A systematic review of the use of prazosin in pregnancy and lactation

Davidson, Ashley D.; Bhat, Amritha; Chu, Frances; Rice, Jessie; Nduom, N Aba; Cowley, Deborah S.

doi:10.1016/j.genhosppsych.2021.03.012

Cited by 3 publications

(9 citation statements)

References 7 publications

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“…A systematic review conducted by Davidson et al ( 2021) [8] looked at pregnancy Prazosin exposures, but could only locate one randomized-control trial (conducted in the third trimester of pregnancy) and 5 cohort studies studying Prazosin use during late pregnancy and lactation. As the indication for use of Prazosin was mostly for maternal hypertension, the role of the underlying condition should be considered in adverse outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…One of the studies cited in the Davidson review [8] was a 1983 study that looked at Prazosin use in 8 sujects in the last trimester of pregnancy [23]. This study found that Prazosin was effective for blood pressure control and outcomes suggested safety when used in the last trimester in these women.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, the use of Prazosin in pregnancy is understudied. One recent systematic review identified one clinical trial and five cohort studies to date, [8] but no data on first trimester exposures. Prazosin is a well-tolerated generically available medication, but the lack of pregnancy safety data, especially with regards to first trimester exposures, leaves physicians and health care providers with very limited options on how to counsel and monitor pregnant patients taking this medication [5,9].…”

Section: Introductionmentioning

confidence: 99%

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Prospective Evaluation of Pregnancy Outcomes after Gestational Exposure to Prazosin

Zitoun

Campbell

Matsui

et al. 2023

Preprint

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Introduction: Prazosin is an antihypertensive medication which can be used to help with post-traumatic stress disorder (PTSD) symptoms. Little data is currently available on its safety in pregnancy. Objective: To assess the fetal and pregnancy safety associated with Prazosin exposures in early Pregnancy. Methods: Subjects were 11 patients who took Prazosin during pregnancy and were counselled at the FRAME clinic in London Health Sciences Centre (Ontario, Canada) between January 1, 2000 to December 31, 2021. Data on their other exposures and pregnancy outcomes were collected from medical records and through telephone questionnaires. Results: It was found that 6 /11 (54.5%) subjects did not report any adverse outcomes and were uneventful pregnancies. There were 2 miscarriages. Birthweights were within the normal range for the remaining 9 pregnancies. Adverse events reported were consistent with background population expectation, including: 1 postpartum hemorrhage, 1 case of preeclampsia, 1 preterm birth, 2 NICU admissions, and 2 caesarean sections. Discussion / Conclusion: For these 11 subjects, pregnancy outcomes after exposure to Prazosin were consistent with typical outcomes from unexposed pregnancies. More data are needed to conclude that Prazosin is safe for use in pregnant subjects. However, the lack of adverse effects above baseline is reassuring to future patients who may be unintentionally exposed to Prazosin while pregnant. Therefore, this study contributes valuable data toward monitoring safety of Prazosin in Pregnancy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective Evaluation of Pregnancy Outcomes after Gestational Exposure to Prazosin

Zitoun

Campbell

Matsui

et al. 2023

Preprint

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“…27 While prazosin is effective for PTSD symptoms outside of pregnancy, there is limited data regarding its safety during pregnancy and lactation, and it may lead to maternal hypotension and subsequent fetal adverse effects. 28 Many patients with a history of CSA experience hallucinations and dissociative symptoms, as demonstrated by Case 1 and 2. 29 In Case 3, Ms. S displayed features of BPAD with significant hypomanic symptoms and worsening suicidality during prior postpartum periods.…”

Section: Mdedgecom/psychiatrymentioning

confidence: 98%

Complex trauma in the perinatal period

Madora¹

2022

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Complex posttraumatic stress disorder (CPTSD) is a condition characterized by classic trauma-related symptoms in addition to disturbances in self organization (DSO). 1-3 DSO symptoms include negative selfconcept, emotional dysregulation, and interpersonal problems. CPTSD differs from PTSD in that it includes symptoms of DSO, and differs from borderline personality disorder (BPD) in that it does not include extreme self-injurious behavior, a complete lack of sense of self, and avoidance of rejection or abandonment (Table , 1,2 page 22). The maladaptive traits of CPTSD are often the result of a chronic lack of safety in early childhood, particularly childhood sexual abuse (CSA). CSA may affect up to 20% of women and is defined by the CDC as "any completed or attempted sexual act, sexual contact with, or exploitation of a child by a caregiver." 4,5 Maternal lifetime trauma is more common among women who are in low-income minority groups and can lead to adverse birth outcomes in this vulnerable patient population. 6 Recent research has found that trauma can increase cortisol levels during pregnancy, leading to increased placental permeability, inflammatory response, and longstanding alterations in the fetal hypothalamic-pituitary adrenal axis. 6 A CPTSD diagnosis is of particular interest during the perinatal period because CPTSD is often a response to interpersonal trauma and attachment adversity, which can be reactivated during the perinatal period. 7 CPTSD in survivors of

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“…Unfortunately, the use of prazosin in pregnancy is understudied. One recent systematic review identified one clinical trial and five cohort studies to date, 8 but no data on first trimester exposures. Prazosin is a well‐tolerated generically available medication, but the lack of pregnancy safety data, especially with regard to first trimester exposures, leaves physicians and health care providers with very limited options on how to counsel and monitor pregnant patients taking this medication 1,5 …”

Section: Introductionmentioning

confidence: 99%

Prospective evaluation of pregnancy outcomes after gestational exposure to prazosin

Zitoun

Campbell

Matsui

et al. 2023

Brit J Clinical Pharma

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AimsPrazosin is an antihypertensive medication which can be used to help with post‐traumatic stress disorder (PTSD) symptoms. Little data is currently available on its safety in pregnancy. The aim of this study was to assess the fetal and pregnancy safety associated with prazosin exposures in early pregnancy.MethodsSubjects were 11 patients who took prazosin during pregnancy and were counselled at the FRAME clinic in London Health Sciences Centre (Ontario, Canada) between 1 January 2000 and 31 December 2021. Data on their other exposures and pregnancy outcomes were collected from medical records and through telephone questionnaires.ResultsIt was found that 6/11 (54.5%) subjects did not report any adverse outcomes and experienced uneventful pregnancies. There were two miscarriages. Birthweights were within the normal range for the remaining nine pregnancies. Adverse events reported were consistent with background population expectation, including: one postpartum haemorrhage, one case of preeclampsia, one preterm birth, two NICU admissions, and two caesarean sections.ConclusionsFor these 11 subjects, pregnancy outcomes after exposure to prazosin were consistent with typical outcomes from unexposed pregnancies. More data are needed to conclude that prazosin is safe for use in pregnant subjects. However, the lack of adverse effects above baseline is reassuring to future patients who may be unintentionally exposed to prazosin while pregnant. Therefore, this study contributes valuable data towards monitoring safety of prazosin in pregnancy.

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A systematic review of the use of prazosin in pregnancy and lactation

Cited by 3 publications

References 7 publications

Prospective Evaluation of Pregnancy Outcomes after Gestational Exposure to Prazosin

Prospective Evaluation of Pregnancy Outcomes after Gestational Exposure to Prazosin

Complex trauma in the perinatal period

Prospective evaluation of pregnancy outcomes after gestational exposure to prazosin

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