Abstract
Background: Depression and anxiety are common public health problems. Citalopram is the first line of treatment for depression among SSRIs with high potency and selectivity for serotonin uptake. Pregnancy appears to increase the risk of anxiety by 10-30% of pregnant women. Women previously known with depressive disorder have an increased risk of depression in connection with pregnancy. The liver is a primary target of adverse drug reactions because it is the predominant site for the biotransformation and metabolism of the drugs. Aim of the study: The aim of the study was to evaluate the effect of administration of citalopram on the liver of the pregnant albino rats and the liver of their offspring.
Material and Methods: Forty pregnant albino rats were chosen for this study. They were divided into two equal groups, each group contained twenty pregnant albino rats. Each group was subdivided into two equal subgroups and each subgroup contained ten pregnant albino rats: Group I (control group): Each pregnant albino rat was already given by a gastric gavage 0.18ml distilled water daily one week before pregnancy. This group was divided equally into 2 sub-groups: Subgroup IA: Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water daily during pregnancy. Subgroup IB: Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water daily during pregnancy and continued daily for 2 weeks after delivery with the same dose. Group II (Citalopram treated group): Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water containing 0.36mg citalopram daily one week before pregnancy. This group was divided equally into 2 sub-groups: Subgroup IIA: Each pregnant albino rat also was given by a gastric gavage 0.18ml distilled water containing 0.3 6mg citalopram daily during pregnancy. Subgroup IIB: Each pregnant albino rat also was given by a gastric gavage 0.18ml distilled water containing 0.36mg citalopram daily during pregnancy and continued 2 weeks after delivery. At the end of the experimental period, the albino rat mothers and their offspring were collected on the 1st day (subgroups IA and IIA) and fifteenth days after delivery (subgroups IB and IIB). Biochemical study was done for all albino rat mothers before liver dissection by taken blood samples to measure the levels of Aspartate Amino Transferase (AST), Alanine Aminotransferase (ALT) and Gamma Glutamyl Transpeptidase (GGT) in the serum followed by statistical analysis of the data using unpaired student's t-test. Paraffin sections for albino rat mothers and their offspring were prepared to be stained with H & E, Masson's trichrome and Gordon and sweet's stains for light microscopic study. Specimens of the liver were also prepared for electron micro-scopic study. The semithin sections were cut and stained with toluidine blue and examined by light microscope. The ultrathin sections were cut and examined using a transmission electron microscope.
Results: Administration of citalopram led to a significant elevation in the liver enzymes of the albino rat mothers. Also, citalopram caused cellular degeneration, necrosis, apoptosis, congestion of the hepatic veins and the portal veins in the hepatic tissue of the albino rat mothers and their offspring.
Conclusion: Citalopram caused degenerative changes in the liver of the albino rat mothers and their offspring when it was administered before and during pregnancy and after delivery.