{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:01:58Z","timestamp":1789948918338,"version":"4.0.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004836","name":"Danmarks Frie Forskningsfond","doi-asserted-by":"publisher","award":["3166\u201000022B"],"award-info":[{"award-number":["3166\u201000022B"]}],"id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postpartum psychotropic medication use is heterogeneous, comprising continuation of prenatal treatment, initiation, transient use and complex polypharmacy. Prior studies have reported the prevalence of potential infant exposure to psychotropics via breast milk, but characterisations better capturing the heterogeneity of this exposure are lacking. We aimed to identify distinct postpartum psychotropic treatment patterns using hierarchical clustering accounting for medication type, timing and polypharmacy, and to describe breastfeeding characteristics across these patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Population\u2010based cohort study of mothers using psychotropics during the first postpartum year using linked Danish national registers 2012\u20132023. From a source population of 659\u2009866 mother\u2013child pairs with live\u2010born singleton births, 38\u2009528 mothers redeemed at least one psychotropic prescription during the first postpartum year and comprised the study cohort. Weekly psychotropic use was defined by redeemed prescriptions using prescribed daily dose assumptions. Hierarchical agglomerative clustering (\n                      <jats:italic>tame<\/jats:italic>\n                      R package) identified distinct treatment patterns based on medication type, timing and polypharmacy. The number of patterns was determined from interpretability, size and examination of the hierarchical dendrogram. Exclusive breastfeeding prevalence and duration were described across patterns among pairs with recorded breastfeeding habits (64%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight distinct treatment patterns were identified, differing in psychotropic type, timing and polypharmacy. Three SSRI\u2010dominated patterns (24\u2009225 pairs, 63%) ranged from increasing SSRI use (Pattern I;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911\u2009731), through continued SSRI use with high persistence (Pattern II;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097167), to mixed use involving SSRIs and other psychotropics (Pattern III;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095327; 48% using three or more medications). The remaining five patterns (14\u2009303 pairs, 37%) were dominated by benzodiazepine\u2010related drugs, other antidepressants, centrally acting sympathomimetics, antipsychotics or complex mixed use, ranging from late\u2010initiated benzodiazepine\u2010related use (Pattern IV; median initiation Week 27; persistence 13%) to early\u2010initiated, highly persistent mixed use (Pattern VIII; median initiation Week 4; persistence 94%). Exclusive breastfeeding duration varied across patterns, with long\u2010duration exclusive breastfeeding (181\u2009days or more) highest in the SSRI\u2010continued pattern (Pattern II, 10.6%) and lowest in the mixed\u2010use\u2010increasing and antipsychotics\u2010sporadic patterns (Patterns III and VII, 5.1% and 5.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Postpartum psychotropic treatment patterns are clinically heterogeneous and exclusive breastfeeding practices differ across treatment patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70470","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:08:31Z","timestamp":1788142111000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postpartum Psychotropic Treatment Patterns and Breastfeeding: Nationwide Clustering Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7509-9127","authenticated-orcid":false,"given":"Anders","family":"Hviid","sequence":"first","affiliation":[{"name":"Department of Data Science and AI in Health Statens Serum Institut  Copenhagen Denmark"},{"name":"PandemiX Center, Department of Science and Environment Roskilde University  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Laksafoss","sequence":"additional","affiliation":[{"name":"Department of Data Science and AI in Health Statens Serum Institut  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"O'Regan","sequence":"additional","affiliation":[{"name":"Department of Data Science and AI in Health Statens Serum Institut  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-4348","authenticated-orcid":false,"given":"Poul","family":"Videbech","sequence":"additional","affiliation":[{"name":"Center for Neuropsychiatric Depression Research Mental Health Center Glostrup, Amager\u2010Hvidovre Hospital  Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid Bech","family":"Svalgaard","sequence":"additional","affiliation":[{"name":"Department of Data Science and AI in Health Statens Serum Institut  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398\u2010021\u201001663\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/8403222"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.12.014"},{"key":"e_1_2_12_5_1","unstructured":"World Health Organization \u201cExclusive Breastfeeding for Optimal Growth Development and Health of Infants \u201d(2026) 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