Please enable JavaScript.
Coggle requires JavaScript to display documents.
COMMON ANTIDEPRESSANTS USED DURING PREGNANCY & POSTPARTUM. - Coggle…
COMMON ANTIDEPRESSANTS USED DURING PREGNANCY & POSTPARTUM.
CITALOPRAM
Therapeutic particulars:
Pharmacodynamics Used for the treatment of depression during the initial phase and as maintenance against potential relapse
Can be taken in the morning or evening on an empty stomach. Treatment results can be expected 2-3 weeks post intital administration.
Standard dosage is 20 mg PO daily. dependent on the individual patient response and the severity of depressive symptoms, the dose can be titrated up 10mg per weeks over the initial 3 week treatment period up to a maximum 40 mg daily
this medication us a selective serition reuptake inhibitor [SSRI]
MECHANISM OF ACTION: The mechanism of action of citalopram results from its inhibition of CNS neuronal reuptake of serotonin (5-HT).
ABSORPTION:
Rapidly and well absorbed from the GI tract. Peak plasma concentrations occur within 4 hours of a single orally administered dose. Bioavailability is 80% following oral administration. Food does not affect absorption
HALF LIFE: 35 HOURS
PHARMACOKENETICS: absorption takes place in the liver. Metabolized in the liver and excreted in urine and faeces.
CONTRAINDICATIONS:
caution should be taken in pts with renal or hepatic dysfunction due to the potential alteration of the metabolism of the drug
caution should be taken with patients with severe depression or people with suicidal thoughts.
SSRIs have been related congenital
NORTRIPYLINE
Pharmacodynamics:
Nortriptyline exerts antidepressant effects likely by inhibiting the reuptake of serotonin and norepinephrine at neuronal cell membranes. It also exerts antimuscarinic effects through its actions on the acetylcholine receptors
Mechanism of action: nortriptyline either inhibits the reuptake of serotonin at the neuronal membrane or acts on the beta-adrenergic receptors.
Contrindicated in pregancy, due to risk of excretion into breastmilk. Benefits should outweigh risk to the neonate.
Adverse effects: sedation, fatigue, hallucinations, disorientation, difficulty concentrating and tremors
Pharmacokinetics: Absorbed in the GI tract, peak levels in 2-3 hrs, metabolised in the liver, excreted in urine
typically antidepressants should be used with extreme care during pregnancy and breastfeeding due to the potiential adverse effects on the fetus and possible neurological deficits that can occur in the baby. Use should be reserved for situations where the benefits outweigh the risks to the neonate
Depression during pregnancy: it affects 15 % of women, can have both short and long term negatice affects for the mother It can be linked to previous trauma, drug and alcohol use and inadequate prenatal care.
Several studies depict an association between the use of antidepressants during pregnancy and poor birth outcomes such as preterm delivery, low birthweight,
Over the years, several studies have researched he association between use of antidepressants and risk of spontaneous abortion. An early study on the use of tricyclic antidepressants [TCAs], during pregnancy found no increased risk of spontaneous abortion associated with [TCAs] (11.5%) when compared with a group exposed to non-TCAs (11.3%)