Antidepressants - MGH Center for Women's Mental Health

New Study Does Not Find Link Between Paroxetine and Cardiovascular Defects

In 2006, GlaxoSmithKline (GSK) elected to change product label warnings for the antidepressant paroxetine (Paxil), advising against the use of this drug by women who are pregnant. This decision was based on preliminary studies which suggested an increase in the risk of cardiovascular malformations among infants exposed to paroxetine in utero. A recent study from the Motherisk Program in Toronto has reported on the outcomes of over 3000 paroxetine-exposed infants.

By MGH Center for Women's Mental Health|2015-08-11T12:19:14-04:00April 23rd, 2008|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Switching Antidepressants After the First Trimester

Q. I am currently talking Remeron for depression. I am about 16 weeks pregnant and doing well. I recently started working with a new psychiatrist, and my new doctor suggested that I switch to Prozac because he thought it would be safer for the baby. I am a little worried about making a change; I have never tried Prozac before and had a bad reaction (horrible anxiety and insomnia) when I tried Lexapro.

By MGH Center for Women's Mental Health|2015-08-11T11:50:58-04:00March 31st, 2008|Antidepressants, Pregnancy & Medications|Comments Off

PPHN and SSRIs: New Findings

Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about 1 to 2 per 1000 live births. Infants with PPHN are typically full-term or near-term and present shortly after delivery with severe respiratory distress. In the worst cases, PPHN requires intubation and mechanical ventilation and may result in long-term morbidity. In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn. Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks).

By MGH Center for Women's Mental Health|2015-08-11T11:42:51-04:00March 31st, 2008|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Pregnancy: Evaluating New Reproductive Safety Data

Over the past 15 years, multiple studies have addressed the reproductive safety of various antidepressants. Data on the overall teratogenicity of SSRIs has come from relatively small prospective observational studies, larger international birth registries, managed health care databases, and case series; these data have cumulatively supported the reproductive safety of fluoxetine and certain other SSRIs. In a recent meta-analysis including 1774 antidepressant-exposed infants, first trimester exposure to SSRIs was not associated with an increased risk of major malformations above the baseline of 2%-3% seen in the general population (Einarson & Einarson, 2005). The bulk of the data thus far has suggested that SSRIs are not major teratogens; however, concerns about the potential teratogenicity of SSRIs were first raised in 2005 when several preliminary studies suggested that paroxetine may be associated with a small increase in risk of congenital abnormalities.

By MGH Center for Women's Mental Health|2015-08-11T10:55:05-04:00March 31st, 2008|Antidepressants, Outcomes, Pregnancy & Medications|Comments Off

Can Paxil (Paroxetine) Be Used While Breastfeeding?

All medications are secreted into the breast milk, although concentrations appear to vary. There is a fair amount of information on the use of Paxil (paroxetine) in nursing women. While Paxil may be detected in the breast milk, there have been no reports of adverse events in the nursing infant. The only situation where one may want to avoid breastfeeding is when the baby is premature or has signs of hepatic immaturity, which may make it more difficult for the infant to metabolize the medication to which he or she is exposed. Premature babies are also probably more vulnerable to the toxic effects of these medications.

By MGH Center for Women's Mental Health|2015-07-28T11:04:33-04:00December 4th, 2007|Antidepressants, Breastfeeding & Medications|Comments Off

Antidepressant-Induced Sexual Side Effects

A recent article published in Psychiatric Times reviews options for the management of antidepressant-induced sexual dysfunction. According to this review, sexual side effects may occur in 40% to 70% of patients treated with serotonin reuptake inhibitors (SRIs) and is a common reason for poor compliance with treatment and eventual discontinuation. When sexual side effects occur, they tend to emerge early, are persistent, and rarely resolve spontaneously.

By MGH Center for Women's Mental Health|2015-07-16T14:56:44-04:00October 1st, 2007|Antidepressants, General, Sexual Health|Comments Off

Evaluating the Long-Term Effects of Prenatal Antidepressant Exposure

Over the last decade information has accumulated regarding the safety of antidepressants taken during pregnancy. While much research has addressed the effect of antidepressant drugs on risk for congenital malformation, less research has focused on the long-term effects of prenatal antidepressant exposure.

By MGH Center for Women's Mental Health|2015-07-28T10:14:44-04:00February 20th, 2007|Antidepressants, Long-Term Outcomes, Neurodevelopmental Disorders, Pregnancy & Medications|Comments Off

Use of Paxil during Pregnancy

Q. I have taken Paxil for about six years for depression and obsessive-compulsive disorder. I have tried several times to stop the medication but the symptoms come back within a few weeks of stopping the medication. My husband and I are now planning a pregnancy, and my obstetrician tells me that I cannot take Paxil during pregnancy. Are there any other options?

By MGH Center for Women's Mental Health|2015-07-28T09:53:02-04:00April 24th, 2006|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.

By MGH Center for Women's Mental Health|2015-07-28T09:51:11-04:00April 24th, 2006|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Persistent Pulmonary Hypertension of the Newborn

These findings are likely to generate significant anxiety among child-bearing women who suffer from depression who would like to maintain antidepressant medication during pregnancy. Future studies are needed to better understand the risk of PPHN in this setting.

By MGH Center for Women's Mental Health|2025-07-26T08:55:25-04:00April 24th, 2006|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off