在怀孕期间停止服用SSRI或SNRI后产后精神病的结果和病假
Carolyn E Cesta1, Johan Reutfors1, Jacqueline M Cohen2,3
1Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|October 8, 2024
概括
大约一半的孕妇停止了选择性血清素再吸收抑制剂 (SSRI) 或血清素-上腺素再吸收抑制剂 (SNRIs). 在怀孕期间停止治疗与产后不良精神病结果或病假无关.
科学领域:
- 围产阶段精神病学 围产阶段精神病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 选择性血清素再吸收抑制剂 (SSRI) 和血清素-上腺素再吸收抑制剂 (SNRIs) 通常在怀孕期间使用.
- 然而,大约一半的孕妇在怀孕期间停止服用这些药物,对产后精神病影响的了解有限.
研究的目的:
- 检查在怀孕期间停止服用SSRI或SNRI与产后精神健康之间的关联.
- 调查与抑郁症,焦虑症,精神病医院住院,门诊访问,自我伤害和分娩后病假缺席的联系.
主要方法:
- 一项基于人口的队列研究利用了2006-2019年的瑞典登记数据.
- 包括怀孕前接受SSRI/SNRI处方的孕妇,但不包括患有严重精神疾病的孕妇.
- 在K-means集群中,在怀孕期间确定了持续与停止的药物使用轨迹.
主要成果:
- 在27,773名女性中,47.5%的人停止了SSRI/SNRIs.
- 停药与年龄较小,教育程度较低,吸烟,非北欧血统以及使用抗焦虑药/催眠药有关.
- 停药和精神病医院住院之间没有发现显著的关联 (aHR,90天1.28;1.5年 aHR,0.81).
- 停药与90天 (aHR,0.59) 和1.5年 (aHR,0.60) 的精神病室门诊访问率较低有关.
- 没有观察到病假的差异,停药组的病假日减少了1.5年.
结论:
- 在怀孕期间停止使用SSRI/SNRIs与增加精神病医院住院或产后自杀行为无关.
- 在停止服用药物的女性中,观察到精神病室门诊次数较低.
- 研究结果表明,在怀孕期间停止服用药物并不会对产后精神健康结果产生负面影响.
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