The Emerging Importance of Transporter Proteins in the Psychopharmacological Treatment of the Pregnant Patient

Jun-Sheng Wang Department of Psychiatry and Behavioral Sciences, and Laboratory of Drug Disposition and Pharmacogenetics, Medical University of South Carolina, Charleston, South Carolina, USA

D. Jeffrey Newport Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

Zachary N. Stowe Department of Psychiatry and Behavioral Sciences, and Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA

Jennifer L. Donovan Department of Psychiatry and Behavioral Sciences, and Laboratory of Drug Disposition and Pharmacogenetics, Medical University of South Carolina, Charleston, South Carolina, USA

Page B. Pennell Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA

C. Lindsay DeVane Department of Psychiatry and Behavioral Sciences, and Laboratory of Drug Disposition and Pharmacogenetics, Medical University of South Carolina, Charleston, South Carolina, USA

Abstract

P-glycoprotein, breast cancer resistance protein, and multidrug resistance proteins have physiological functions in placental tissue. Several antidepressants, antipsychotics, and anti-epileptic drugs have been found to be substrates of P-glycoprotein and other transporters. The extent that drugs pass through the placental barrier is likely influenced by drug transporters. The rational choice of psychoactive drugs to treat mental illness in women of child-bearing age should incorporate knowledge of both drug disposition as well as expected pharmacologic effects. This review summarizes the current data on drug transporters in the placental passage of medications, with a focus on medications used in clinical psychopharmacology.

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The Emerging Importance of Transporter Proteins in the Psychopharmacological Treatment of the Pregnant Patient

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