在整个怀孕和产后期间,S-Citalopram血度的变化
Catherine S Stika1, Michael J Avram2, Alfred L George3
1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Clinical pharmacology and therapeutics
|March 18, 2025
概括
血 (S) -citalopram水平在怀孕期间保持稳定,但在分娩后显著增加. 在CYP2C19代谢中的遗传变异可能会影响孕妇的抗抑郁药疗效.
科学领域:
- 药理学 药理学是指药理学的学科.
- 精神病学是一个精神病学.
- 遗传学 是一个遗传学.
背景情况:
- 大型抑郁症在怀孕期间很普遍.
- 奇塔洛普拉姆/埃斯基塔洛普拉姆经常被处方给孕妇,但其药理动力学仍未得到充分研究.
- 有限的数据存在于 (S) -citalopram度与怀孕期间和分娩后的剂量相比.
研究的目的:
- 为了研究整个怀孕和产后期 (S) -citalopram的血度与剂量 (C/D) 的比例.
- 检查药物遗传学,特别是CYP2C19表型对 (S) -citalopram消除的影响.
- 评估怀孕个体中亚治疗性抗抑郁药度的风险,具有不同的CYP2C19活性.
主要方法:
- 一项前性观察性队列研究,对30名持续服用西塔洛普拉姆/埃斯卡托普拉姆的孕妇进行了研究.
- 在怀孕期间每月抽取血液样本,分娩后抽取两次血液样本,以测量反原体度.
- 在妊娠和产后期间分析 (S) -citalopram C/D比率,按CYP2C19表型分层.
主要成果:
- 与36周参考期相比,怀孕期间没有观察到 (S) - 奇塔洛普拉姆C/D比率的显著变化.
- 在产后6-8周 (P < 0.001) 观察到平均 (S) - 西塔洛普拉姆C/D比率上升了63%.
- 与其他代谢剂组相比,CYP2C19中间代谢剂的晚产后 (S) -citalopram C/D比率大约是其两倍.
结论:
- 产后 (S) -citalopram C/D比率显著增加,这表明分娩后药物消除发生了变化.
- 在怀孕期间,CYP2C19中间代谢剂可能会出现较低的 (S) -citalopram度.
- 对于中等或低CYP2C19活性的人来说,可能需要调整剂量以保持怀孕期间的治疗水平.
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