Serotonin Reuptake Inhibitor-Induced Perinatal Complications

Abstract

There are a growing number of concerns about the utilization of serotonin reuptake inhibitors (SRIs) in late pregnancy and the onset of perinatal complications. This review aimed to analyze and summarize the studies evaluating the risk of perinatal complications (such as low birth weight, preterm delivery, withdrawal or toxic phenomena, and other detrimental events/poor neonatal outcomes) related to maternal SRI use in late pregnancy. A computerized search of MEDLINE (1966-January 2007) and PsycINFO (1974-January 2007) databases was performed. Articles describing perinatal complications after late in utero exposure to SRIs were selected and also reviewed for additional references. Fifty studies met the inclusion criteria. Exposure to SRIs late in pregnancy is clearly associated with an increased risk of infants developing a constellation of symptoms, including CNS and respiratory effects, often requiring close infant observation and supportive or specific treatment in intensive care units. Such symptoms are not always due to toxic or withdrawal reactions. Indeed, some evidence suggests that SRIs may interfere with the physiology of the respiratory system and parasympathetic activity in neonates. Of the most methodologically relevant studies reviewed, 50% have been published in the last 3 years. Hence, it is possible that further concerning data will become available in the future. For these reasons, the opportunity of tapering and discontinuing SRIs in late pregnancy should be taken into consideration, although to date the evidence to support such a clinical decision is preliminary.

“A View You Won’t Get Anywhere Else”? Depressed Mothers, Public Regulation and ‘Private’ Narrative

“…SSRIs are the most commonly prescribed method of dealing with antenatal as well as postnatal depression. Studies of women who have taken SSRIs while pregnant or lactating have shown some evidence of potential harmful effects on the developing baby during pregnancy (as noted passim in the NICE guidelines), though the decision to treat a pregnant woman remains with the individual practitioner (Cipriani et al 2007;Gentile 2007). chemical changes associated with emotional and frequently gendered states may seem a step toward the acknowledgement of the pathology model, and this may appear to play into the hands of those who would caricature the 'hormonal', depressed woman as malfunctioning and dangerous.…”

Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk

“…2005, Gentile 2007a, Belik 2008. Ancak bu belirtiler destek yaklaşımla düzelmekte ve birkaç hafta içinde ortadan kalkmaktadır.…”

Drug treatment for mood disorders in pregnancy

“…Indeed, circulars sent out in 2004 by the FDA, Health Canada, and pharmaceutical sectors highlighted concerns on the use of SSRIs and SNRIs during late pregnancy [21][22][23][24]. Moreover, the FDA issued a second advisory on 19 July 2006, based on evidence showing their use may be linked to persistent pulmonary hypertension of the newborn (PPHN), a potentially life-threatening condition [25].…”