SSRIs - MGH Center for Women's Mental Health

Autism Spectrum Disorders and SSRIs

It is now estimated that autism spectrum disorders (ASD) affect about 1% to 2% of the population. Data derived from twin and sibling studies indicate that ASD is highly heritable. While genetic factors clearly play an important role, other studies point to an interplay between environmental and genetic factors in the etiology of this disorder. Over the years, various environmental exposures have been implicated, including vaccinations, mercury, and insecticides; however, it has been difficult to generate solid evidence linking specific environmental factors with increased risk for autism.

By MGH Center for Women's Mental Health|2024-07-24T11:49:06-04:00July 18th, 2011|Autism Spectrum Disorder, Child Outcomes, Pregnancy & Medications|Comments Off

Serotonin Reuptake Inhibitors and Fertility (Part 2): What Can Basic Science Tell Us?

Serotonin (5-HT) is one of the neurotransmitters involved in mood regulation and has been implicated in the development of mood and anxiety disorders. Serotonin transporters (SERT) facilitate the transfer of serotonin into neurons; serotonin reuptake inhibitor (SSRI) antidepressants bind to these transporters and appear to exert their effect on mood by inhibiting the reuptake of serotonin and thus increasing the levels of this neurotransmitter at the synapse.

By MGH Center for Women's Mental Health|2015-07-28T14:39:53-04:00July 5th, 2011|Antidepressants, Pregnancy & Medications|Comments Off

Serotonin Reuptake Inhibitors and Fertility (Part 1): A Clinical Perspective

We previously reported that paroxetine, a selective serotonin reuptake inhibitor (SSRI), may affect sperm motility and may thus have a negative impact on male fertility. Many women who are planning a pregnancy question whether SSRIs and other antidepressants may affect fertility; this is obviously a particularly important issue for those who are having difficulty conceiving.

By MGH Center for Women's Mental Health|2015-07-28T14:39:33-04:00July 1st, 2011|Antidepressants, Pregnancy & Medications|Comments Off

Clinical Case: Should SSRIs Be Tapered Prior To Delivery?

Ms. T is a 33 year old woman with a history of recurrent depression who is 32 weeks pregnant with her first pregnancy. She has remained on her citalopram (Celexa) throughout pregnancy and has been well. Her gynecologist has encouraged her to enquire about coming off the Celexa prior to delivery in order to avoid symptoms of neonatal distress. What should she do?

By MGH Center for Women's Mental Health|2015-07-28T14:36:21-04:00June 13th, 2011|Antidepressants, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Antidepressants and Weight Gain

Many individuals have the experience of weight gain while receiving treatment with an antidepressant, and often wonder if selective serotonin reuptake inhibitors (SSRIs) are associated with weight gain. This is an excellent, complex, and clinically important question.

By MGH Center for Women's Mental Health|2015-08-13T11:41:37-04:00November 4th, 2010|Antidepressants, General|Comments Off

Discontinuation of Antidepressants: Slower is Better

About half of all pregnancies are unplanned. In this situation, many women who conceive while on psychotropic medications decide to abruptly stop their medications when they discover they are pregnant. While this may seem like the safest option, in terms of protecting the developing fetus, we have data demonstrating high rates of relapse in women who discontinue antidepressant medications or mood stabilizers proximate to conception. We now have data (from several studies in non-pregnant populations) to indicate that the rate of medication discontinuation (abrupt vs. gradual) may also affect risk of relapse.

By MGH Center for Women's Mental Health|2015-08-13T11:01:51-04:00September 13th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Antidepressants and Risk of Spontaneous Abortion

Although the last several decades of research have yielded important findings regarding the safety of antidepressants during pregnancy, some areas are still understudied. For example, there are no conclusive results concerning the risk of spontaneous abortions following antidepressant exposure during the first trimester. Several recent meta-analyses, including one from the Motherisk program (Hemels, 2005), have observed an increased risk of spontaneous abortion among women taking antidepressants.

By MGH Center for Women's Mental Health|2015-08-12T16:45:03-04:00June 21st, 2010|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Do SSRIs Increase the Risk of Preeclampsia?

Hypertension in pregnancy is generally defined as a diastolic blood pressure of 90 mm Hg or greater or a systolic pressure at or above 140 mm Hg. Preeclampsia is defined as the development of hypertension with proteinuria or edema induced by pregnancy, generally in the second half of gestation. It is more common in women who have not carried a previous pregnancy beyond 20 weeks and in women at the extremes of the reproductive years.

By MGH Center for Women's Mental Health|2015-07-28T11:31:33-04:00June 22nd, 2009|Antidepressants, Pregnancy & Medications, Pregnancy Outcomes|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