Herbal safety in pregnancy: Treatment options for nonpsychotic mental diseases

Pregnancy is a critical period for medical care, as the well-being of both the woman and the embryo/foetus must be considered. This is particularly relevant in managing mental disorders: numerous pregnant women use synthetic central nervous system (CNS)-active drugs, and both untreated mental diseases and treatments featuring CNS-active drugs may negatively affect pregnancy course and outcome. Empirical knowledge and clinical evidence show that some herbal preparations (phytopharmaceuticals) possess sedative, antidepressant, or anxiolytic properties. Since most patients and many health professionals consider these preparations safe, their consumption during pregnancy is high; nonetheless, very few experimental or clinical studies of phytopharmaceuticals have been conducted to assess these safety aspects during pregnancy. The assessment of safety issues with phytopharmaceuticals is highly challenging, as the active ingredients are herbal extracts - that is, complex multicomponent mixtures of compounds. Many of these compounds likely undergo metabolization by the intestinal microbiota upon oral administration, and metabolization in the liver upon reaching systemic blood circulation. The question arises as to whether some of these compounds, whether unmetabolized or metabolized, might be toxic and reach the embryo/foetus via the placenta. The current study looks to fill a critical knowledge gap regarding the safety of commonly used herbal medications in treating nonpsychotic mental diseases during pregnancy. This study’s general approach and methodology can be generically applied to future pharmacological and safety studies on phytomedicines.

Collaboration between the University Hospital of Zürich (Obstetrics Division, Research Group Perinatal Pharmacology and Biochemistry, P. Simoes-Wüst) and the University of Basel (Division of Pharmaceutical Biology, M. Hamburger and O. Potterat) facilitates the use of a wide palette of experimental models. We have established and validated a platform technology, including protocols by which to analyse the cytotoxicity and genotoxicity of immunocompetent T and NK cells as well as the activity and functional parameters of human primary immunocompetent T and NK cells. This platform is ideal for fulfilling the objectives of the current project and assessing these important safety aspects.