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孕期及哺乳期5-羟色胺与去甲肾上腺素再摄取抑制剂(SSRI和SNRI)的治疗

[TREATMENT OF SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SSRIS AND SNRIS) DURING PREGNANCY AND LACTATION].

作者信息

Rozner Lihi, Aisenberg Romano Gabi, Klieger Chagit, Bloch Miki

机构信息

Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.

Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Harefuah. 2023 Feb;162(2):86-91.

Abstract

Women are more likely to develop depression during the perinatal period than at any other time in their lives. Studies from recent years raise significant concerns regarding the potential of a depressive disorder in the pregnant mother to cause adverse obstetric results for the mother and the newborn. As antidepressants can penetrate the placenta to different degrees, concern has been raised regarding their teratogenic potential. In recent years various inconsistent and ambiguous reports specifying mild risks to the fetus and newborn from exposure to serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) during pregnancy have been published. This paper provides a review of current medical knowledge regarding the pharmacological treatment with common antidepressants such as SSRIs and SNRIs in pregnant women. Based on this review we also present treatment and follow-up recommendations of the major published guidelines for the treatment of serotonin and norepinephrine reuptake inhibitors (SSRIs and SNRIs) during pregnancy for the medical care providers.

摘要

女性在围产期比一生中的任何其他时期更易患抑郁症。近年来的研究引发了人们对怀孕母亲患抑郁症可能给母亲和新生儿带来不良产科后果的重大担忧。由于抗抑郁药可不同程度地穿透胎盘,人们对其致畸潜力也产生了担忧。近年来,已发表了各种不一致且含混不清的报告,指明孕期接触5-羟色胺再摄取抑制剂(SSRI)和5-羟色胺及去甲肾上腺素再摄取抑制剂(SNRI)会给胎儿和新生儿带来轻微风险。本文综述了关于孕妇使用SSRI和SNRI等常用抗抑郁药进行药物治疗的当前医学知识。基于这一综述,我们还为医疗服务提供者提出了孕期5-羟色胺及去甲肾上腺素再摄取抑制剂(SSRI和SNRI)治疗主要已发表指南的治疗及随访建议。

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