The safety of antidepressant drugs during pregnancy

@article{Klln2007TheSO,
  title={The safety of antidepressant drugs during pregnancy},
  author={Bengt K{\"a}ll{\'e}n},
  journal={Expert Opinion on Drug Safety},
  year={2007},
  volume={6},
  pages={357 - 370}
}
  • B. Källén
  • Published 1 July 2007
  • Medicine, Psychology
  • Expert Opinion on Drug Safety
This article discusses known or suspected effects of maternal use of antidepressants during pregnancy on pregnancy outcome. It is unlikely that any marked teratogenic effect occurs with the possible exception of an increased risk for cardiovascular defects after maternal use of clomipramine or paroxetine. An increased risk for preterm birth is seen. Transient neonatal symptoms are common after the use of antidepressants in late pregnancy. Few firm data are available on the possible impact on… 
Maternal Use of Antidepressants and Infant Congenital Malformations
  • B. Källén
  • Medicine, Psychology
    Maternal Drug Use and Infant Congenital Malformations
  • 2019
TLDR
If possible the two most suspected drugs (clomipramine and paroxetine) should be avoided but if exposure has already occurred, the risk is only moderately high and the involved cardiac defects are usually not very serious.
Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data
TLDR
Women using antidepressants during pregnancy and their newborns have increased pathology, but it is not clear how much of this is due to drug use or underlying pathology.
Managing unipolar depression in pregnancy
TLDR
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.
Current models for studying the safety of drugs in pregnancy
TLDR
The safety of different classes of antidepressants are evaluated and no convincing evidence of an increased risk for any adverse outcomes in an appreciable fashion is found.
Antidepressant use in pregnancy
TLDR
The safety of different classes of antidepressants are evaluated and no convincing evidence of an increased risk for any adverse outcomes in an appreciable fashion is found.
Maternal Use of Antipsychotics in Early Pregnancy and Delivery Outcome
TLDR
There was a statistically significant increase in the risk for a congenital malformation-after exclusion of some common and minor conditions, and there seems to be little drug specificity, and it is possible that underlying pathology or unidentified confounding explains the excess risk.
Fetal exposure to neurotropic drugs : neonatal effects and long-term outcome
TLDR
How neurotropic drugs and/or maternal chronic illness during pregnancy may influence the health of the child, both in the neonatal period and long-term outcome, with emphasis on neurodevelopment is described.
Antidepressant Use During Pregnancy and Asthma in the Offspring
TLDR
Antidepressant use during pregnancy generally did not increase the risk of asthma, and only use of older antidepressants was associated with an increasedrisk of asthma.
Maternal use of selective serotonin re‐uptake inhibitors and persistent pulmonary hypertension of the newborn
TLDR
The mechanism behind the association between SSRI and PPHN is unclear but an increased risk for respiratory problems after maternal use of SSRI is well known, and P PHN could be a rare part of this association.
...
...

References

SHOWING 1-10 OF 102 REFERENCES
The Use of Selective Serotonin Reuptake Inhibitors During Pregnancy and Breast-feeding: A Review and Clinical Aspects
TLDR
In the treatment of mood and anxiety disorders during pregnancy, the serotonin reuptake inhibitors are often preferred over tricyclic antidepressants because of their relatively few adverse effects and safety in overdose.
Maternal use of selective serotonin re-uptake inhibitors in early pregnancy and infant congenital malformations.
TLDR
Use of SSRIs in early pregnancy does not seem to be a major risk factor for infant malformations, and the association between paroxetine use and infant cardiovascular defects may be a result of multiple testing, but is supported by other studies.
Birth outcomes after prenatal exposure to antidepressant medication.
TLDR
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.
Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study.
TLDR
The new SSRIs, fluvoxamine, paroxetine, and sertraline, do not appear to increase the teratogenic risk when used in their recommended doses.
Perinatal outcome following third trimester exposure to paroxetine.
TLDR
When used near term, paroxetine is associated with a high rate of neonatal complications, possibly caused by its common discontinuation syndrome.
The impact of depression and fluoxetine treatment on obstetrical outcome
TLDR
This study prospectively followed women over the course of pregnancy to assess the impact of depression and/or antidepressant treatment on obstetrical outcome and did not demonstrate an adverse effect of fluoxetine exposure per se.
Maternal drug use in early pregnancy and infant cardiovascular defect.
...
...