在怀孕期间治疗双极性障碍的处方模式:一项回顾性队列研究
Nalinoë J Kernizan1,2, Abigail M Yancey1,2, Alicia B Forinash1,2
1Department of Pharmacy Practice, St. Louis College of Pharmacy, University of Health Sciences and Pharmacy, St. Louis, MO 63110, USA.
Journal of clinical medicine
|March 17, 2025
概括
怀孕期间对双相情绪障碍的治疗往往没有使用情绪稳定剂,许多患者仅服用抗抑郁药,增加了风险. 这项研究突出了不理想的处方模式,表明在怀孕期间需要改进治疗策略.
科学领域:
- 产科和妇科 产科和妇科
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 怀孕期间未经治疗的双相情感障碍会给母亲和胎儿带来风险,包括不良的产前护理和产后并发症.
- 情绪稳定剂是第一线治疗,但在怀孕期间经常停止使用.
- 由于躁狂和快速循环的风险增加,不建议在双相情感障碍患者中单独使用抗抑郁药.
研究的目的:
- 描述当前的处方模式,用于药理管理双相情感障碍在孕妇患者.
- 分析初次诊所,整个怀孕期间和分娩时的药物使用情况.
主要方法:
- 怀孕患者 (≥14年) 被诊断患有双相情感障碍的回顾性队列研究.
- 纳入标准:2014年1月以后≥2次诊所访问,到2017年10月交付.
- 通过ICD代码和电子健康记录识别的药物数据.
主要成果:
- 在214例怀孕中,134例 (62.6%) 使用精神药物,79例 (59%) 使用情绪稳定剂.
- 在分娩时,45.8%的怀孕在服用精神药物,其中49%是情绪稳定剂.
- 抗抑郁药单一治疗在一些怀孕中持续存在,这表明潜在的管理不善.
结论:
- 在整个怀孕期间,情绪稳定剂的使用率不够理想,在第一次访问时只有14%,在分娩时只有22.4%.
- 卢拉西和拉莫特里金是最常被处方的情绪稳定剂.
- 该研究发现了不适当的疾病管理,特别是怀孕期间抗抑郁药单一治疗的持续性.
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