Dispensing patterns of selective serotonin reuptake inhibitors before, during and after pregnancy: a 16-year population-based cohort study from the Netherlands

Molenaar, Nina M.; Berg, Mijke P. Lambregtse–van den; Bonsel, Gouke J.

doi:10.1007/s00737-019-0951-5

Cited by 22 publications

(31 citation statements)

References 39 publications

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“… 30–32 In the Netherlands, approximately 2%–3% of pregnant women use antidepressants. 29 33 34 In the USA, this prevalence is approximately 6%–7%, 35–37 but could even be as high as 15% in some states. 38 Therefore, it is urgent and clinically relevant to investigate alternative approaches to treat antepartum depression, such as bright light therapy (BLT).…”

Section: Introductionmentioning

confidence: 99%

Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

et al. 2020

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ObjectivesApproximately 11%–13% of pregnant women suffer from depression. Bright light therapy (BLT) is a promising treatment, combining direct availability, sufficient efficacy, low costs and high safety for both mother and child. Here, we examined the effects of BLT on depression during pregnancy.DesignRandomised, double-blind controlled trial.SettingPrimary and secondary care in The Netherlands, from November 2016 to March 2019.Participants67 pregnant women (12–32 weeks gestational age) with a DSM-5 diagnosis of depressive disorder (Diagnostic and Statistical Manual of Mental Disorders).InterventionsParticipants were randomly allocated to treatment with either BLT (9000 lux, 5000 K) or dim red light therapy (DRLT, 100 lux, 2700 K), which is considered placebo. For 6 weeks, both groups were treated daily at home for 30 min on awakening. Follow-up took place weekly during the intervention, after 6 weeks of therapy, 3 and 10 weeks after treatment and 2 months postpartum.Primary and secondary outcome measuresDepressive symptoms were measured primarily with the Structured Interview Guide for the Hamilton Depression Scale—Seasonal Affective Disorder. Secondary measures were the Hamilton Rating Scale for Depression and the Edinburgh Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time were analysed using generalised linear mixed models.ResultsMedian depression scores decreased by 40.6%–53.1% in the BLT group and by 50.9%–66.7% in the DRLT group. We found no statistically significant difference in symptom change scores between BLT and DRLT. Sensitivity and post-hoc analyses did not change our findings.ConclusionsDepressive symptoms of pregnant women with depression improved in both treatment arms. More research is necessary to determine whether these responses represent true treatment effects, non-specific treatment responses, placebo effects or a combination hereof.Trial registration numberNTR5476.

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Section: Introductionmentioning

confidence: 99%

Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

et al. 2020

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“…Antidepressant drug use during pregnancy increased from 2.0% of deliveries in 1996 to 7.6% of deliveries in 2004 and 2005 in the United States (Andrade et al, ). Dispensing rates of selective serotonin reuptake inhibitors (SSRIs) steadily increased in Netherland from 0.8% in 1999/2000 to 2.1% in 2013/2014 (Molenaar et al, ). In Denmark, the rate of AD exposure during pregnancy increased from 0.2% in 1997 to 3.2% in 2010 (Jimenez‐Solem et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of depression during pregnancy is substantial (Bennett, Einarson, Taddio, Koren, & Einarson, 2004;Gavin et al, 2005), and use of antidepressants (ADs) during pregnancy has increased in most developed countries in recent decades (Andrade et al, 2008;Jimenez-Solem et al, 2013;Molenaar, Lambregtse-van den Berg, & Bonsel, 2019). Antidepressant drug use during pregnancy increased from 2.0% of deliveries in 1996 to 7.6% of deliveries in 2004 and 2005 in the United States (Andrade et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Trend of antidepressants before, during, and after pregnancy across two decades—A population‐based study

et al. 2019

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IntroductionFactors that influence antidepressant (AD) prescription and use during pregnancy are multiple including, in particular, the balance between the potential risk of untreated depression and the potential risk of AD treatment. Surveillance of temporal trends of AD use might identify areas requiring further research. We studied the use of ADs before, during, and after pregnancy using national data across two decades in Denmark.MethodsWe included 1,232,233 pregnancies leading to live birth in Denmark between 1 January 1997 and 31 December 2016. Information on redemption of AD prescriptions was obtained from the Danish National Prescription Register.ResultsWe identified 29,504 (2.4%) pregnancies having at least one AD prescription (96,232 AD prescriptions) during pregnancy. The majority redeemed more than one prescription (69.7%) often for a single kind of AD (83.5%), and in 94% of the AD‐exposed pregnancies, the estimated duration of treatment was 1 month or longer. Prescription of ADs during pregnancy increased steadily from 0.4% in 1997 to 4.6% in 2011, but decreased thereafter to 3.1% in 2016. The proportion of pregnancies with ADs in 2011 was 6.05‐fold higher than that in 1997. The temporal trends in AD prescription in the years before and after pregnancy were similar to the trend during pregnancy. The decreasing use of ADs during pregnancy after 2011 was mainly driven by a decrease in the use of selective serotonin reuptake inhibitors (SSRIs), especially citalopram, the main type of SSRIs used in Denmark.ConclusionPrescription of ADs during pregnancy in Denmark increased steadily from 1997 to 2011 but decreased sharply thereafter. More research is needed to show whether the same trend exists in other populations, like women of reproductive age, men of reproductive age, and old people, and other countries. We also need to find explanation for the decreasing trend in recent years and potential risk for untreated depression.

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“…The study suggested that although psychotherapy has been the first treatment option for mild to moderate psychiatric disorder, %70 of patients are primarily treated with antidepressants [3]. The studies also revealed an increase in the prevalence of antidepressant exposure from 0.2% to 3.2% between 1997 and 2010 in Denmark [4] and from 0.8% to 2.1% between 1999 and 2014 in the Netherlands [5]. The rate of use of SSRI (Serotonine Reuptake Inhibitors) in all antidepressants during pregnancy was reported as 63% to 85% [6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the groups treated with mirtazapine and selective serotonine reuptake inhibitors with respect to birth outcomes and severity of psychiatric disorder

Güngör

Öztürk

Atar

2019

Psychiatry and Clinical Psychopharmacology

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Objective: The literature provides very limited information on mirtazapine usage in the pregnancy period. The groups including pregnant women who used SSRI or mirtazapine as a single treatment, SSRI-mirtazapine combination treatment and unmedicated groups were compared with respect to illness severity and birth outcomes. Method: The study sample included 120 pregnant women; 40 women with SSRI usage, 16 women with mirtazapine usage, 18 women with combined SSRI-mirtazapine usage, 23 women with unmedicated psychiatric disorder and who elected not to take medication during their pregnancy or discontinued antidepressants by themselves, and 23 healthy control women. Results: No difference was obtained with regard to the gestation week of birth, birth weight, the duration of stay in the neonatal care unit among the SSRI, mirtazapine, SSRI-mirtazapine combination, unmedicated patient and control groups. The likelihood of a new diagnosis was highest in the mirtazapine group. The majority of pregnant women whose psychiatric disorders were more severe and more relapsed used SSRI-mirtazapine combination treatment. Conclusion: No difference was observed between the SSRI and mirtazapine usage in the pregnancy period with regard to the birth outcomes. Similar birth outcomes could present clinicians with the option of prescribing mirtazapine as a safe alternative to SSRI in the treatment of antenatal psychiatric patients.

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Dispensing patterns of selective serotonin reuptake inhibitors before, during and after pregnancy: a 16-year population-based cohort study from the Netherlands

Cited by 22 publications

References 39 publications

Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

Trend of antidepressants before, during, and after pregnancy across two decades—A population‐based study

Comparison of the groups treated with mirtazapine and selective serotonine reuptake inhibitors with respect to birth outcomes and severity of psychiatric disorder

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