Neonatal Signs After Late In Utero Exposure to Serotonin Reuptake Inhibitors

Moses‐Kolko, Eydie L.; Bogen, Debra L.; Perel, James M.; Bregar, Amy; Uhl, Kathleen; Levin, Bob; Wisner, Katherine L.

doi:10.1001/jama.293.19.2372

Cited by 494 publications

(339 citation statements)

References 62 publications

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“…Chambers et al (2006) demonstrated an association between late antenatal SSRI use and persistent pulmonary hypertension in the newborn, a rare but serious condition (Chambers et al, 2006). There is a growing literature regarding a neonatal syndrome and medical complications with late pregnancy antidepressant use (Moses-Kolko et al, 2005). Although the literature suggests low levels of antidepressant exposure through breastmilk, there have been case reports of suspected adverse events in breastfed babies and a lack of long-term safety data (Weissman et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Freeman

Davis

Sinha

et al. 2008

Journal of Affective Disorders

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Section: Introductionmentioning

confidence: 99%

Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Freeman

Davis

Sinha

et al. 2008

Journal of Affective Disorders

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173

136

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“…Neonates with severe symptoms need more aggressive treatment such as anticonvulsant therapy, intravenous fluids, and respiratory support 2, 8. Our case required oxygen therapy, fluid restriction, furosemide, and nasogastric tube feeding for some days.…”

Section: Discussionmentioning

confidence: 99%

“…To reduce or prevent neonatal symptoms, it has been suggested to taper or discontinue SRIs approximately 2 weeks prior to the due date and resume after delivery 2, 4, 8. Some authors have also proposed a 3‐day clinical observation period for neonates exposed to SRIs during the last trimester of pregnancy 7, 22.…”

Section: Discussionmentioning

confidence: 99%

Cardiac dysfunction and prenatal exposure to venlafaxine

Araújo

Marçal

Tuna

et al. 2016

Clinical Case Reports

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“…blood tension, fluctuations in temperature (0.5°C), fluctuations in cardiac rhythms, dyspnoea, excitement and apathy, based on research by Laine et al, Moses-Kolko et al and Dilsaver et al [29,31,32]. Other relevant explorative data of the neonates, such as gestational age and birth weight, were collected.…”

Section: Methodsmentioning

confidence: 99%

Clomipramine concentration and withdrawal symptoms in 10 neonates

Horst

Linde

Smit³

et al. 2012

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Antidepressants are associated with withdrawal symptoms after in utero exposure.• Half-life of clomipramine in neonates is prolonged compared with that in adults. WHAT THIS STUDY ADDS• We present 10 cases of neonates exposed in utero to clomipramine, with detailed information about withdrawal symptoms and pharmacokinetics.• There is a high and severe complication rate in our cohort regarding the mother and the neonate. AIMAfter in utero exposure to tricyclic antidepressants, neonatal withdrawal symptoms have been reported with an estimated incidence between 20 and 50%; however, few data are available for clomipramine. This could also be the case for neonatal pharmacokinetic clomipramine parameters and so this study was set up. METHODSBabies exposed to clomipramine in utero were included in an observational study, approved by the local ethics committee, after written informed consent. Withdrawal symptoms were scored at 12, 24 and 48 h after birth using the Finnegan score. Plasma concentrations were determined using an in-house-developed, validated liquid chromatography with mass detection (LC-MSMS) method at 0, 12, 24 and 48 h after birth. RESULTSWe found that three of 11 pregnancies were complicated with pre-eclampsia. Ten neonates were observed for clomipramine withdrawal symptoms. The observed withdrawal symptoms were too short a period of sleep after feeding (6), poor feeding (3), mild to severe tremors (6), hyperactive Moro reflex (3) and respiratory rate >60 breaths min -1. Serious withdrawal reactions, such as tachycardia and cyanosis, were seen. We calculated a half-life value of 42 Ϯ 16 h for clomipramine in neonates. Only a weak correlation was found between withdrawal reactions and clomipramine plasma concentration or desmethylclomipramine plasma concentration. CONCLUSIONSIn neonates, clomipramine is eliminated with a half-life value of 42 h, compared with 20 h in adults. In two of 10 neonates, tachycardia and cyanosis were seen as serious withdrawal symptoms after maternal use of clomipramine.

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Neonatal Signs After Late In Utero Exposure to Serotonin Reuptake Inhibitors

Cited by 494 publications

References 62 publications

Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Cardiac dysfunction and prenatal exposure to venlafaxine

Clomipramine concentration and withdrawal symptoms in 10 neonates

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