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Gursoy BK, Atay E, Bilir A, Firat F, Soylemez ESA, Kurt GA, Gozen M, Ertekin T. Effect of aripiprazole on neural tube development in early chick embryos. Toxicol Appl Pharmacol 2024; 489:117009. [PMID: 38906509 DOI: 10.1016/j.taap.2024.117009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/30/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Aripiprazole (ARI) is a recently developed antipsychotic medication that belongs to the second generation of antipsychotics. The literature has contradictory information regarding ARI, which has been classified as pregnant use category C by the FDA. METHODS 125 pathogen-free fertilized eggs were incubated for 28 h and divided into five groups of 25 eggs each (including the control group), and 18 eggs with intact integrity were selected from each group. After the experimental groups were divided, ARI was administered subblastodermally with a Hamilton micro-injector at 4 different doses (1 mg/kg, 5 mg/kg, 10 mg/kg, 20 mg/kg). At the 48th hour of incubation, all eggs were hatched and embryos were removed from the embryonic membranes. And then morphologic (position of the neural tube (open or closed), crown-rump length, number of somites, embryological development status), histopathologic (apoptosis (caspase 3), cell proliferation (PCNA), in situ recognition of DNA breaks (tunnel)), genetic (BRE gene expression) analyzes were performed. RESULTS According to the results of the morphological analysis, when the frequency of neural tube patency was evaluated among the experimental groups, a statistically significant difference was determined between the control group and all groups (p < 0.001). In addition, the mean crown-rump length and somite number of the embryos decreased in a dose-dependent manner compared to the control group. It was determined that mRNA levels of the BRE gene decreased in embryos exposed to ARI compared to the control group (p < 0.001). CONCLUSION Morphologically, histopathologically, and genetically, aripiprazole exposure delayed neurogenesis and development in early chick embryos. These findings suggest its use in pregnant women may be teratogenic. We note that these results are preliminary for pregnant women, but they should be expanded and studied with additional and other samples.
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Affiliation(s)
- Betul Kurtses Gursoy
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar, Turkey.
| | - Emre Atay
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Anatomy, Afyonkarahisar, Turkey
| | - Abdulkadir Bilir
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Anatomy, Afyonkarahisar, Turkey
| | - Fatma Firat
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Histology and Embryology, Afyonkarahisar, Turkey
| | - Evrim Suna Arikan Soylemez
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Medical Biology, Afyonkarahisar, Turkey
| | - Gulan Albas Kurt
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Anatomy, Afyonkarahisar, Turkey
| | - Mert Gozen
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Psychiatry, Afyonkarahisar, Turkey
| | - Tolga Ertekin
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Anatomy, Afyonkarahisar, Turkey
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Costa B, Vale N. Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring. J Clin Med 2024; 13:4398. [PMID: 39124665 PMCID: PMC11312735 DOI: 10.3390/jcm13154398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Advancements in psychotropic therapy for pregnant women are pivotal for addressing maternal mental health during the perinatal period. Screening for mood and anxiety symptoms during pregnancy is recommended to enable early intervention. Psychotropic medications, including antidepressants, benzodiazepines, antipsychotics, and mood stabilizers, are commonly used, but challenges remain regarding their safety and efficacy during pregnancy. Pregnancy induces significant changes in pharmacokinetics, necessitating personalized dosing strategies and careful monitoring. Real-time monitoring technologies, such as smartphone-integrated platforms and home-based monitoring, enhance accessibility and accuracy. Prospective studies and collaboration among healthcare providers are essential for evidence-based guidelines and optimal treatment strategies. Reducing stigma around mental health during pregnancy is crucial to ensure women seek help and discuss treatment options, promoting understanding and acceptance within the community.
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Affiliation(s)
- Bárbara Costa
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Centre for Parasite Biology and Immunology, Department of Infectious Diseases, National Health Institute Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal
| | - Nuno Vale
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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Cui J, Zhai Q, Yang Z, Liu Y. The role of gut microbiota and blood metabolites in postpartum depression: a Mendelian randomization analysis. Front Cell Infect Microbiol 2024; 14:1416298. [PMID: 39050131 PMCID: PMC11266010 DOI: 10.3389/fcimb.2024.1416298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Background Postpartum depression (PPD) is a common complication of pregnancy that imposes a heavy health and economic burden on individuals, families and society. The etiology of PPD is complex and incompletely defined, and recent studies have identified an important role for gut microbiota (GM) and their metabolites in neurological disorders. However, fewer studies on GM and PPD are available and have not yielded uniform results. Methods Instrumental variables for GM and blood metabolites were obtained from the MiBioGen consortium and metabolomics GWAS server. Single nucleotide polymorphisms (SNPs) associated with PPD phenotypes were obtained from the FinnGen consortium. Inverse variance weighted (IVW), weighted median, weighted mode, and MR-Egger methods were used to assess causal effects. Inverse MR analysis and sensitivity analysis were also utilized to improve the stability of the results. Results In this study, 5 intestinal species and 24 blood metabolites causally associated with PPD were identified using MR analysis. In addition, MR analysis showed that Prevotellaceae and Bifidobacteria may reduce the risk of PPD by elevating Xanthine and 1-arachidonoylglycerophosphoinositol (LysoPI) levels. Conclusions This study identified GM and blood metabolites causally associated with PPD. The results of this study may provide a theoretical basis for the discovery of PPD-related biomarkers and the treatment of the disease by regulating the gut microenvironment.
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Affiliation(s)
- Ji Cui
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qilong Zhai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhu Yang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Jarque P, Carmona M, Roca A, Barcelo B, Pichini S, Elorza MÁ, Sanchis P, Rendal Y, Gomila I. Evaluation of three-year neurodevelopmental outcomes in infants prenatally exposed to substance use. Drug Alcohol Depend 2024; 259:111284. [PMID: 38640866 DOI: 10.1016/j.drugalcdep.2024.111284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Prenatal exposure to substance use is associated with long-term deficits in the neurodevelopment of children. The objective was to investigate the association between cognitive, motor, and language neurodevelopment at three years of age in infants prenatally exposed to substance use. MATERIAL AND METHODS A prospective matched case-control study was conducted. Biomarkers of fetal exposure were measured in meconium samples. The Bayley Scales of Infant and Toddler Development (BSID-III) were used to calculate neurodevelopment scores. RESULTS 32 non-exposed and 32 exposed infants were evaluated, of which 16 were exposed to cannabis, 8 to ethanol, 2 to cocaine and 6 to more than one substance. Normal BSID-III scores ≥85 in all domains, were detected in 23 exposed infants to any substance and 29 infants non-exposed. Neurodevelopmental delay was detected in the language domain, specifically in male infants exposed to cannabis. Two infants exposed to cannabis had a severe developmental delay (score<70). Infants exposed to any substance obtained significantly lower total scores than control infants in all domains. Infants exposed to cannabis obtained significantly lower composite scores in the cognitive and motor domains. Infants exposed to more than one substance had lower scores in motor skills. By gender, only males exposed obtained significantly lower composite scores than non-exposed males in the cognitive domain. CONCLUSIONS The most common and severe neurodevelopmental delay at 36 months was detected in the domain of language in male infants prenatally exposed to cannabis. Neurodevelopmental disorders detected can enable an early intervention and plan therapeutic strategies.
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Affiliation(s)
- Pilar Jarque
- Division of Neonatology, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Pediatric Multidisciplinary Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Miguel Carmona
- Division of Neuropediatrics, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Antonia Roca
- Division of Neonatology, Department of Pediatrics, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Pediatric Multidisciplinary Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Bernardino Barcelo
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome 00161, Italy.
| | - Miguel Ángel Elorza
- Clinical Analysis Service, Clinical Toxicology Unit, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Pilar Sanchis
- Department of Chemistry, University of the Balearic Islands, Valldemossa Road, km 7.5, Palma de Mallorca 07122, Spain; Research Group in Vascular and Metabolic Pathologies of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Yolanda Rendal
- Division of Child and Youth Psychiatry, Son Espases University Hospital, Valldemossa Road, 79, Palma de Mallorca 07120, Spain.
| | - Isabel Gomila
- Clinical Toxicology Research Group of Balearic Islands Health Research Institute (IdISBa), Valldemossa Road, 79, Palma de Mallorca 07120, Spain; Clinical Analysis Service, Son Llàtzer University Hospital, Manacor Road, Palma de Mallorca 07198, Spain.
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Gennaro S, Melnyk BM, Szalacha LA, Hoying J, Cooper A, Aviles MM, O'Connor C, Gibeau A. Depression, anxiety, and stress in pregnant Black people: A case for screening and evidence-based intervention. Nurse Pract 2023; 48:37-46. [PMID: 37991519 DOI: 10.1097/01.npr.0000000000000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND Guidelines call for pregnant people to be screened for depression and anxiety. Screening may be particularly important for pregnant Black individuals who are reported to be more likely than non-Hispanic White pregnant people to experience prenatal stress, anxiety, and depressive symptoms. The purpose of this study was to determine if depression, anxiety, and stress co-occur in pregnant Black people and to identify which demographic factors are related to these mental health concerns. METHODS A subset analysis of an ongoing randomized controlled trial examined the risk of coexisting mental health conditions in pregnant Black people who screened eligible to participate (that is, they had high levels of depression, anxiety, and/or stress) in two urban clinics using a descriptive correlational design. RESULTS Of the 452 pregnant Black people who were screened for eligibility, 194 (42.9%) had elevated scores on depression, anxiety, and/or stress measures and were enrolled in the larger study. The average scores of the 194 enrolled participants were anxiety, mean (M) = 9.16 (standard deviation [SD] = 4.30); depression, M = 12.80 (SD = 4.27); and stress, M = 21.79 (SD = 4.76). More than one-third (n = 70, 36.1%) experienced two symptoms and 64 (33.0%) reported all three symptoms. CONCLUSION Pregnant Black individuals experience high levels of comorbid mental health distress including depression, anxiety, and stress. The findings indicate that treatment for mental health concerns needs to be broad-based and effective for all three conditions. Prenatal interventions should aim to address mental health distress through screening and treatment of depression, anxiety, and stress, especially for pregnant Black individuals. This study furthers understanding of the prevalence of prenatal mental health conditions in pregnant Black people.
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Zepeda RC, Juárez-Portilla C, Molina-Jiménez T. St. John's Wort usage in treating of perinatal depression. Front Behav Neurosci 2023; 16:1066459. [PMID: 36688122 PMCID: PMC9851381 DOI: 10.3389/fnbeh.2022.1066459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Affiliation(s)
- Rossana C. Zepeda
- Laboratorio de Biomedicina Integral y Salud, Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Claudia Juárez-Portilla
- Laboratorio de Biomedicina Integral y Salud, Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico
| | - Tania Molina-Jiménez
- Facultad de Química Farmacéutica Biológica, Universidad Veracruzana, Xalapa, Veracruz, Mexico,*Correspondence: Tania Molina-Jiménez ✉
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Aoki Y, Takaesu Y, Baba H, Iga J, Hori H, Inoue T, Mishima K, Tajika A, Kato M. Development and acceptability of a decision aid for major depressive disorder considering discontinuation of antidepressant treatment after remission. Neuropsychopharmacol Rep 2022; 42:306-314. [PMID: 35775506 PMCID: PMC9515698 DOI: 10.1002/npr2.12269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 12/02/2022] Open
Abstract
Aim While evidence‐based antidepressant treatment is available for major depressive disorder, standard approaches for discontinuation of antidepressants after remission have not yet been established. Decision aids are structured clinical tools that facilitate shared decision‐making between patients and healthcare providers. This study aimed to describe the development process and acceptability of decision aids for major depressive disorder following discontinuation of antidepressant treatment after remission. Methods We systematically developed a decision aids according to the International Patient Decision Aid Standards. First, a decision aids prototype was created using the results of a systematic review and meta‐analysis previously conducted to identify the consequences of continuing and discontinuing antidepressant treatment. Second, a mixed‐methods questionnaire (alpha acceptability testing) was administered to patients and healthcare providers to improve the decision aids prototype and develop it into a final version acceptable for clinical settings. Results Our decision aids consisted of a description of major depressive disorder, the option to continue or discontinue antidepressant treatment, the advantages and disadvantages of each option, the consequences of each option, and value clarification exercises for each option. The patients (n = 22) reported that the decision aids had acceptable language (91%), adequate information (91%), and a well‐balanced presentation (95%). Healthcare providers (n = 20) provided favorable feedback. The final decision aids fulfilled all six International Patient Decision Aid Standards qualifying criteria. Conclusion We successfully developed a decision aids for discontinuation of antidepressant treatment after remission, which could be used during the shared decision‐making process. Further studies are needed to verify the effects of using the decision aids during the shared decision‐making process.
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Affiliation(s)
- Yumi Aoki
- Department Psychiatric and Mental Health Nursing, Graduate School of Nursing St. Luke's International University Tokyo Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine University of the Ryukyus Okinawa Japan
- Department of Neuropsychiatry Kyorin University School of Medicine Tokyo Japan
| | - Hajime Baba
- Department of Psychiatry, Juntendo Koshigaya Hospital Juntendo University Faculty of Medicine Saitama Japan
| | - Jun‐ichi Iga
- Department of Neuropsychiatry, Molecules and Function Ehime University Graduate School of Medicine Ehime Japan
| | - Hikaru Hori
- Department of Psychiatry, Faculty of Medicine Fukuoka University Fukuoka Japan
| | - Takeshi Inoue
- Department of Psychiatry Tokyo Medical University Tokyo Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry Akita University Graduate School of Medicine Akita Japan
| | - Aran Tajika
- Department of Health Promotion and Human Behavior, School of Public Health Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masaki Kato
- Department of Neuropsychiatry Kansai Medical University Osaka Japan
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