Zuklopentiksol dekanoat u trudnoći: uspešan ishod dve uzastopne trudnoće iste majke

  • Vladimir Janjić Psychiatry Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Dragan R. Milovanović Department of Pharmacology and Toxicology, Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Dejana Ružić Zečević Department of Pharmacology and Toxicology, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Dragan Lončar Gynecology and Obstetrics Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Olivera Laban Gynecology and Obstetrics Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Marija Stepanović Department of Pharmacology and Toxicology, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Mirjana Varjačić Gynecology and Obstetrics Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Slobodan Obradović Pediatric Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Slavica Djukić Dejanović Psychiatry Clinic, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Slobodan Janković Department of Pharmacology and Toxicology, Clinical Centre ”Kragujevac“ and Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
DOI: https://doi.org/10.2298/1502
Ključne reči: psychotic disorders||, ||psihotički poremećaji, pregnancy||, ||trudnoća, risk factors||, ||faktori rizika, psychotropic drugs||, ||psihotropni lekovi, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. S obzirom na to da ne postoje ili su podaci o ishodu trudnoće u slučaju njihovog korišćenja oskudni, skoro svi antipsihotici su svrstani u kategoriju sa srednjim rizikom u slučaju trudnoće. Prikazano je korišćenje zuklopentiksol-dekanoata u dve uzastopne trudnoće iste žene, što do sada nije bilo objavljeno u dostupnoj recenziranoj literaturi. Prikaz bolesnika. Žena srednjih godina koja je bolovala od šizofrenije primala je injekciju zuklopentiksol-dekanoata tokom svoje dve uzastopne trudnoće. Oko četiri i po meseca pre dijagnoze prve trudnoće (~3,5 godine posle početka psihoze) u terapijski protokol je uveden zuklopentiksol-dekanoat (400 mg svake druge nedelje, i.m. injekcija) zbog prethodnog neredovnog uzimanja haloperidola i risperidona. Postignuto je značajno kliničko poboljšanje, pa je doza leka tokom trudnoća snižena na 200 mg jednom mesečno i održavana do sada. U obe trudnoće rođena je po jedna zdrava devojčica i normalno su se razvijale do uzrasta od šest meseci, odnosno 3,5 godine. Tokom trudnoća i posle rođenja dece psihijatrijski status i socijalno funkcionisanje majke bili su značajno poboljšani i do danas stabilni. Pomno praćenje zdravstvenog stanja majke, multidisciplinarni pristup njenom lečenju i praćenju trudnoća kao i potpuna komplijansa sa propisanim medikamentnim protokolom najverovatnije su bili presudni za terapijski uspeh. Zaključak. Povoljni ishodi prikazane bolesnice ukazuju da je kod trudnica obolelih od psihoze zuklopentiksol-dekanoat racionalna terapijska opcija, kada očekivana korist prevazilazi potencijalne rizik, ali su za definitivan dokaz o njegovoj bezbednosti potrebne kontrolisane studije sa velikim uzorkom.

Reference

Howard LM. Fertility and pregnancy in women with psychotic disorders. Eur J Obstet Gynecol Reprod Biol 2005; 119(1): 3−10.

Seeman MV. Gender differences in the prescribing of antipsy-chotic drugs. Am J Psychiatry 2004; 161(8): 1324−33.

Newport DJ, Calamaras MR, DeVane CL, Donovan J, Beach AJ, Winn S, et al. Atypical antipsychotic administration during late pregnancy: placental passage and obstetrical outcomes. Am J Psychiatry 2007; 164(8): 1214−20.

Trixler M, Gáti A, Fekete S, Tényi T. Use of antipsychotics in the management of schizophrenia during pregnancy. Drugs 2005; 65(9): 1193−206.

Kennedy D. Antipsychotic drugs in pregnancy and breastfeed-ing. Aust Prescr 2007; 30(6): 162−3.

Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lacta-tion. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

Sweetman SC, Blake PS, McGlashan JM, Parsons AV. Anxiolytic Sedatives Hypnotics and Antipsychotics. In: Sweetman SC, edi-tor. Martindale, the complete drug reference. 33rd ed. London: Pharmaceutical Press; 2002. p. 714.

Clopixol Depot. Auckland: Drugsite Trust; 2011. Available from: http://www.drugs.com/international/clopixol-depot.html.

Antipsychotic depot injections: British National Formulary. London: BMJ Gropup and RPS Publishing; 2009. p. 202−4.

Leucht C, Heres S, Kane JM, Kissling W, Davis JM, Leucht S. Oral versus depot antipsychotic drugs for schizophrenia-a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res 2011; 127(1−3): 83−92.

Haloperidol Decanoate Injection: Current Drug Shortages. Sil-ver Spring, Food and Drug Administration, 2011. Available from: http:// www.fda.gov/ Drugs/ DrugSafety/ DrugShortages/ ucm050792.htm. [cited 2011 October 5].

Kim SW, Kim KM, Kim JM, Shin IS, Shin HY, Yang SJ, et al. Use of long-acting injectable risperidone before and throughout pregnancy in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31(2): 543−5.

Handal M, Matheson I, Bechensteen AG, Lindemann R. Antipsy-chotic agents and pregnant women. A case report. Tidsskr Nor Laegeforen 1995; 115(20): 2539−40. (Norwegian)

American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108(3): 776−89.

Galbally M, Snellen M, Walker S, Permezel M. Management of an-tipsychotic and mood stabilizer medication in pregnancy: rec-ommendations for antenatal care. Aust N Z J Psychiatry 2010; 44(2): 99−108.

McCauley-Elsom K, Gurvich C, Elsom SJ, Kulkarni J. Antipsychot-ics in pregnancy. J Psychiatr Ment Health Nurs 2010; 17(2): 97−104.

Objavljeno
2017/01/19
Broj časopisa
Vol. 70 Br. 5 (2013)
Rubrika
Prikaz bolesnika