 737
EP  - 750
ER  -