Antidepressant Therapy for Improved Blood Vessel Health After Preeclampsia

Role of Antidepressant Therapy to Improve Vascular Function After Preeclampsia

Preeclampsia is a condition in pregnancy where a woman develops high blood pressure and other complications. Women who develop preeclampsia are 4 times more likely to have heart disease later in life. They are also more likely to have depression after pregnancy. Why they are more likely to develop these conditions is not known. It may be because their blood vessels were damaged during pregnancy. Changes in blood vessel health can predict heart disease. These changes have been recorded after pregnancy in women who had preeclampsia. These changes have also been recorded in women who have depression. In the previous phase of this award, we found that women who had preeclampsia in pregnancy had changes in blood vessel health after pregnancy. We also found that if these women were taking a medicine to treat depression, their blood vessel health was normal. This could mean that treatment for depression can also increase blood vessel health in women who had preeclampsia. In this project we will study how changes in blood vessel health are related to preeclampsia and depression in women who have had both. We will also study how medicine to treat depression can improve blood vessel health after preeclampsia. We will do this by measuring how blood vessels work in women who have had preeclampsia compared to women who did not, and in women who have depression and women who do not. This will tell us more about why risk for depression and heart disease is higher in women who have had preeclampsia. It will also help us understand if medicine for depression can reduce cardiovascular disease risk after preeclampsia.

Study Overview

• Status: Recruiting
• Conditions: Preeclampsia; Endothelial Function
• Intervention / Treatment: Drug: Paroxetine Hydrochloride; Drug: Ascorbic acid (Vitamin C)

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Early Phase 1

Contacts and Locations

• Study Contact: Name: Anna Reid-Stanhewicz, PHD; Phone Number: 319-467-1732; Email: anna-stanhewicz@uiowa.edu

Study Locations

• United States
  • Iowa
    • Iowa City, Iowa, United States, 52242-3521
      • Recruiting
      • University of Iowa
      • Contact: Anna Stanhewicz; Phone Number: 319-467-1732; Email: anna-stanhewicz@uiowa.edu
      • Contact: Willis Barr; Email: willis-barr@uiowa.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

18-24 years old, 12 weeks - 5 years post pregnancy one of the following:

1. a history of a normal pregnancy with a current diagnosis of depression,
2. a history of a normal pregnancy without a current diagnosis of depression,
3. a history of a preeclamptic pregnancy with a current diagnosis of depression, 4) and history of preeclamptic pregnancy without a current diagnosis of depression.

Exclusion Criteria:

history of cardiovascular, metabolic, and/or skin diseases current or history of tobacco/nicotine/ e-cigarette use history of gestational diabetes current antihypertensive or cholesterol-lowering medication currently pregnant allergy to materials used during the experiment (e.g. latex), known allergy to study drugs currently using SSRI medications

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Cutaneous Vascular Response to Local Heat; All women will complete the same protocol, regardless of pregnancy history and depression status. Four intradermal microdialysis fibers will be placed in the ventral forearm for the local delivery of: (1) lactated Ringer's (control), (2) paroxetine HCl, (3) ascorbic acid, or (4) paroxetine HCl + ascorbic acid. Skin blood flow will be measured with laser-Doppler flowmetry directly over each microdialysis fiber during a standard local heating protocol to 42 degrees Celsius. Once a stable plateau in blood flow has been reached, each site is perfused with L-NAME to inhibit nitric oxide synthase. Following a post-L-NAME plateau, maximal dilation is induced by perfusing sodium nitroprusside and increasing local temperature to 43 degrees Celsius.

Drug: Paroxetine Hydrochloride; Localized delivery of paroxetine HCl to the cutaneous microvasculature via intradermal microdialysis.; Drug: Ascorbic acid (Vitamin C); Localized delivery of ascorbic acid to the cutaneous microvasculature via intradermal microdialysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Microvascular endothelium-dependent dilation response measured by laser-Doppler flowmetry	Cutaneous vascular conductance responses to local heating over a microdialysis fiber receiving treatments compared to lactated Ringer's solution (control).	at the study visit, an average of 4 hours
Nitric oxide-dependent dilation response measured by laser-Doppler flowmetry	Difference in cutaneous vascular conductance between local heating plateau and post-L-NAME plateau within each treated microdialysis site compared to lactated Ringer's (control).	at the study visit, an average of 4 hours

Collaborators and Investigators

• Sponsor: Anna Stanhewicz, PhD

Study record dates

Study Major Dates

• Study Start (Estimated): August 30, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): June 1, 2027

Study Registration Dates

• First Submitted: July 15, 2026
• First Submitted That Met QC Criteria: July 15, 2026
• First Posted (Actual): July 20, 2026

Study Record Updates

• Last Update Posted (Actual): July 20, 2026
• Last Update Submitted That Met QC Criteria: July 15, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Pregnancy Complications; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Organic Chemicals; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Carbohydrates; Sugar Acids; Acids, Acyclic; Carboxylic Acids; Hydroxy Acids; Piperidines; Ascorbic Acid; Paroxetine
• Other Study ID Numbers: 202605218; 26BCDA1622718 (Other Grant/Funding Number: American Heart Association)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No