Document Detail

Antidepressant use in pregnancy: a critical review focused on risks and controversies.
MedLine Citation:
PMID:  23240634     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Conflicting data have led to controversy regarding antidepressant use during pregnancy. The objectives of this study are to i) review the risks of untreated depression and anxiety, ii) review the literature on risks of exposure to antidepressants during pregnancy, iii) discuss the strengths and weaknesses of the different study designs used to evaluate those risks, and iv) provide clinical recommendations.
METHOD: MEDLINE/PubMed was searched for reports and studies on the risk of first-trimester teratogenicity, postnatal adaptation syndrome (PNAS), and persistent pulmonary hypertension (PPHN) with in utero antidepressant exposure.
RESULTS: While some individual studies suggest associations between some specific major malformations, the findings are inconsistent. Therefore, the absolute risks appear small. PNAS occurs in up to 30% of neonates exposed to antidepressants. In some studies, PPHN has been weakly associated with in utero antidepressant exposure, while in other studies, there has been no association.
CONCLUSION: Exposures of concern include that of untreated maternal illness as well as medication exposure. It is vital to have a careful discussion, tailored to each patient, which incorporates the evidence to date and considers methodological and statistical limitations. Past medication trials, previous success with symptom remission, and women's preference should guide treatment decisions.
N Byatt; K M Deligiannidis; M P Freeman
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-12-14
Journal Detail:
Title:  Acta psychiatrica Scandinavica     Volume:  127     ISSN:  1600-0447     ISO Abbreviation:  Acta Psychiatr Scand     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-10     Completed Date:  2013-06-28     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  0370364     Medline TA:  Acta Psychiatr Scand     Country:  United States    
Other Details:
Languages:  eng     Pagination:  94-114     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
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MeSH Terms
Abnormalities, Drug-Induced / etiology
Antidepressive Agents / adverse effects,  therapeutic use*
Depressive Disorder / complications*,  drug therapy
Infant, Newborn
Paroxetine / adverse effects,  therapeutic use
Persistent Fetal Circulation Syndrome / chemically induced
Pregnancy Complications / drug therapy*,  psychology
Pregnancy Trimester, First / drug effects
Prenatal Exposure Delayed Effects / chemically induced
Risk Factors
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
Grant Support
Reg. No./Substance:
0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors; 41VRH5220H/Paroxetine
Comment In:
Acta Psychiatr Scand. 2013 Feb;127(2):115-6   [PMID:  23301721 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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