PhD defence R. (Robi) Robiyanto

Utilisation and safety of psychotropics in pregnancy

Choosing the right psychotropic treatment for pregnant women can be challenging. To ensure optimal drug treatment, it is essential to understand prescribing trends and assess the safety risks of psychotropic medications during pregnancy. This thesis investigates the use of psychotropic drugs and its potential impact on maternal and child health, while also exploring the ability to detect safety signals related to drug-drug interactions.In the past twenty years, the use of psychotropic medications, particularly atypical antipsychotics and SSRIs, has increased among pregnant women in the Netherlands. Those who continue antidepressant treatment during pregnancy typically maintain the type of medication and dosage they used before pregnancy.

In the IADB.nl database, we investigated two potential adverse drug reactions associated with psychotropic use during pregnancy. The first study found that SSRI use was not linked to an increased risk of ADHD in offspring. The second study showed that selecting antidepressants with low or non-antagonistic effects on histamine H1 and serotonin 5-HT2C receptors may help reduce the risk of gestational diabetes. Finally, we explored the feasibility of using spontaneous reporting systems to detect safety signals of drug-drug interactions in pregnant populations, demonstrating that thorough analysis of case report details is essential in this process.

The studies in this thesis show the effective use of multiple data sources to study the use of psychotropic medications among pregnant women and provide valuable insights for the treatment of psychiatric conditions during pregnancy.