Paroxetine Use During Pregnancy: Is it Safe?

  title={Paroxetine Use During Pregnancy: Is it Safe?},
  author={Genine Thormahlen},
  journal={Annals of Pharmacotherapy},
  pages={1834 - 1837}
Objective: To evaluate the literature assessing the neonatal risks of antepartum paroxetine use. Data Sources: MEDLINE (1966–August 2006) and International Pharmaceutical Abstracts (1970–August 2006) searches were performed. Key search terms included paroxetine, SSRI, pregnancy, malformations, neonate, and fetus. Data Synthesis: Selective serotonin-reuptake inhibitors (SSRIs) are associated with neonatal withdrawal symptoms such as respiratory distress, irritability, lethargy, and tremors. In a… 
Psychotropics in pregnancy: safety and other considerations.
Prenatal Depression and Selective Serotonin Reuptake Inhibitors
  • T. Field
  • Psychology
    The International journal of neuroscience
  • 2010
A review of the literature suggests mixed findings on the effects of prenatal antidepressants, with research on the selective serotonin reuptake inhibitors suggesting that late pregnancy exposure may have worse effects than first and second trimester exposure, leading to the neonatal abstinence syndrome.
The Risks Associated With Maternal Antidepressant Use During the Prenatal and Postnatal Stages of Development
  • J. Stolzer
  • Medicine
    Ethical Human Psychology and Psychiatry
  • 2010
The goal of this article is to offer a scientifically sound alternative to the current medical model’s definition and treatment of maternal depression and to explore the historical, neurological, hormonal, familial, political, economical, and cultural correlates that have been associated with maternal depression in the United States.
Risks of using SSRI / SNRI antidepressants during pregnancy and lactation
Treatment of depression during pregnancy and breastfeeding is a controversial issue, as antidepressants can negatively affect the developing fetus and untreated depression can adversely affect maternal health and increase the risk of preeclampsia and eclamping.
Neonatal Adaptation Issues After Maternal Exposure to Prescription Drugs: Withdrawal Syndromes and Residual Pharmacological Effects
This narrative review is aimed at the description of drugs and drug classes for which licit maternal use in the predelivery period has been associated with neonatal non-teratogenic disorders, mainly for substances used illicitly for recreational purposes.
Review: Problems associated with long-term treatment with selective serotonin reuptake inhibitors
Although the selective serotonin reuptake inhibitors (SSRIs), which are now widely used as a first-line treatment for depression and many other psychiatric conditions, are generally well tolerated,
Neuroendocrine and behavioral consequences of untreated and treated depression in pregnancy and lactation.
The authors stress the need to evaluate the relative safety of SNRIs/SNRIs by means of relevant experimental models to assess if these drugs can be assigned to treat pregnant and lactating depressive women.
Effect of Selected Antidepressants on Placental Homeostasis of Serotonin: Maternal and Fetal Perspectives
It is suggested that antidepressants have the potential to affect serotonin levels in the placenta or fetus when administered at therapeutic doses, and the effect of antidepressants on serotonin homeostasis in rat Placenta was sex dependent.
Neonatal withdrawal syndrome following in utero exposure to paroxetine, clonazepam and olanzapine
A full-term infant with failed respiratory effort and decerebrate posturing following in utero exposure to paroxetine was described, which resolved by the second day of life.
Effect of maternal mental illness on pregnancy outcomes
What is known about the prevalence of mental illness during pregnancy as well as how such disorders may influence pregnancy outcomes is reviewed, with an emphasis on the role of the obstetrical provider.


Neonatal symptoms following maternal paroxetine treatment: Serotonin toxicity or paroxetine discontinuation syndrome?
It is recommended that all neonates exposed to antidepressants during the last trimester should be followed-up closely for adverse symptoms commencing in the first 10 days after birth, though an important differential diagnosis is a paroxetine discontinuation (withdrawal) syndrome.
Treatment with Selective Serotonin Reuptake Inhibitors in the Third Trimester of Pregnancy
The interpretation of the current literature suggests that the risk of not receiving adequate antidepressant treatment in the third trimester when indicated outweighs the risks of adverse events in the infant, and adequate pharmacological treatment should not be withheld from a depressed pregnant woman in late pregnancy.
Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure.
While transient neonatal symptoms were found in infants after single-agent prenatal exposure to SSRIs, the addition of clonazepam appeared to alter paroxetine metabolism, leading to increased drug levels and risk for transient Neonatal symptoms.
Antidepressant Use during Pregnancy and the Rates of Spontaneous Abortions: A Meta-Analysis
Maternal exposure to antidepressants may be associated with increased risk for SA; however, depression itself cannot be ruled out.
Paroxetine withdrawal in a neonate with historical and laboratory confirmation
We describe a term neonate born to a mother who stopped paroxetine intake 48 h prior to birth, who had features suggestive of paroxetine withdrawal and supported by paroxetine not being detected in
Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications.
Available evidence indicates that in utero exposure to SRIs during the last trimester through delivery may result in a self-limited neonatal behavioral syndrome that can be managed with supportive care.
Prevalence of Depression During Pregnancy: Systematic Review
Rates of depression, especially during the second and third trimesters of pregnancy, are substantial, and clinical and economic studies to estimate maternal and fetal consequences are needed.
Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors
Five cases of neonatal withdrawal syndrome after third trimester in utero SSRI exposure are reported, with Symptoms were irritability, constant crying, shivering, increased tonus, eating and sleeping difficulties and convulsions.
Withdrawal reactions of a premature neonate after maternal use of paroxetine
The pregnancy and delivery had been uneventful, with no apparent reason for prematurity, and there were no problems in the first few days and the girl drank quickly and she drank quickly (bottle feeding).
Antepartum Depressive Symptomatology Is Associated With Adverse Obstetric and Neonatal Outcomes
The findings add to this body of evidence, which together suggest an adverse impact of antepartum psychological morbidity on maternal and neonatal well-being, and suggest that growth retardation, premature delivery, and epidural analgesia may be associated with adverse obstetric and Neonatal outcomes.