Evidence map›Paper›PMID 41058051›Full record

Observational studyBritish journal of clinical pharmacology2026

Pharmacokinetic profiles of sertraline in pregnancy as a predictor of postpartum depressive symptoms.

Sílvia M Illamola, Zachary N Stowe, Marc L Kalin, Michael D Evans, Catherine M Sherwin, Maged M Costantine, D Jeffrey Newport, James C Ritchie, Angela K Birnbaum

Abstract readObservational Study
In one paragraph

Observational study in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sílvia M IllamolaExperimental and Clinical Pharmacology Department, University of Minnesota, Minneapolis, MN, USA.
Zachary N StoweDepartment of Psychiatry, University of Wisconsin at Madison, Madison, WI, USA.
Marc L KalinDepartment of Psychiatry, University of Wisconsin at Madison, Madison, WI, USA.
Michael D EvansClinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.
Catherine M SherwinExperimental and Clinical Pharmacology Department, University of Minnesota, Minneapolis, MN, USA.ORCID https://orcid.org/0000-0002-0844-3207
Maged M CostantineDivision of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
D Jeffrey NewportDepartments of Psychiatry & Behavioral Sciences and Womens Health, The University of Texas at Austin Dell Medical School, Austin, TX, USA.
James C RitchieEmory University School of Medicine, Atlanta, GA, USA.
Angela K BirnbaumExperimental and Clinical Pharmacology Department, University of Minnesota, Minneapolis, MN, USA.ORCID https://orcid.org/0000-0002-3969-4906

Funding

Pharmacokinetic/Pharmacodynamic model in pregnant women with depression to guide sertraline dosingR21HD105297 · NICHD · UNIVERSITY OF MINNESOTA · PI BIRNBAUM, ANGELA K, ILLAMOLA, SILVIA MARTINEZ · 2022 to 2023
$413k
Eunice Kennedy Shriver National Institute of Child Health and Human Development R21HD105297National Institutes of Health's National Center for Advancing Translational Sciences UL1TR002494NICHD NIH HHS R21 HD105297NIMH NIH HHS P50MH68036
6 · The paper itself

Abstract

aimTo characterize pharmacokinetic changes of sertraline and its metabolite during pregnancy and postpartum, and their relationship to maternal postpartum depressive symptoms.

methodsThis was a prospective observational, longitudinal study of pregnant women with a major depressive disorder treated with sertraline (N = 185 women, 205 pregnancies). Women were enrolled at <16 weeks' gestation and followed at 4-8 week intervals throughout pregnancy and the first postpartum year. Baseline measures included structured clinical interviews and demographic information. Drug and metabolite concentrations and psychometric measures (study outcomes) (ie, Hamilton Rating Scale for depression - 17 item, Beck Depression Inventory, Edinburgh Postnatal Depression Scale [EPDS], Clinical Global Impression [CGI]) were measured at follow-up visits. Serum sertraline and N-desmethylsertraline exposure were reported asstandardized 24-h concentration-to-dose (C/D) and parent to metabolite (P/M) ratios. Linear mixed-effects and latent trajectory models were used to characterize longitudinal patterns in concentration measures across pregnancy and postpartum, and their association with study outcomes.

resultsMean 24-h C/D ratios showed high variability throughout pregnancy and postpartum that were characterized by three trajectories for sertraline and five for N-desmethylsertraline and P/M ratio corresponding to different sertraline pharmacokinetic profiles. At postpartum, sertraline drug exposure was inversely associated with higher EPDS score (P < .05), while N-desmethylsertraline exposure was associated with higher scores for all measured depression scales (P < .001). Higher P/M ratios had higher CGI scores (P < .05) postpartum.

conclusionSertraline pharmacokinetic profiles varied across pregnant women and were associated with postpartum depressive symptoms. The use of therapeutic monitoring may provide clinical insight that can be useful for identifying patients with a potential toward depressive symptoms.

Indexed as

Antidepressive AgentsDepression, PostpartumMajor Depressive DisorderPregnancy ComplicationsSelective Serotonin Reuptake InhibitorsSertralineAdultFemaleHumansLongitudinal StudiesPregnancyProspective StudiesPsychiatric Status Rating ScalesYoung AdultAntidepressive AgentsSelective Serotonin Reuptake InhibitorsSertralineantidepressantspharmacokineticspregnancysertraline

Identifiers

PMID41058051
PMCPMC12930024

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Registered trials

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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.