Katherine Leah Wisner Feinberg School of Medicine, Feinberg Clinical, Psychiatry and Behavioral Sciences

Katherine Leah Wisner

    Feinberg School of Medicine
    Feinberg Clinical
    Psychiatry and Behavioral Sciences
    Current Appointments:

    Professor; Psychiatry and Behavioral Sciences; Feinberg School of Medicine

    Professor; Obstetrics and Gynecology; Feinberg School of Medicine

    Norman and Helen Asher Professor of Psychiatry and Behavioral Sciences; Faculty Affairs; Feinberg School of Medicine

Research Interest Keywords

Depression, Pharmacology, Psychiatry, Women's Health, Women's Health; Women's Reproductive Health

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Returning to tricyclic antidepressants for depression during childbearing: Clinical and dosing challenges

Lauren M. Osborne; Catherine A. Birndorf; Lauren E. Szkodny; Katherine L. Wisner

(Profiled Author: Katherine Leah Wisner)

Archives of Women's Mental Health. 2014;17(3):239-246.


Managing depression and anxiety during pregnancy and the postpartum period is challenging. Both pharmacological treatment and the lack thereof can pose threats to a fetus. SSRIs are the drugs of choice for use during pregnancy, but there is considerable evidence for the safety and efficacy of older antidepressants during pregnancy as well. This study highlights a single case of the use of the tricyclic nortriptyline during pregnancy and postpartum. The subject involved had an unexpectedly high ratio of serum level to drug dose during the postpartum period. We monitored the subject for a significantly greater portion of the postpartum period than has been done in previous studies, and explored medical and lifestyle changes that could account for the level-to-dose ratios we observed. Differences in smoking patterns, coupled with the patient's status as a genetic poor metabolizer, were the most likely explanations. © 2014 Springer-Verlag.

PMID: 24668283     PMCID: PMC4116330    

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