| Disposition of chiral and racemic fluoxetine and norfluoxetine across childbearing. | |
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MedLine Citation:
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PMID: 20631556 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To 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. METHODS: The 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. RESULTS: The 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. CONCLUSIONS: The 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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Authors:
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Dorothy Sit; James M Perel; James F Luther; Stephen R Wisniewski; Joseph C Helsel; Katherine L Wisner |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of clinical psychopharmacology Volume: 30 ISSN: 1533-712X ISO Abbreviation: J Clin Psychopharmacol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-15 Completed Date: 2010-11-03 Revised Date: 2011-12-29 |
Medline Journal Info:
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Nlm Unique ID: 8109496 Medline TA: J Clin Psychopharmacol Country: United States |
Other Details:
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Languages: eng Pagination: 381-6 Citation Subset: IM |
Affiliation:
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Women's Behavioral HealthCARE, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00279370 |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antidepressive Agents, Second-Generation / pharmacokinetics*, therapeutic use Depressive Disorder, Major / complications, drug therapy* Female Fluoxetine / analogs & derivatives*, pharmacokinetics*, therapeutic use Humans Postpartum Period Pregnancy Pregnancy Complications Pregnancy Trimester, Second Pregnancy Trimester, Third Psychiatric Status Rating Scales Stereoisomerism |
| Grant Support | |
ID/Acronym/Agency:
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1K23 MH082114/MH/NIMH NIH HHS; K23 MH082114-01A2/MH/NIMH NIH HHS; K23 MH082114-04/MH/NIMH NIH HHS; R01 MH057102/MH/NIMH NIH HHS; R01 MH060335-04/MH/NIMH NIH HHS; R01 MH071825/MH/NIMH NIH HHS; R01 MH075921/MH/NIMH NIH HHS; R01 MH60335/MH/NIMH NIH HHS; R25 MH060473/MH/NIMH NIH HHS; R25 MH060473-10/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antidepressive Agents, Second-Generation; 54910-89-3/Fluoxetine; 56161-73-0/norfluoxetine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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