Disposition of chiral and racemic fluoxetine and norfluoxetine across childbearing.

Journal of Clinical Psychopharmacology
Dorothy SitKatherine L Wisner

Abstract

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. 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. 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. The findings extend earlier rep...Continue Reading

Associated Clinical Trials

Jan 19, 2006·Katherine Wisner

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Citations

Dec 24, 2011·Obstetrical & Gynecological Survey·Avinash S PatilEleanor H J Rhee
Aug 10, 2011·The Journal of Clinical Psychiatry·Dorothy SitKatherine L Wisner
Feb 21, 2018·Journal of Psychopharmacology·Subhi Marwari, Gavin S Dawe
Oct 23, 2018·Clinical Pharmacology and Therapeutics·Daniela Miarelli CarvalhoElaine Christine Dantas Moisés
Dec 2, 2017·Journal of Clinical Psychopharmacology·Emily A PinheiroCrystal T Clark
Dec 5, 2019·Journal of Women's Health·Hannah K Betcher, Katherine L Wisner
Apr 3, 2020·Expert Opinion on Drug Metabolism & Toxicology·Georgios SchoretsanitisAndreas A Westin
Jun 24, 2017·Clinical Pharmacology and Therapeutics·Andreas A WestinOlav Spigset
Jul 23, 2018·Archives of Women's Mental Health·Joseph S Lonstein
Feb 23, 2020·Seminars in Perinatology·Gabrielle A MeschesHannah K Betcher

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