Selective Serotonin Reuptake Inhibitor Pharmacokinetics During Pregnancy: Clinical and Research Implications.

SSRI (selective serotonergic reuptake inhibitors) anxiety depression pharmacokinctics pregnancy

Journal

Frontiers in pharmacology
ISSN: 1663-9812
Titre abrégé: Front Pharmacol
Pays: Switzerland
ID NLM: 101548923

Informations de publication

Date de publication:
2022
Historique:
received: 10 12 2021
accepted: 24 01 2022
entrez: 14 3 2022
pubmed: 15 3 2022
medline: 15 3 2022
Statut: epublish

Résumé

Pregnancy and associated physiologic changes affect the pharmacokinetics of many medications, including selective serotonin reuptake inhibitors-the first-line pharmacologic interventions for depressive and anxiety disorders. During pregnancy, SSRIs exhibit extensive pharmacokinetic variability that may influence their tolerability and efficacy. Specifically, compared to non-pregnant women, the activity of cytochrome P450 (CYP) enzymes that metabolize SSRIs drastically changes (e.g., decreased CYP2C19 activity and increased CYP2D6 activity). This perspective examines the impact of pharmacokinetic genes-related to CYP activity on SSRI pharmacokinetics during pregnancy. Through a simulation-based approach, plasma concentrations for SSRIs metabolized primarily by CYP2C19 (e.g., escitalopram) and CYP2D6 (e.g., fluoxetine) are examined and the implications for dosing and future research are discussed.

Identifiants

pubmed: 35281909
doi: 10.3389/fphar.2022.833217
pii: 833217
pmc: PMC8916222
doi:

Types de publication

Journal Article

Langues

eng

Pagination

833217

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD098757
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD099775
Pays : United States

Informations de copyright

Copyright © 2022 Poweleit, Cinibulk, Novotny, Wagner-Schuman, Ramsey and Strawn.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Ethan A Poweleit (EA)

Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Department of Biomedical Informatics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Pediatrics, Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Pediatrics, Division of Research in Patient Services, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Margaret A Cinibulk (MA)

Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, United States.

Sarah A Novotny (SA)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Mississippi, Jackson, MS, United States.

Melissa Wagner-Schuman (M)

Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States.

Laura B Ramsey (LB)

Department of Pediatrics, Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Pediatrics, Division of Research in Patient Services, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Jeffrey R Strawn (JR)

Department of Pediatrics, Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States.
Department of Pediatrics, Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

Classifications MeSH