共识小组对患有产后抑郁症的母乳养妇女药理管理的建议
Georgios Eleftheriou1,2, Riccardo Zandonella Callegher3,4,5, Raffaella Butera1,2
1Italian Society of Toxicology (SITOX), Via Giovanni Pascoli 3, 20129 Milan, Italy.
概括
哺乳与抗抑郁药或抗焦虑药并没有禁忌. 选择性血清素再吸收抑制剂 (SSRI) 是在哺乳期的新抗抑郁药处方中首选的,与多学科护理一起.
科学领域:
- 围产阶段精神病学 围产阶段精神病学
- 哺乳期药理学 哺乳期药理学
- 新生儿毒理学 新生儿毒理学
背景情况:
- 临床不确定性围绕着在母乳养母亲中使用抗抑郁药和抗焦虑药.
- 担心婴儿受到伤害可能会导致不必要的治疗停止或配方养.
- 这使婴儿无法享受母乳的好处,使母亲无法获得必要的心理健康治疗.
研究的目的:
- 澄清在哺乳期妇女中使用抗抑郁药和抗焦虑药的指导方针.
- 为了应对在哺乳期未经治疗的母亲抑郁症相关的风险.
- 为哺乳期的药物使用提供基于证据的建议.
主要方法:
- 16名专家小组制定了一份共识声明.
- 代表八个科学协会的专家专注于产后抑郁症.
- 名称组技术和文献审查为共识提供了信息.
主要成果:
- 孕产妇的抑郁和焦虑障碍需要在哺乳期接受治疗.
- 评估了药物暴露给婴儿的累积风险.
- 考虑了长期婴儿神经发育结果.
- 评估了哺乳期妇女对阿片类药物滥用的药理干预措施.
结论:
- 抑郁症/焦虑症及其治疗并不是母乳养的禁忌.
- 继续有效的怀孕药物;如果开始,使用最低有效剂量的SSRI.
- 对于短期的焦虑/睡眠问题,二是可以接受的.
- 在母乳养期间不建议停止阿片类药物滥用治疗.
- 建议多学科专家合作,以获得最佳的护理.
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