Patkar Ashwin A, Bilal Louai, Masand Prakash S
Department of Psychiatry, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ann Clin Psychiatry. 2004 Apr-Jun;16(2):87-100. doi: 10.1080/10401230490453662.
About 20% of pregnant women experience clinical depression. Inadequate treatment of depression has been associated with adverse outcomes in the mother as well as the newborn. Clinicians are often uncertain about pharmacological interventions to treat depressed pregnant women due to concerns regarding fetal exposure to medications. Moreover newer antidepressants with different pharmacological profiles and little data on fetal risk continue to be introduced at a brisk pace. Accumulating data from pharmaceutical registries, cohort studies, toxicology centers, some prospective studies, and case series have permitted certain guidelines for antidepressant use during pregnancy. We review the safety profiles of commonly used antidepressants, discuss clinical decision making based on risk-benefit considerations and make recommendations for pharmacological treatment of depressed women during pregnancy.
约20%的孕妇会出现临床抑郁症。抑郁症治疗不充分与母亲及新生儿的不良结局相关。由于担心胎儿接触药物，临床医生在治疗抑郁孕妇时，对于药物干预往往犹豫不决。此外，具有不同药理特性且胎儿风险数据较少的新型抗抑郁药仍在快速推出。来自药物登记处、队列研究、毒理学中心、一些前瞻性研究和病例系列的累积数据，已形成了孕期使用抗抑郁药的某些指导原则。我们回顾常用抗抑郁药的安全性概况，基于风险效益考量讨论临床决策，并对孕期抑郁女性的药物治疗提出建议。
