Characteristics and consequences of antenatal exposure to selective serotonin reuptake inhibitors

Julyan, Tom Everett (2018) Characteristics and consequences of antenatal exposure to selective serotonin reuptake inhibitors. MD thesis, University of Glasgow.

Abstract

Depression is a common condition, affecting around one in 20 people worldwide. It is challenging conceptually and clinically, with treatment being ineffective for many, and significant consequences for individuals and societies alike. Depression is particularly problematic during pregnancy, where it is no less common, but poses additional difficulties. Both depression and its pharmacological treatments are associated with a range of short- and longer- term sequelae for offspring, and current data is insufficient to allow fully informed decisions to be made by mothers, midwives, or doctors.
Research is affected by practical, ethical, and methodological issues, and a myriad of confounding factors, which combine to increase uncertainties over the risks and benefits of prescribing (or not). Retrospective and prospective observational studies accompany epidemiological data linkage and meta- analyses involving millions of subjects, in contributing to both current knowledge and testable hypotheses to inform future directions for research, while clinical and preclinical studies with smaller sample sizes provide invaluable and complementary details. However, significant gaps remain, not least in delivering optimal care to each individual mother and baby.
While the overall emerging picture appears reassuring to some, others acknowledge that we do not even possess all the pieces of the puzzle yet. There remains an urgent need for more comprehensive and relevant data. This thesis presents the findings from a series of pilot studies on evaluating the characteristics and consequences of antenatal exposure to selective serotonin reuptake inhibitors. Up to one in 10 women in the general Scottish population may be exposed to an antidepressant at some point during pregnancy, but adverse outcomes may be related more to underlying maternal depression, rather than its pharmacological treatment. We highlight areas of both intelligence and ignorance, and make proposals for future research.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Antenatal, depression, antidepressants, selective serotonin reuptake, inhibitors, ssris, neurodevelopment, neuroimaging.
• Subjects: R Medicine > R Medicine (General)
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Supervisor's Name: Cavanagh, Professor Jonathan
• Date of Award: 2018
• Depositing User: Dr Tom Everett Julyan
• Unique ID: glathesis:2018-30712
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 02 Aug 2018 10:52
• Last Modified: 30 Aug 2018 07:49
• URI: https://theses.gla.ac.uk/id/eprint/30712