ReviewJournal of clinical psychopharmacology2014
Pharmacotherapy for mood disorders in pregnancy: a review of pharmacokinetic changes and clinical recommendations for therapeutic drug monitoring.
Review in Journal of clinical psychopharmacology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03774641 (A Pilot Study of Prophylactic Management of Lamotrigine for Bipolar Disorder in Pregnant Women), which is not on this map. Cited by 48 papers, 7 of them syntheses 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.
A Pilot Study of Prophylactic Management of Lamotrigine for Bipolar Disorder in Pregnant Women
Who cites it
48 citing papers in PubMed, 7 syntheses or guidelines pooled it, 179 citations in OpenAlex.
- Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2025Guideline
- The Association of Antidepressants in Late Pregnancy with Postpartum Hemorrhage: Systematic Review of Controlled Observational Studies.Journal of child and adolescent psychopharmacology · 2024Pooled it
- Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis.Progress in neuro-psychopharmacology & biological psychiatry · 2023Pooled it
- Antidepressant transfer into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis.Progress in neuro-psychopharmacology & biological psychiatry · 2021Pooled 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
- Clinical Lactation Studies of Lithium: A Systematic Review.Frontiers in pharmacology · 2019Pooled it
- Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review.PLoS medicine · 2016Pooled it
- Sertraline concentrations in pregnant women are steady and the drug transfer to their infants is low.European journal of clinical pharmacology · 2021Trial
- Management of Lithium in Pregnancy and Lactation: An Individualized Approach.Current psychiatry reports · 2026Review
- Review
- Safety in treatment: Classical pharmacotherapeutics and new avenues for addressing maternal depression and anxiety during pregnancy.Pharmacological reviews · 2025Review
- Changes in the pharmacokinetics of lurasidone in a pregnant woman with schizophrenia.PCN reports : psychiatry and clinical neurosciences · 2024Article
- Depression Treatment in Pregnancy: Is It Safe, or Is It Not?International journal of environmental research and public health · 2024Review
- Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024Review
- Evaluating the Effectiveness of Complementary and Integrative Health Therapies in Preventing Postpartum Depression: A Target Trial Emulation Study.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Antidepressant treatment in pregnancy: a Danish registry linkage study in pregnant women with pre-existing obsessive-compulsive disorder.Translational psychiatry · 2023Article
- Intersection of Sex and Depression: Pathogenesis, Presentation, and Treatments.Handbook of experimental pharmacology · 2023Article
- A cross-sectional study of the relationship between CYP2D6 and CYP2C19 variations and depression symptoms, for women taking SSRIs during pregnancy.Archives of women's mental health · 2022Article
- Lack of psychotropic medication changes among mood disordered women across the peripartum period.Human psychopharmacology · 2021Article
- Clinical Pharmacy in Psychiatry: Towards Promoting Clinical Expertise in Psychopharmacology.Pharmacy (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivePharmacotherapy for mood disorders during pregnancy is often complicated by pregnancy-related pharmacokinetic changes and the need for dose adjustments. The objectives of this review are to summarize the evidence for change in perinatal pharmacokinetics of commonly used pharmacotherapies for mood disorders, discuss the implications for clinical and therapeutic drug monitoring (TDM), and make clinical recommendations.
methodsThe English-language literature indexed on MEDLINE/PubMed was searched for original observational studies (controlled and uncontrolled, prospective and retrospective), case reports, and case series that evaluated or described pharmacokinetic changes or TDM during pregnancy or the postpartum period.
resultsPregnancy-associated changes in absorption, distribution, metabolism, and elimination may result in lowered psychotropic drug levels and possible treatment effects, particularly in late pregnancy. Mechanisms include changes in both phase 1 hepatic cytochrome P450 and phase 2 uridine diphosphate glucuronosyltransferase enzyme activities, changes in hepatic and renal blood flow, and glomerular filtration rate. Therapeutic drug monitoring, in combination with clinical monitoring, is indicated for tricyclic antidepressants and mood stabilizers during the perinatal period.
conclusionsSubstantial pharmacokinetic changes can occur during pregnancy in a number of commonly used antidepressants and mood stabilizers. Dose increases may be indicated for antidepressants including citalopram, clomipramine, imipramine, fluoxetine, fluvoxamine, nortriptyline, paroxetine, and sertraline, especially late in pregnancy. Antenatal dose increases may also be needed for lithium, lamotrigine, and valproic acid because of perinatal changes in metabolism. Close clinical monitoring of perinatal mood disorders and TDM of tricyclic antidepressants and mood stabilizers are recommended.
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Identifiers
What OpenQuestion holds
Registered trials
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.