Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574 Japan.
Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574 Japan; Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573 Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573 Japan.
J Affect Disord. 2020 Mar 1;264:295-303. doi: 10.1016/j.jad.2020.01.016. Epub 2020 Jan 7.
The prevalence and pattern of perinatal antidepressant prescriptions in Japan are unknown.
The prevalence of antidepressant prescriptions between 180 days before pregnancy onset and 180 days postpartum was evaluated using a large administrative database. The dates of pregnancy onset and delivery were estimated using developed algorithms.
Of 33,941 women, at least one antidepressant was prescribed to 451 (133/10,000 deliveries) between 180 days before pregnancy and 180 days postpartum and to 241 (71/10,000 deliveries) during pregnancy. The prevalence of antidepressant prescriptions decreased during the first and second trimesters and increased in the postpartum period. Of 339 women with antidepressant prescriptions before pregnancy, 151 (44.5%) discontinued it during pregnancy. Selective serotonin-reuptake inhibitors were the most frequently prescribed class of antidepressants in the time period studied (356 women, 105/10,000 deliveries), followed by tricyclic/non-tricyclic antidepressants (101 women, 30/10,000 deliveries). Of the 57 women who had at least one record of paroxetine prescription in the first trimester, 13 (22.8%) were prescribed >25 mg/day. Fifty-seven women (17/10,000 deliveries) were concurrently prescribed two or more classes of antidepressants between 180 days before pregnancy and 180 days postpartum.
It may not always have been the case that the prescribed antidepressants were used. Women whose pregnancy ended in an abortion or stillbirth were not included.
Various antidepressants were prescribed to prenatal and postpartum women in Japan. Approximately half of pregnant women discontinued treatment with antidepressants after becoming pregnant. Women of childbearing age should select an appropriate antidepressant considering the risk/benefit profile.
在日本，围产期抗抑郁药处方的流行情况和模式尚不清楚。
使用大型行政数据库评估了从受孕前 180 天到产后 180 天期间抗抑郁药处方的流行情况。使用开发的算法估算了受孕日期和分娩日期。
在 33941 名女性中，至少有 1 种抗抑郁药在受孕前 180 天至产后 180 天期间开给了 451 名（133/10000 分娩），在怀孕期间开给了 241 名（71/10000 分娩）。抗抑郁药处方的流行率在妊娠的前三个月和第二个三个月下降，并在产后期间增加。在有受孕前抗抑郁药处方的 339 名女性中，有 151 名（44.5%）在怀孕期间停止了用药。在研究期间，选择性 5-羟色胺再摄取抑制剂是最常开的抗抑郁药类别（356 名女性，105/10000 分娩），其次是三环/非三环类抗抑郁药（101 名女性，30/10000 分娩）。在至少有 1 次记录在孕早期开帕罗西汀处方的 57 名女性中，有 13 名（22.8%）开了>25 毫克/天。57 名女性（17/10000 分娩）在受孕前 180 天至产后 180 天期间同时开了两种或两种以上类别的抗抑郁药。
所开的抗抑郁药并不一定总是被使用。未包括妊娠以流产或死产告终的女性。
日本的孕妇和产后妇女开了各种抗抑郁药。大约一半的孕妇在怀孕后停止了抗抑郁治疗。有生育能力的妇女应根据风险/获益情况选择适当的抗抑郁药。
