SSRIs - MGH Center for Women's Mental Health

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|Psychiatric Disorders During Pregnancy|1 Comment

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|Psychiatric Disorders During Pregnancy|0 Comments

SSRIs and Pregnancy: Putting the Risks into Perspective

Depression is common during pregnancy, affecting 10% to 15% of women. While psychotherapy is an attractive option for the treatment of depression during pregnancy, all women do not respond to this intervention and many require pharmacotherapy. Thus far, no antidepressants have yet been approved by the FDA for use during pregnancy. Although data accumulated over the past 30 years suggest that certain medications, including the serotonin reuptake inhibitors (SSRIs), may be used safely during pregnancy, several new studies have raised concerns regarding the use of these medications during pregnancy.

By MGH Center for Women's Mental Health|2015-07-28T10:29:44-04:00October 7th, 2007|Psychiatric Disorders During Pregnancy|0 Comments

Expert Guidelines for the Treatment of PMDD

In this review, guidelines for the treatment of PMDD are provided.

By MGH Center for Women's Mental Health|2015-07-28T10:23:13-04:00August 31st, 2007|PMS and PMDD|24 Comments

Use of SSRIs During Pregnancy

Q. I have been taking antidepressants on and off for the last ten years, and I am now planning a pregnancy. I am now on Effexor, and my psychiatrist recommended switching to Prozac and staying on it up until the end of the second trimester. He said that antidepressants should be avoided later on in pregnancy because they may cause problems for the baby at the time of delivery. I am concerned about having to come off my medication for such a long time. In the past, every time I have tried to stop the medication, my depression has come back within a month or so.

By MGH Center for Women's Mental Health|2015-07-28T10:01:52-04:00July 30th, 2006|Psychiatric Disorders During Pregnancy|0 Comments

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|Psychiatric Disorders During Pregnancy|0 Comments

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|Psychiatric Disorders During Pregnancy|0 Comments

Venlafaxine for Postpartum Depression

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) sertraline, fluoxetine, and fluvoxamine for the treatment of this disorder. In a recent report, Cohen and colleagues have demonstrated the efficacy of venlafaxine for the treatment of PPD.

By MGH Center for Women's Mental Health|2016-03-28T13:24:00-04:00February 20th, 2002|New Research, Postpartum Psychiatric Disorders|2 Comments

Intermittent Dosing of SSRIs for PMS

Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate some of the physical symptoms of PMS.

By MGH Center for Women's Mental Health|2015-07-20T09:25:29-04:00April 6th, 2000|PMS and PMDD|1 Comment