TY - JOUR
AU - E. Lovegrove
AU - A. Maidwell-Smith
AU - B. Stuart
AU - M. Santer
A1 - 
AB - BACKGROUND: Depression is the second most common chronic condition affecting women of reproductive age; 23.4% of women enter pregnancy with depression and use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy is often necessary for maternal wellbeing. However, SSRI use during pregnancy can cause congenital malformations, postpartum haemorrhage (PPH), and persistent pulmonary hypertension of the newborn (PPHN). In UK primary care, prescribing formularies are one medium by which prescribers are provided with local medicines advice. AIM: To review all local prescribing formularies with respect to prescribing SSRIs in women of reproductive age, during pregnancy, and during breastfeeding. DESIGN & SETTING: A systematic review of prescribing formularies in England and Wales. METHOD: A systematic keyword search of all clinical commissioning group and Integrated Care Board websites in England and Local Health Board websites in Wales was undertaken between December 2021-22 to identify prescribing formularies. Data were extracted on prescribing guidance for SSRIs. RESULTS: Seventy-four prescribing formularies were reviewed. Of these, 14.9% (n = 11/74) provided links to the Medicines and Healthcare products Regulatory Agency guidance on congenital abnormalities associated with SSRIs, 28.4% (n = 21/74) provided links to guidance on PPH risk, and 1.4% (n = 1/74) provided links to guidance on PPHN. Specific local guidance was given on SSRI prescribing for women of reproductive age, during pregnancy, and during breastfeeding in 12.2% (n = 9/74), 23.0% (n = 17/74), and 21.6% (n = 16/74) of formularies, respectively. CONCLUSION: Our results suggest that prescribers may be poorly informed by local formularies about the risks of SSRI use around pregnancy. This could place babies at increased risk of unintentional SSRI exposure.
AD - Primary Care Research Centre, University of Southampton, Southampton, UK e.lovegrove@soton.ac.uk.; Hampshire Hospitals NHS Trust, Southampton, UK.; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.; Primary Care Research Centre, University of Southampton, Southampton, UK.
AN - 38272494
BT - BJGP Open
C5 - Healthcare Disparities
CP - 2
DA - Jul
DO - 10.3399/bjgpo.2023.0255
DP - NLM
ET - 20240729
IS - 2
JF - BJGP Open
LA - eng
N2 - BACKGROUND: Depression is the second most common chronic condition affecting women of reproductive age; 23.4% of women enter pregnancy with depression and use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy is often necessary for maternal wellbeing. However, SSRI use during pregnancy can cause congenital malformations, postpartum haemorrhage (PPH), and persistent pulmonary hypertension of the newborn (PPHN). In UK primary care, prescribing formularies are one medium by which prescribers are provided with local medicines advice. AIM: To review all local prescribing formularies with respect to prescribing SSRIs in women of reproductive age, during pregnancy, and during breastfeeding. DESIGN & SETTING: A systematic review of prescribing formularies in England and Wales. METHOD: A systematic keyword search of all clinical commissioning group and Integrated Care Board websites in England and Local Health Board websites in Wales was undertaken between December 2021-22 to identify prescribing formularies. Data were extracted on prescribing guidance for SSRIs. RESULTS: Seventy-four prescribing formularies were reviewed. Of these, 14.9% (n = 11/74) provided links to the Medicines and Healthcare products Regulatory Agency guidance on congenital abnormalities associated with SSRIs, 28.4% (n = 21/74) provided links to guidance on PPH risk, and 1.4% (n = 1/74) provided links to guidance on PPHN. Specific local guidance was given on SSRI prescribing for women of reproductive age, during pregnancy, and during breastfeeding in 12.2% (n = 9/74), 23.0% (n = 17/74), and 21.6% (n = 16/74) of formularies, respectively. CONCLUSION: Our results suggest that prescribers may be poorly informed by local formularies about the risks of SSRI use around pregnancy. This could place babies at increased risk of unintentional SSRI exposure.
PY - 2024
SN - 2398-3795
ST - Selective serotonin reuptake inhibitors (SSRIs) in women of reproductive age: a systematic review of local formularies
T1 - Selective serotonin reuptake inhibitors (SSRIs) in women of reproductive age: a systematic review of local formularies
T2 - BJGP Open
TI - Selective serotonin reuptake inhibitors (SSRIs) in women of reproductive age: a systematic review of local formularies
U1 - Healthcare Disparities
U3 - 10.3399/bjgpo.2023.0255
VL - 8
VO - 2398-3795
Y1 - 2024
ER -