Antidepressants - MGH Center for Women's Mental Health

SSRIs and Neonatal Outcomes: A Population-Based Study from Finland

Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for "toxicity" in newborns exposed to antidepressants around the time of labor and delivery. Several recent studies have suggested that exposure to SSRIs at the time of delivery may be associated with poor perinatal outcomes (Casper 2003, Laine 2003, Simon 2002, Zeskind and Stephens 2004) and prompted the FDA to include warnings in the packaging inserts regarding the use of certain antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) and venlafaxine (Effexor), during pregnancy. These studies have been reviewed previously on the CWMH website (Newsletters Fall 2004 and Spring 2005).

By MGH Center for Women's Mental Health|2015-07-23T14:51:24-04:00January 24th, 2006|Antidepressants, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Reviewing the Safety of SSRI’s in Pregnancy

Over the past 15 years, multiple studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs). Data on the overall teratogenicity of SSRIs come from relatively small cohort studies and larger international programs, and they have cumulatively supported the reproductive safety of fluoxetine (Prozac) and certain other SSRIs. However, several recent studies have raised concerns regarding the use of SSRIs during pregnancy.

By MGH Center for Women's Mental Health|2015-07-23T14:50:24-04:00December 31st, 2005|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Should SSRIs Be Discontinued Prior to Delivery?

About 10-15% of women suffer from depression during pregnancy. The rates are probably even higher among those women who have histories of depression prior to pregnancy. Thus, many women with recurrent illness make the decision to remain on antidepressant during pregnancy. While there have been many studies supporting the reproductive safety of certain antidepressants, including Prozac and the tricyclic antidepressants, during pregnancy, concerns have emerged as to whether antidepressants, including the selective serotonin reuptake inhibitors (SSRIs), may increase the risk of adverse events in the newborn.

By MGH Center for Women's Mental Health|2015-07-22T14:41:25-04:00June 13th, 2005|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Recent Antidepressant Label Changes

In October, the Food and Drug Administration (FDA) ordered drug manufacturers to include warnings in the packaging inserts regarding the use of certain antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) and venlafaxine (Effexor), during pregnancy. The labels now describe a spectrum of adverse events in newborns exposed to these drugs late in the third trimester, including jitteriness, irritability, hypoglycemia (low blood sugar), feeding difficulties, respiratory distress, abnormal muscle tone, and constant crying. Complications requiring “prolonged hospitalization, respiratory support and tube feeding” are also mentioned.

By MGH Center for Women's Mental Health|2015-07-21T12:51:48-04:00April 15th, 2005|Antidepressants, Pregnancy & Medications|Comments Off

Pregnancy and SSRIs: Is There a Risk to the Newborn?

The increasing number of reproductive-age women taking antidepressants has raised concerns about the potential risks of using these medications during pregnancy. Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for “toxicity” in newborns exposed to antidepressants around the time of labor and delivery. These concerns are not new. Twenty years ago, case reports suggested that maternal use of tricyclic antidepressants near the time of delivery was associated with problems in the newborn such as difficulty feeding, restlessness, or jitteriness.

By MGH Center for Women's Mental Health|2015-07-21T11:39:06-04:00October 15th, 2004|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Is St. John’s Wort Safe in Breastfeeding Women?

Postpartum depression is a relatively common event, affecting 10 to 15% of women after the birth of a child. Many women, however, do not receive treatment, and one of the most common reasons for avoiding or deferring treatment is concern regarding the use of medications while breastfeeding. A preliminary study from Lee and colleagues at the Motherisk Program in Toronto, Canada has investigated the use of St. John’s wort in breastfeeding women.

By MGH Center for Women's Mental Health|2015-07-21T11:28:28-04:00January 18th, 2004|Antidepressants, Breastfeeding & Medications|Comments Off

Long-term Effects of Fetal Exposure to Antidepressants

Although data accumulated over the last 30 years suggest that some medications may be used safely during pregnancy, our knowledge regarding the risks of prenatal exposure to psychotropic medications is incomplete. Because neuronal migration and differentiation occur throughout pregnancy and into the early years of life, the central nervous system (CNS) remains particularly vulnerable to toxic agents throughout pregnancy. While insults that occur early in pregnancy may result in gross abnormalities, exposures that occur after neural tube closure (at 32 days of gestation) may produce more subtle changes in behavior and functioning.

By MGH Center for Women's Mental Health|2015-07-21T11:25:18-04:00March 31st, 2003|Antidepressants, Child Outcomes, Long-Term Outcomes, Pregnancy & Medications|Comments Off

Breastfeeding and Antidepressants

When discussing the use of antidepressant medications by breastfeeding women, It is somewhat misleading to say that certain medications are “safer” than others. All medications taken by the mother are secreted into the breast milk. The amount of drug to which the infant is exposed depends on many factors, including the medication dosage, as well as the infant’s age and feeding schedule. To date, we have not found that certain medications are found at lower levels in the breast milk and may therefore pose less of a risk to the nursing infant. Nor have we found that any antidepressant medication has been associated with serious adverse events in the baby.

By MGH Center for Women's Mental Health|2015-07-20T10:19:39-04:00January 6th, 2002|Antidepressants, Breastfeeding & Medications|Comments Off