December 5, 2022

MDG – 500

Trailblazing Healthy Quality

Greater Use of Cannabis and Benzodiazepines, But Not Antidepressants

4 min read


When we have witnessed decreasing costs of alcohol and tobacco use all through being pregnant over the past several decades, the use of cannabis in the course of pregnancy is on the increase.  Qualitative scientific studies reveal that expecting women report using cannabis to manage a variety of psychological signs or symptoms, including sleeplessness, nervousness, and melancholy.  Experiments carried out prior to the legalization of health care and recreational cannabis (in some states) have shown that pregnant females with active depressive symptoms and/or anxiousness are additional probable to use substances.  A cross-sectional analyze from Californaia examines the associations between prenatal cannabis use and the use of prescribed psychotropic drugs between pregnant people with depression or anxiousness in a large, built-in healthcare process (concerning 2012 and 2018).

In this study, info from the Kaiser Permanente Northern California (KPNC) health care process was made use of to detect pregnant people today with a depressive or stress condition described by Intercontinental Classification of Disorders codes.  Sufferers were screened for prenatal material use applying a self-described questionnaire and urine toxicology tests as aspect of plan prenatal treatment.  In addition, any dispensation of antidepressants, benzodiazepines, and/or sedative-hypnotics during pregnancy was assessed.  Severity of depressive signs was measured utilizing the Affected person Health Questionnaire (PHQ-9).

This cross-sectional examine examined the associations between prenatal hashish use and the use of recommended psychotropic treatment use among the pregnant individuals with a analysis of an anxiety condition or despair.  The examination integrated 35,047 pregnancies (32,278 folks 17.6% under 25 several years of age, 48.1% non-Hispanic White).  In this populace, 12.8% of the women screened favourable for hashish use.

After modifying for affected individual age, profits, race/ethnicity, and depression symptom severity, the researchers located that  12.6% of the people who screened positive for prenatal hashish use were far more probable to display beneficial for prenatal benzodiazepine use (adjusted odds ratios [aOR] = 1.40) and for sedative-hypnotic use (aOR = 1.28).  However, girls were not a lot more probable to use antidepressants (aOR = 1.05).  The odds of prenatal benzodiazepine and sedative-hypnotic use in combination with prenatal cannabis use ended up better among the pregnancies with intense melancholy symptom severity (31.8% of the sample).  

Other Conclusions of Issue

Although this research focuses principally on the association in between hashish use and the use of approved psychotropic medicines, 1 of the most concerning results is that ladies with a diagnosis of melancholy and/or nervousness disorder (irrespective of hashish use) ended up not extra probably to use an antidepressants but were additional possible to use benzodiazepines and/or sedative-hypnotic medications. Even when they seemed only at gals with better melancholy severity (31.8% of the females had a PHQ-9 of 10 or better) , females had been extra possible to use benzodiazepines (aOR 1.37) and sedative-hypnotic drugs (aOR 1.45) but not antidepressants.

Offered this type of cross-sectional study, it is not feasible to thoroughly have an understanding of how girls with depression and/or stress and anxiety make decisions with regards to treatment use through pregnancy however, the recent analyze raises some critical issues.  

Even though screening for perinatal temper and anxiety diseases was routinely finished through pregnancy, did these women receive proper counseling pertaining to the use of drugs all through being pregnant and the dangers involved with untreated psychiatric disease in the mom? Ended up they ready to access psychological wellness solutions? 

Are gals with depression and/or anxiety deciding on to stay away from antidepressants and to use in its place benzodiazepines and sedative-hypnotics (or hashish) for the reason that these drugs can be applied as necessary rather of on a everyday foundation?  

If prices of hashish use is higher amongst frustrated gals, does this suggest that gals may well imagine that cannabis is safer than antidepressants? Is it less difficult to get hashish than antidepressants? Does hashish lead to or worsen despair in this population? Is hashish use a symptom of depression (akin to lousy self-treatment)?

Potential research are required to improved understand the choice-making process nonetheless, this review raises quite a few issues.  In this subset of women of all ages with melancholy and/or nervousness, particularly those with more critical symptoms, what we have is a substantial proportion of pregnancies with various exposures which have been associated with worse results for both equally the mom and her boy or girl.  About a 3rd of this populace reported extreme depressive signs (Exposure #1).  This team of women of all ages were being far more most likely to use psychotropic prescription drugs — benzodiazepines and/or sedative-hypnotics — that did not final result in resolution of depressive indicators or stress (Publicity #2), whilst it is probable that these medicines had some impression on the severity of signs or symptoms.  Gals with severe depressive signs or symptoms had been extra probable to use hashish (Exposure #3).  And lastly, despair through pregnancy is a robust predictor of postpartum depression (Exposure #4). 

Ruta Nonacs, MD PhD

Hirschtritt ME, Avalos LA, Sarovar V, Ridout KK, Goler NC, Ansley DR, Satre DD, Young-Wolff KC.  Association Between Prenatal Cannabis Use and Psychotropic Treatment Use in Pregnant Sufferers With Melancholy and Nervousness.  J Addict Med. 2022 Jan 11. 

 

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