Trial reportJournal of clinical psychopharmacology2010
Disposition of chiral and racemic fluoxetine and norfluoxetine across childbearing.
Trial report in Journal of clinical psychopharmacology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of pregnancy on the pharmacokinetics of antidepressants: a systematic critical review and meta-analysis.Expert opinion on drug metabolism & toxicology · 2020Pooled it
- The effect of gastric bypass on the pharmacokinetics of serotonin reuptake inhibitors.The American journal of psychiatry · 2012Trial
- Advancing Bioanalytical Method Validation: A Comprehensive ICH M10 Approach for Validating LC-MS/MS to Quantify Fluoxetine in Human Plasma and Its Application in Pharmacokinetic Studies.Molecules (Basel, Switzerland) · 2024Article
- Pharmacokinetics of Antidepressants in Pregnancy.Journal of clinical pharmacology · 2023Review
- Changes in Sertraline Plasma Concentrations Across Pregnancy and Postpartum.Clinical pharmacology and therapeutics · 2022Observational
- Selective Serotonin Reuptake Inhibitor Pharmacokinetics During Pregnancy: Clinical and Research Implications.Frontiers in pharmacology · 2022Article
- A common clinical conundrum: Antidepressant treatment of depression in pregnant women.Seminars in perinatology · 2020Review
- Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles.Journal of women's health (2002) · 2020Review
- The dynamic serotonin system of the maternal brain.Archives of women's mental health · 2019Article
- Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition.Clinical pharmacology and therapeutics · 2018Article
- Quetiapine Dose Adjustments in Pregnant and Postpartum Women With Bipolar Disorder.Journal of clinical psychopharmacology · 2018Observational
- Selective serotonin reuptake inhibitors and venlafaxine in pregnancy: Changes in drug disposition.PloS one · 2017Article
- Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.Pharmacoepidemiology and drug safety · 2015Observational
- Pharmacotherapy for mood disorders in pregnancy: a review of pharmacokinetic changes and clinical recommendations for therapeutic drug monitoring.Journal of clinical psychopharmacology · 2014Review
- Obstetric Pharmacokinetic Dosing Studies are Urgently Needed.Frontiers in pediatrics · 2014Review
- Mother-infant antidepressant concentrations, maternal depression, and perinatal events.The Journal of clinical psychiatry · 2011Article
- Concentrations of Fluoxetine Enantiomers Decline During Pregnancy and Increase After Birth.Journal of clinical psychopharmacologyObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo add to the limited data on the clinical pharmacology of antidepressants during pregnancy, we examined the dose-corrected chiral and racemic levels (level/dose) of fluoxetine (FLX) and norfluoxetine (NorFLX) during pregnancy and early postpartum.
methodsThe authors evaluated 17 pregnant women who received fluoxetine therapy. Doses were recorded weekly across gestation and postpartum. At 20, 30, and 36 weeks of gestation, during delivery, and 12 weeks after delivery, the depression level was assessed with the Hamilton Rating Scale for Depression (HRS-D), and plasma samples were analyzed for levels of S- and R-FLX and S- and R-NorFLX.
resultsThe mean ratios of the chiral parent drug (S-FLX + R-FLX) to metabolite levels (S-NorFLX + R-NorFLX) decreased across pregnancy. The differences were significant between 20-36 weeks and 30-36 weeks. After delivery, the mean dose-corrected level of the active moiety S-FLX and the mean ratio of the chiral parent drug (S-FLX + R-FLX) to metabolite level (S-NorFLX + R-NorFLX) significantly increased between delivery and 12 weeks postpartum. Most of the fluoxetine-treated subjects experienced remitted depressive episodes and euthymic mood levels during pregnancy and postpartum.
conclusionsThe findings extend earlier reports of increased antidepressant metabolism during pregnancy and refractory metabolism after delivery. These data may inform treatment decisions related to dosing in patients who receive fluoxetine during pregnancy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.