Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review

  title={Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review},
  author={Cesario Bellantuono and Giovanni Migliarese and Salvatore Gentile},
  journal={Human Psychopharmacology: Clinical and Experimental},
To review studies conducted to establish the risk of major congenital malformations in women exposed to serotonin reuptake inhibitors (SRIs) during the first trimester of pregnancy. 

Selective serotonin reuptake inhibitor exposure during early pregnancy and the risk of birth defects

  • S. Gentile
  • Medicine, Biology
    Acta psychiatrica Scandinavica
  • 2011
It is necessary to select serotonin reuptake inhibitor exposure during early pregnancy to reduce the risk of birth defects in women with high-risk pregnancies, according to Gentile S.

Early pregnancy exposure to selective serotonin reuptake inhibitors, risks of major structural malformations, and hypothesized teratogenic mechanisms

  • S. Gentile
  • Medicine, Psychology
    Expert opinion on drug metabolism & toxicology
  • 2015
A cautious approach of using SSRI during pregnancy only in the case of major depressive episodes should be applied, and this risk should be balanced against the risks associated with the worsening of depressive symptoms.

Prenatal exposure to serotonin reuptake inhibitors: a case report

Two premature twins were born to a woman who had used paroxetine during pregnancy for an anxiety-depression disorder, where they showed prolonged RDS, cardiovascular malformations, and facial dysmorphisms, which partially disappeared during the following weeks, although alterations of tone persisted even at discharge.

Is the exposure to antidepressant drugs in early pregnancy a risk factor for spontaneous abortion? A review of available evidences

SUMMARY Aim – To review studies conducted to establish the risk of spontaneous abortion (SA) in women exposed to anti-depressant drugs (ADs) during early pregnancy. Methods – By using different

Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy

Pregnant women who require treatment for depression and their physicians often face a difficult choice regarding the use of SSRIs, as the possibility of such functional abnormalities is an additional concern.

Serotonin Reuptake Inhibitors in Pregnancy: Can Genes Help Us in Predicting Neonatal Adverse Outcome?

This review describes possible relationship between SSRIs pharmacogenetics and different neonatal outcomes and summarizes the current pharmacogenetic inquiries in relation to maternal-foetal environment.

Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence

In women suffering from major depression and responding to a pharmacological treatment, introduction or continuation of an SSRI should be encouraged in order to prevent maternal complications and to preserve maternal–infant bonding.

More questions than answers! Clinical dilemmas in psychopharmacology in pregnancy and lactation

Clinical questions are presented considering the available literature on safety of psychotropics in pregnancy and lactation and the application of these recommendations into clinical practice appears to be complex.

Critical determinants of the risk-benefit assessment of antidepressants in pregnancy : pharmacokinetic, safety and economic considerations.

Factors that should be included in these analyses include the pharmacokinetics and pharmacodynamics of antidepressants in pregnancy and their maternal and fetal safety.

Perinatal depression--assessment and management.

  • A. Buist
  • Medicine, Psychology
    Australian family physician
  • 2006
An approach to assessment and management of perinatal depression is outlined, mindful of risks and benefits to both mother and infant, is the best current approach to improving outcomes.



Newer antidepressants in pregnancy and rates of major malformations: a meta‐analysis of prospective comparative studies

A large number of women of childbearing age suffer from depression and relatively little is known about the safety of antidepressant use during pregnancy, so it is necessary to select patients suitable for antidepressant use.

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.

Risks Associated With Selective Serotonin Reuptake Inhibitors in Pregnancy

Use of SSRIs during pregnancy is not independently associated with increased risk of adverse perinatal outcome other than need for treatment in neonatal special or intensive care unit.

Selective serotonin reuptake inhibitors and adverse pregnancy outcomes.

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.

Maternal Use of Selective Serotonin Reuptake Inhibitors and Risk of Congenital Malformations

An increased risk of congenital malformations after exposure to SSRIs in early pregnancy is found, although it is unclear whether the effects were causal or due to factors related to the underlying disease.

Safety of selective serotonin reuptake inhibitors in pregnancy.

The review tries to clarify the blurred aspects of the use of SSRI during pregnancy and to give sensible and up-to-dated guidelines for the treatment of psychiatric disorders with SSRIs during pregnancy.

Citalopram in pregnancy and lactation

The aim of this study was to examine the efficacy and safety of citalopram in relation to concentrations of cITALopram and its metabolites during pregnancy and lactation.

Safety of fluoxetine during the first trimester of pregnancy: a meta-analytical review of epidemiological studies

The use of fluoxetine during the first trimester of pregnancy is not associated with measurable teratogenic effects in human and power analysis indicates that 26 controlled studies of similar size, would be required, to reverse this finding.