Document Detail


Safety concerns associated with the use of serotonin reuptake inhibitors and other serotonergic/noradrenergic antidepressants during pregnancy: a review.
MedLine Citation:
PMID:  19698902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is ongoing debate about the safety of selective serotonin reuptake inhibitors (SSRIs) and other serotonergic/noradrenergic antidepressants when used during pregnancy. OBJECTIVE: This article reviews the available literature on the main safety concerns associated with the use of SSRIs and other serotonergic/noradrenergic antidepressants (serotonin-norepinephrine reuptake inhibitors, norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic antidepressants) during pregnancy. METHODS: English-language reports of analytical and descriptive studies, including case reports, case series, and meta-analyses, were identified through searches of MEDLINE, EMBASE, and PsycINFO (1966-April 2009). The search terms were fluoxetine, paroxetine, sertraline, Citalopram, escitalopram, fluvoxamine, venlafaxine, mirtazapine, reboxetine, duloxetine, SSRI, SNRI, NaSSA, and NRI in association with depression, pregnancy, prenatal exposure, miscarriage, spontaneous abortion, malformation, in utero exposure, and neonatal complications. RESULTS: Paroxetine has been associated with significant risks of major malformation, particularly cardiac defects, when used during pregnancy. Significant associations between maternal exposure to SSRIs and both persistent pulmonary hypertension of the newborn and a self-limiting neonatal behavioral syndrome have been reported in a number of recent original studies and meta-analyses. Some studies have suggested a relationship between the use of SSRIs or other serotonergic/noradrenergic antidepressants and the occurrence of miscarriage, although these studies had methodologic limitations that affected the strength of the data. Evidence for a possible association between in utero exposure to SSRIs or other serotonergic/noradrenergic antidepressants and alterations in neurobehavioral development, bleeding, and QTc-interval prolongation is currently weak. CONCLUSION: The available evidence suggests that SSRIs and other serotonergic/noradrenergic antidepressants should be used with caution during pregnancy, with careful follow-up of infants exposed to these agents in utero.
Authors:
Marco Tuccori; Arianna Testi; Luca Antonioli; Matteo Fornai; Sabrina Montagnani; Narcisa Ghisu; Rocchina Colucci; Tiberio Corona; Corrado Blandizzi; Mario Del Tacca
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical therapeutics     Volume:  31 Pt 1     ISSN:  1879-114X     ISO Abbreviation:  Clin Ther     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2009-11-09     Revised Date:  2010-02-02    
Medline Journal Info:
Nlm Unique ID:  7706726     Medline TA:  Clin Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1426-53     Citation Subset:  IM    
Affiliation:
Division of Pharmacology and Chemotherapy, Department of Internal Medicine, University of Pisa, Pisa, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced
Depression / complications,  drug therapy*
Female
Humans
Neurotransmitter Uptake Inhibitors / adverse effects*,  therapeutic use
Norepinephrine / metabolism
Pregnancy
Pregnancy Complications / drug therapy*
Serotonin Uptake Inhibitors / adverse effects*,  therapeutic use
Teratogens
Chemical
Reg. No./Substance:
0/Neurotransmitter Uptake Inhibitors; 0/Serotonin Uptake Inhibitors; 0/Teratogens; 51-41-2/Norepinephrine

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


Previous Document:  Desvenlafaxine 50 and 100 mg/d in the treatment of major depressive disorder: An 8-week, phase III, ...
Next Document:  Cost-effectiveness of quetiapine plus mood stabilizers compared with mood stabilizers alone in the m...