Antidepressant dispensing before, during, and after pregnancy in New Zealand, 2005‒2014

Donald, Sarah; Sharples, Katrina; Barson, Dave; Horsburgh, Simon; Parkin, Lianne

doi:10.1111/ajo.13352

Cited by 6 publications

(23 citation statements)

References 28 publications

(30 reference statements)

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“…Previous studies have shown large-scale cessation during pregnancy, thought to be related to an unwillingness to prescribe antidepressants due to potential risks their use poses to the foetus (Grigoriadis et al, 2014;Huang et al, 2014;Roerecke et al, 2013;Udechuku et al, 2010). Compared to previous research, the reduction in use observed in this study is negligible (Donald et al, 2021;Jimenez-Solem et al, 2013;Petersen et al, 2011;Ramos et al, 2007;Zoega et al, 2015). However, while we observed stable use over pregnancy in our sample, we were unable to determine what the pre-pregnancy dispensing prevalence was like nor whether there was a reduction from trimesters two to three, as this information was not collected.…”

Section: Discussioncontrasting

confidence: 98%

“…First, antidepressant prevalence among pregnant New Zealand women would be in line with the international prevalence estimates (Molenaar et al, 2020). Second, antidepressant use would substantially decrease across trimesters, consistent with global trends (Donald et al, 2021;Jimenez-Solem et al, 2013;Petersen et al, 2011;Ramos et al, 2007;Zoega et al, 2015). Third, women aged ⩾ 35 years would show the highest percentage of antidepressant use across pregnancy, consistent with previous research, as well as evidence that antidepressant use increased with increasing age in NZ (Donald et al, 2021;Jimenez-Solem et al, 2013;Ramos et al, 2007;Donald et al, 2021;Wilkinson and Mulder, 2018).].…”

Section: Introductionsupporting

confidence: 76%

“…Ethnicity-stratified antidepressant use revealed a pattern similar to the one identified in NZ pregnant women and in the overall NZ population (Donald et al, 2021;Wilkinson and Mulder, 2018). Women of NZ European ethnicity used antidepressants at a notably higher rate than other women, particularly Māori, Pasifika and Asian mothers.…”

Section: Discussionsupporting

confidence: 60%

“…Second, antidepressant use would substantially decrease across trimesters, consistent with global trends (Donald et al, 2021;Jimenez-Solem et al, 2013;Petersen et al, 2011;Ramos et al, 2007;Zoega et al, 2015). Third, women aged ⩾ 35 years would show the highest percentage of antidepressant use across pregnancy, consistent with previous research, as well as evidence that antidepressant use increased with increasing age in NZ (Donald et al, 2021;Jimenez-Solem et al, 2013;Ramos et al, 2007;Donald et al, 2021;Wilkinson and Mulder, 2018).]. Fourth, there would be a positive association between antidepressant use and deprivation, in line with evidence that low income is a predictor of greater antidepressant use across pregnancy (Jimenez- Solem et al, 2013;Ramos et al, 2007).…”

Section: Introductionmentioning

confidence: 63%

“…Fourth, there would be a positive association between antidepressant use and deprivation, in line with evidence that low income is a predictor of greater antidepressant use across pregnancy (Jimenez- Solem et al, 2013;Ramos et al, 2007). Fifth, NZ Europeans would have the highest antenatal antidepressant use, following the trend witnessed in other NZ studies (Donald et al, 2021;Wilkinson and Mulder, 2018). Finally, we expected that a large proportion of women that were experiencing antenatal depressive symptoms would not be using antidepressants, consistent with the discrepancy in the literature between antenatal…”

Section: Introductionmentioning

confidence: 67%

See 4 more Smart Citations

Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women

Svardal

Waldie

Milne

et al. 2021

Aust N Z J Psychiatry

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Background: Throughout pregnancy, women are at an increased risk of depression, with prevalence estimates between 6.5% and 18%. Global prevalence of antenatal antidepressant use is considerably lower at 3%. Objective: The present study determined the proportion of women taking antidepressants across pregnancy in New Zealand. We investigated whether variation exists across age bands, area-level deprivation and ethnicities, and identified how many women experienced unmedicated depression. Method: Antenatal data ( n = 6822) consisted of primarily third-trimester interviews conducted with mothers participating in Growing Up in New Zealand, a longitudinal study investigating child development. Women were asked about their antidepressant intake during pregnancy and assessed on antenatal depression symptoms using the Edinburgh Postnatal Depression Scale. Antidepressant use data were also compared to population-level data from Statistics New Zealand’s Integrated Data Infrastructure. Results: Antidepressant prevalence across pregnancy was 3.2%, with a 2.7% prevalence in trimester one and 2.6% following the first trimester. There was no significant difference in usage within age bands and area-level deprivation quintiles. Ethnicity-specific data revealed that Pasifika and Asian ethnicities had the lowest antidepressant use, and New Zealand Europeans the highest. The rate of unmedicated depression, where women met the Edinburgh Postnatal Depression Scale criteria for significant depressive symptoms but did not receive antidepressants during pregnancy, was 11.8%, indicating that antenatal depression treatment may be inadequate. Greater rates of unmedicated depression were seen for younger women (⩽24 years), those living in high deprivation areas and mothers of Pasifika, Asian and Māori ethnicities. Conclusions: Antenatal antidepressant use in New Zealand follows global prevalence estimates and highlights possible undertreatment of antenatal depression in New Zealand. Future research including other treatment types (e.g. behavioural therapy) is needed to evaluate whether undertreatment occurs across all treatment options.

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Section: Discussioncontrasting

confidence: 98%

Section: Introductionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 67%

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Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women

Svardal

Waldie

Milne

et al. 2021

Aust N Z J Psychiatry

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Exposure to psychotropic drugs before and during pregnancy: what has changed over the last two decades?

Robiyanto

Schuiling-Veninga

Bos

et al. 2023

Arch Womens Ment Health

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Trends in prescribing psychotropic drugs before and during pregnancy may have changed over the years, but actual information is lacking. We therefore compared and assessed the exposure and acceptance rates of classes of antipsychotic (+ lithium), anxiolytic, sedative/hypnotic, antidepressant, and psychostimulant before and during pregnancy in the past two decades. All singleton pregnancies with ≥1 prescription of psychotropic drug from six months before pregnancy until child’s birthdate were identified in the pregnancy subset of the IADB.nl prescription database. The prescription patterns of psychotropics were distinguished as continuation rate (CR), initiation rate (IR), discontinuation rate (DR), total exposure rate (TER), and acceptance rate. Singleton pregnancies exposed to psychotropic drugs before and during pregnancy increased from 118.4 to 136.5 (per 1000 singleton pregnancies) between decades. Changing trends were observed in decade 2, including a high increase in the TER of antipsychotic class (3.3 to 6.8) and antidepressant class (23.0 to 40.6). A marked increase for individual drugs was seen for sertraline (TER: 0.6 to 6.6 and PAT: 35.3% to 82.5%), citalopram (TER: 2.3 to 10.0 and PAT: 51.1% to 74.6%), and quetiapine (TER: 0.4 to 3.1 and PAT: 57.1% to 66.0%). Although the total exposure rates of five classes of psychotropics in singleton pregnancies increased in decade 2, only antidepressant class had a higher acceptance rate during pregnancy. Certain SSRI antidepressants and atypical antipsychotics were more frequently prescribed in decade 2 than in decade 1, reflecting that treatment options were preferred for safer treatment choices.

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Switching pattern and dose adjustment of antidepressants before and during pregnancy

Robiyanto

Roos

Bos

et al. 2023

Arch Womens Ment Health

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The purpose of the study is to examine the switching pattern and dose adjustment of antidepressants (ADs) prescribed to women from six months before to six months during pregnancy in the Netherlands. The recorded dispenses or refills were collected from the University of Groningen IADB.nl pregnancy subset for all singleton pregnancies in which the mother received ≥ 1 prescription of an AD dispensed before pregnancy and was present in the database at least six months after conception. The rates of continuation, discontinuation, and switching between 2001 and 2020 were assessed for the ADs studied. The mean number of Defined Daily Doses (DDDs) of the most frequently continued ADs used was calculated both before and during pregnancy, and a paired t-test was used to test for significant changes. The continuation rates for AD users, especially for SSRI and SNRI continued users, increased over time from 27% and 19% (2001–2005) to 65% and 65% (2016–2020). The switching rate between ADs remained consistently low from the start of the study (2001–2005) at 2.0% to the end of the study (2016–2020) at 2.3%. Most women who switched between antidepressants during pregnancy received a different SSRI monotherapy (85%), followed by an SNRI (6%), a TCA (4%), and an “other AD” (4%). In most cases observed, the dose adjustment for the mean DDDs during pregnancy compared to the mean DDDs before pregnancy only changed little (less than 10%). Continued use of SSRIs among singleton pregnancies doubled over the study period. The low rate of AD switching and little changes in the DDD adjustment for most AD continuers indicate that pregnant women prefer to continue their prepregnancy medication rather than switch it. Most observed findings cohere with the Dutch national guidelines for antidepressant use during pregnancy.

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Antidepressant dispensing before, during, and after pregnancy in New Zealand, 2005‒2014

Cited by 6 publications

References 28 publications

Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women

Prevalence of antidepressant use and unmedicated depression in pregnant New Zealand women

Exposure to psychotropic drugs before and during pregnancy: what has changed over the last two decades?

Switching pattern and dose adjustment of antidepressants before and during pregnancy

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