Changes in drug disposition of lithium during pregnancy: a retrospective observational study of patient data from two routine therapeutic drug monitoring services in Norway
| Autor: | Marianne Aadal, Eirik Skogvoll, Andreas Austgulen Westin, Olav Spigset, Malin Brekke, Espen Molden |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Drug Pediatrics medicine.medical_specialty Bipolar Disorder Lithium (medication) Pregnancy Trimester Third media_common.quotation_subject law.invention 03 medical and health sciences 0302 clinical medicine Antimanic Agents Pregnancy law CLINICAL PHARMACOLOGY Humans Medicine Dosing Retrospective Studies media_common Clinical pharmacology medicine.diagnostic_test Norway business.industry Research Postpartum Period Retrospective cohort study General Medicine medicine.disease Pharmacology and Therapeutics 030227 psychiatry Therapeutic drug monitoring Linear Models Lithium Compounds PSYCHIATRY Female Drug Monitoring business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | Objectives Pregnancy may cause changes in drug disposition, dose requirements and clinical response. For lithium, changes in disposition during pregnancy have so far been explored in a single-dose study on 4 participants only. The aim of this study was to determine the effect of pregnancy on serum levels of lithium in a larger patient material in a naturalistic setting. Design A retrospective observational study of patient data from 2 routine therapeutic drug monitoring services in Norway, linked to the Medical Birth Registry of Norway. Setting Norway, October 1999 to December 2011. Measurements Dose-adjusted drug concentrations of lithium during pregnancy were compared with the women's own baseline (non-pregnant) values, using a linear mixed model. Results Overall, coupling 196 726 serum concentration measurements from 54 393 women to the national birth registry identified 25 serum lithium concentration analyses obtained from a total of 14 pregnancies in 13 women, and 63 baseline analyses from the same women. Dose-adjusted serum concentrations in the third trimester were significantly lower than baseline (−34%; CI −44% to −23%, p |
| Databáze: | OpenAIRE |
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