Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy
Summary What is known and objective Depression during pregnancy is common and includes risks for mother and child. Pharmacokinetics of venlafaxine may be changed during pregnancy. This study aimed to describe changes in metabolic ratios and concentrations of venlafaxine and its main metabolite O‐des...
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| Veröffentlicht in: | Journal of clinical pharmacy and therapeutics 2014-10, Vol.39 (5), p.541-544 |
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| creator | ter Horst, P. G. J. Larmené-Beld, K. H. M. Bosman, J. van der Veen, E. L. Wieringa, A. Smit, J. P. |
| description | Summary
What is known and objective
Depression during pregnancy is common and includes risks for mother and child. Pharmacokinetics of venlafaxine may be changed during pregnancy. This study aimed to describe changes in metabolic ratios and concentrations of venlafaxine and its main metabolite O‐desmethylvenlafaxine during and after pregnancy.
Methods
To study this, we used data from our study of compliance to Antidepressants During Pregnancy (the ADAP study) to investigate the course of venlafaxine and O‐desmethylvenlafaxine concentrations during pregnancy and in the period post‐partum.
Results and discussion
We found that the venlafaxine concentration significantly changed during pregnancy when compared to the post‐partum period (P = 0·028). The median concentration of venlafaxine in the first trimester was 98·9% (54·2–292·0%), the second 100·0% (46·5–264·0%) and the third trimester 87·0% (61·5–217·2%). We did not found differences in O‐desmethylvenlafaxine concentrations in the different trimesters of pregnancy compared with the post‐partum period, P = 0·565. Also the ratio of O‐desmethylvenlafaxine/venlafaxine concentrations increased significantly from 76·9% (range 32·8–142·0%) in the first trimester to 196·7% (range 83·3–427·6%) in the third trimester compared with the post‐partum period, P = 0·004. Further, three of seven patients had concentrations below the therapeutic reference range (100–400 μg/L) in any period of pregnancy, whereas no one had subtherapeutic concentrations in the post‐partum period.
What is new and conclusion
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations, therefore routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations; therefore, routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy. |
| doi_str_mv | 10.1111/jcpt.12188 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1558517660</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1558517660</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4618-3c975fc81431ad9ae073571da0d37a0b606e6a609d4d696aa2b56eaff09af9453</originalsourceid><addsrcrecordid>eNp90F1rFDEUBuAgil2rN_4AGRBBhKnJ5GtyWQetlmILVnol4Ww-ataZzJrMaPffm3W3Vbzw3IQDzzknvAg9JfiIlHq9MuvpiDSkbe-hBaGC140k-D5a4EaomslGHqBHOa8wxkI29CE6aJhqFaNsgb50YzQuTgmmMMZcjb764WIPHm5CdBVEW4UpVwOEWA1uguXYh8lV57V1ufRfN_3f3M4pxOtqndx1hGg2j9EDD312T_bvIfr87u1l974-Oz_50B2f1YYJ0tbUKMm9aQmjBKwChyXlkljAlkrAS4GFEyCwsswKJQCaJRcOvMcKvGKcHqKXu73rNH6fXZ70ELJxfQ_RjXPWhPOWEykELvT5P3Q1zimW322VxJIT1Rb1aqdMGnNOzut1CgOkjSZYb0PX29D179ALfrZfOS8HZ-_obcoFvNgDyAZ6n0o2If9xrRRcqKY4snM_Q-82_zmpT7uLy9vj9W4m5Mnd3M1A-qaFpJLrq48n-qoTnxh_c6ov6C95y6kz</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1557075198</pqid></control><display><type>article</type><title>Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>ter Horst, P. G. J. ; Larmené-Beld, K. H. M. ; Bosman, J. ; van der Veen, E. L. ; Wieringa, A. ; Smit, J. P.</creator><creatorcontrib>ter Horst, P. G. J. ; Larmené-Beld, K. H. M. ; Bosman, J. ; van der Veen, E. L. ; Wieringa, A. ; Smit, J. P.</creatorcontrib><description>Summary
What is known and objective
Depression during pregnancy is common and includes risks for mother and child. Pharmacokinetics of venlafaxine may be changed during pregnancy. This study aimed to describe changes in metabolic ratios and concentrations of venlafaxine and its main metabolite O‐desmethylvenlafaxine during and after pregnancy.
Methods
To study this, we used data from our study of compliance to Antidepressants During Pregnancy (the ADAP study) to investigate the course of venlafaxine and O‐desmethylvenlafaxine concentrations during pregnancy and in the period post‐partum.
Results and discussion
We found that the venlafaxine concentration significantly changed during pregnancy when compared to the post‐partum period (P = 0·028). The median concentration of venlafaxine in the first trimester was 98·9% (54·2–292·0%), the second 100·0% (46·5–264·0%) and the third trimester 87·0% (61·5–217·2%). We did not found differences in O‐desmethylvenlafaxine concentrations in the different trimesters of pregnancy compared with the post‐partum period, P = 0·565. Also the ratio of O‐desmethylvenlafaxine/venlafaxine concentrations increased significantly from 76·9% (range 32·8–142·0%) in the first trimester to 196·7% (range 83·3–427·6%) in the third trimester compared with the post‐partum period, P = 0·004. Further, three of seven patients had concentrations below the therapeutic reference range (100–400 μg/L) in any period of pregnancy, whereas no one had subtherapeutic concentrations in the post‐partum period.
What is new and conclusion
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations, therefore routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations; therefore, routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.</description><identifier>ISSN: 0269-4727</identifier><identifier>EISSN: 1365-2710</identifier><identifier>DOI: 10.1111/jcpt.12188</identifier><identifier>PMID: 24989434</identifier><identifier>CODEN: JCPTED</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Adult ; Biological and medical sciences ; Cyclohexanols - administration & dosage ; Cyclohexanols - blood ; Cyclohexanols - pharmacokinetics ; Desvenlafaxine Succinate ; Female ; Humans ; Medical sciences ; O-desmethylvenlafaxine ; pharmacokinetics ; Pharmacology. Drug treatments ; Postpartum Period - metabolism ; pregnancy ; Pregnancy - metabolism ; Pregnancy Outcome ; Pregnancy Trimesters - metabolism ; Serotonin Uptake Inhibitors - administration & dosage ; Serotonin Uptake Inhibitors - blood ; Serotonin Uptake Inhibitors - pharmacokinetics ; venlafaxine ; Venlafaxine Hydrochloride</subject><ispartof>Journal of clinical pharmacy and therapeutics, 2014-10, Vol.39 (5), p.541-544</ispartof><rights>2014 John Wiley & Sons Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2014 John Wiley & Sons Ltd.</rights><rights>Copyright © 2014 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4618-3c975fc81431ad9ae073571da0d37a0b606e6a609d4d696aa2b56eaff09af9453</citedby><cites>FETCH-LOGICAL-c4618-3c975fc81431ad9ae073571da0d37a0b606e6a609d4d696aa2b56eaff09af9453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpt.12188$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpt.12188$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28765692$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24989434$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ter Horst, P. G. J.</creatorcontrib><creatorcontrib>Larmené-Beld, K. H. M.</creatorcontrib><creatorcontrib>Bosman, J.</creatorcontrib><creatorcontrib>van der Veen, E. L.</creatorcontrib><creatorcontrib>Wieringa, A.</creatorcontrib><creatorcontrib>Smit, J. P.</creatorcontrib><title>Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy</title><title>Journal of clinical pharmacy and therapeutics</title><addtitle>J Clin Pharm Ther</addtitle><description>Summary
What is known and objective
Depression during pregnancy is common and includes risks for mother and child. Pharmacokinetics of venlafaxine may be changed during pregnancy. This study aimed to describe changes in metabolic ratios and concentrations of venlafaxine and its main metabolite O‐desmethylvenlafaxine during and after pregnancy.
Methods
To study this, we used data from our study of compliance to Antidepressants During Pregnancy (the ADAP study) to investigate the course of venlafaxine and O‐desmethylvenlafaxine concentrations during pregnancy and in the period post‐partum.
Results and discussion
We found that the venlafaxine concentration significantly changed during pregnancy when compared to the post‐partum period (P = 0·028). The median concentration of venlafaxine in the first trimester was 98·9% (54·2–292·0%), the second 100·0% (46·5–264·0%) and the third trimester 87·0% (61·5–217·2%). We did not found differences in O‐desmethylvenlafaxine concentrations in the different trimesters of pregnancy compared with the post‐partum period, P = 0·565. Also the ratio of O‐desmethylvenlafaxine/venlafaxine concentrations increased significantly from 76·9% (range 32·8–142·0%) in the first trimester to 196·7% (range 83·3–427·6%) in the third trimester compared with the post‐partum period, P = 0·004. Further, three of seven patients had concentrations below the therapeutic reference range (100–400 μg/L) in any period of pregnancy, whereas no one had subtherapeutic concentrations in the post‐partum period.
What is new and conclusion
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations, therefore routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations; therefore, routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cyclohexanols - administration & dosage</subject><subject>Cyclohexanols - blood</subject><subject>Cyclohexanols - pharmacokinetics</subject><subject>Desvenlafaxine Succinate</subject><subject>Female</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>O-desmethylvenlafaxine</subject><subject>pharmacokinetics</subject><subject>Pharmacology. Drug treatments</subject><subject>Postpartum Period - metabolism</subject><subject>pregnancy</subject><subject>Pregnancy - metabolism</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Trimesters - metabolism</subject><subject>Serotonin Uptake Inhibitors - administration & dosage</subject><subject>Serotonin Uptake Inhibitors - blood</subject><subject>Serotonin Uptake Inhibitors - pharmacokinetics</subject><subject>venlafaxine</subject><subject>Venlafaxine Hydrochloride</subject><issn>0269-4727</issn><issn>1365-2710</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90F1rFDEUBuAgil2rN_4AGRBBhKnJ5GtyWQetlmILVnol4Ww-ataZzJrMaPffm3W3Vbzw3IQDzzknvAg9JfiIlHq9MuvpiDSkbe-hBaGC140k-D5a4EaomslGHqBHOa8wxkI29CE6aJhqFaNsgb50YzQuTgmmMMZcjb764WIPHm5CdBVEW4UpVwOEWA1uguXYh8lV57V1ufRfN_3f3M4pxOtqndx1hGg2j9EDD312T_bvIfr87u1l974-Oz_50B2f1YYJ0tbUKMm9aQmjBKwChyXlkljAlkrAS4GFEyCwsswKJQCaJRcOvMcKvGKcHqKXu73rNH6fXZ70ELJxfQ_RjXPWhPOWEykELvT5P3Q1zimW322VxJIT1Rb1aqdMGnNOzut1CgOkjSZYb0PX29D179ALfrZfOS8HZ-_obcoFvNgDyAZ6n0o2If9xrRRcqKY4snM_Q-82_zmpT7uLy9vj9W4m5Mnd3M1A-qaFpJLrq48n-qoTnxh_c6ov6C95y6kz</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>ter Horst, P. G. J.</creator><creator>Larmené-Beld, K. H. M.</creator><creator>Bosman, J.</creator><creator>van der Veen, E. L.</creator><creator>Wieringa, A.</creator><creator>Smit, J. P.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Hindawi Limited</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>201410</creationdate><title>Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy</title><author>ter Horst, P. G. J. ; Larmené-Beld, K. H. M. ; Bosman, J. ; van der Veen, E. L. ; Wieringa, A. ; Smit, J. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4618-3c975fc81431ad9ae073571da0d37a0b606e6a609d4d696aa2b56eaff09af9453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cyclohexanols - administration & dosage</topic><topic>Cyclohexanols - blood</topic><topic>Cyclohexanols - pharmacokinetics</topic><topic>Desvenlafaxine Succinate</topic><topic>Female</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>O-desmethylvenlafaxine</topic><topic>pharmacokinetics</topic><topic>Pharmacology. Drug treatments</topic><topic>Postpartum Period - metabolism</topic><topic>pregnancy</topic><topic>Pregnancy - metabolism</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Trimesters - metabolism</topic><topic>Serotonin Uptake Inhibitors - administration & dosage</topic><topic>Serotonin Uptake Inhibitors - blood</topic><topic>Serotonin Uptake Inhibitors - pharmacokinetics</topic><topic>venlafaxine</topic><topic>Venlafaxine Hydrochloride</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ter Horst, P. G. J.</creatorcontrib><creatorcontrib>Larmené-Beld, K. H. M.</creatorcontrib><creatorcontrib>Bosman, J.</creatorcontrib><creatorcontrib>van der Veen, E. L.</creatorcontrib><creatorcontrib>Wieringa, A.</creatorcontrib><creatorcontrib>Smit, J. P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical pharmacy and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ter Horst, P. G. J.</au><au>Larmené-Beld, K. H. M.</au><au>Bosman, J.</au><au>van der Veen, E. L.</au><au>Wieringa, A.</au><au>Smit, J. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy</atitle><jtitle>Journal of clinical pharmacy and therapeutics</jtitle><addtitle>J Clin Pharm Ther</addtitle><date>2014-10</date><risdate>2014</risdate><volume>39</volume><issue>5</issue><spage>541</spage><epage>544</epage><pages>541-544</pages><issn>0269-4727</issn><eissn>1365-2710</eissn><coden>JCPTED</coden><abstract>Summary
What is known and objective
Depression during pregnancy is common and includes risks for mother and child. Pharmacokinetics of venlafaxine may be changed during pregnancy. This study aimed to describe changes in metabolic ratios and concentrations of venlafaxine and its main metabolite O‐desmethylvenlafaxine during and after pregnancy.
Methods
To study this, we used data from our study of compliance to Antidepressants During Pregnancy (the ADAP study) to investigate the course of venlafaxine and O‐desmethylvenlafaxine concentrations during pregnancy and in the period post‐partum.
Results and discussion
We found that the venlafaxine concentration significantly changed during pregnancy when compared to the post‐partum period (P = 0·028). The median concentration of venlafaxine in the first trimester was 98·9% (54·2–292·0%), the second 100·0% (46·5–264·0%) and the third trimester 87·0% (61·5–217·2%). We did not found differences in O‐desmethylvenlafaxine concentrations in the different trimesters of pregnancy compared with the post‐partum period, P = 0·565. Also the ratio of O‐desmethylvenlafaxine/venlafaxine concentrations increased significantly from 76·9% (range 32·8–142·0%) in the first trimester to 196·7% (range 83·3–427·6%) in the third trimester compared with the post‐partum period, P = 0·004. Further, three of seven patients had concentrations below the therapeutic reference range (100–400 μg/L) in any period of pregnancy, whereas no one had subtherapeutic concentrations in the post‐partum period.
What is new and conclusion
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations, therefore routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.
Venlafaxine concentrations decreases during pregnancy, and the ratio of the concentrations of O‐desmethylvenlafaxine/venlafaxine increases during pregnancy. Pregnant women using venlafaxine are at risk for subtherapeutic concentrations; therefore, routine monitoring of concentrations venlafaxine and O‐desmethylvenlafaxine is recommendable during pregnancy.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24989434</pmid><doi>10.1111/jcpt.12188</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical pharmacy and therapeutics, 2014-10, Vol.39 (5), p.541-544 |
| issn | 0269-4727 1365-2710 |
| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adult Biological and medical sciences Cyclohexanols - administration & dosage Cyclohexanols - blood Cyclohexanols - pharmacokinetics Desvenlafaxine Succinate Female Humans Medical sciences O-desmethylvenlafaxine pharmacokinetics Pharmacology. Drug treatments Postpartum Period - metabolism pregnancy Pregnancy - metabolism Pregnancy Outcome Pregnancy Trimesters - metabolism Serotonin Uptake Inhibitors - administration & dosage Serotonin Uptake Inhibitors - blood Serotonin Uptake Inhibitors - pharmacokinetics venlafaxine Venlafaxine Hydrochloride |
| title | Concentrations of venlafaxine and its main metabolite O-desmethylvenlafaxine during pregnancy |
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