Safety of Newer Antidepressants in Pregnancy

  title={Safety of Newer Antidepressants in Pregnancy},
  author={Cynthia M Way},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  • Cynthia M Way
  • Published 1 April 2007
  • Medicine, Psychology
  • Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Pharmacotherapy for depression is often necessary during pregnancy. The information available about use of the newer antidepressants in pregnant women is limited by trial design and lack of long‐term follow‐up of exposed infants. Selective serotonin reuptake inhibitors (SSRIs) are not generally thought to be major teratogens. Some recent studies, however, have suggested that paroxetine may be associated with a small increase in risk of congenital abnormalities, particularly cardiac defects… 
Managing unipolar depression in pregnancy
Clinicians need to keep abreast of changes in the management of depression during pregnancy so that the most up-to-date recommendations may be provided to pregnant women.
Disturbed development of the enteric nervous system after in utero exposure of selective serotonin re-uptake inhibitors and tricyclic antidepressants. Part 2: Testing the hypotheses.
The increased laxative use after second and third trimester exposure to SSRIs might be explained through the inhibitory effect of the serotonin re-uptake transporter (SERT) and because of selectivity for the 5-HT(2B) receptor which affects the ENS.
The Pharmacotherapy of Perinatal Mood Disorders
The recent data on the potential risks of the most commonly prescribed medications for treating mood disorders in pregnant and lactating women are discussed.
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Duloxetine was found to be well tolerated and can be safely administered even in older patients and in those with concomitant illnesses, and no increase in death from suicide and suicidal thoughts and behavior were detected as compared to placebo.
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Depression in childbearing women: when depression complicates pregnancy.
The Relationship between Antidepressant Use and Smoking Cessation in Pregnant Women in Treatment for Substance Abuse
Data support continued study of bupropion in depressed pregnant substance-dependent smokers and trend for greater decrease in smoking for the bupropions vs. citalopram/escitaloprams group and similar to that seen in the no antidepressant group.
Drugs of abuse and human placenta.
Longitudinal trajectories of antidepressant use in pregnancy and the postnatal period
The highest trajectory group of antidepressant use in pregnancy was associated with a modest reduction in birth weight but not with gestational age at delivery, and the highest trajectories during pregnancy were associated with reduced birth weight.


Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study.
The new SSRIs, fluvoxamine, paroxetine, and sertraline, do not appear to increase the teratogenic risk when used in their recommended doses.
Pharmacotherapy of depression in pregnancy.
  • A. PatkarLouai BilalP. Masand
  • Medicine, Psychology
    Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 2004
The safety profiles of commonly used antidepressants are reviewed, clinical decision making based on risk-benefit considerations are discussed and recommendations for pharmacological treatment of depressed women during pregnancy are made.
Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn.
Data support an association between the maternal use of SSRIs in late pregnancy and PPHN in the offspring; these findings should be taken into account in decisions as to whether to continue the use ofSSRIs during pregnancy.
Birth outcomes after prenatal exposure to antidepressant medication.
After prenatal use of selective serotonin reuptake inhibitor antidepressant medications, neonatal complications and congenital anomalies appear to occur within general population rates, however, maternal use of high doses of fluoxetine throughout pregnancy may be associated with a risk for low birth weight.
Selective serotonin reuptake inhibitors and adverse pregnancy outcomes.
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.
Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study.
Exposure to tricyclic antidepressants or fluoxetine throughout gestation does not appear to adversely affect cognition, language development, or the temperament of preschool and early-school children, whereas mothers' depression is associated with less cognitive and language achievement by their children.
Outcomes of prenatal antidepressant exposure.
The authors found no association between tricyclic antidepressant or SSRI exposure and either congenital malformations or developmental delay, and women considering taking SSRIs during pregnancy may balance any higher fetal risk against the risk of persistent or recurrent depression.
Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes.
Mirtazapine does not appear to increase the baseline rate of major malformations in newborns when used by pregnant women, but the higher number of spontaneous abortions in the antidepressant groups confirms the higher rates of spontaneous pregnancies in pregnant women taking antidepressant medications found in previous studies.