In 2006, Chambers and colleagues published an article in the New England Journal of Medicine linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Based on these findings, the “Usage in Pregnancy” section on the labels for SRRI antidepressants was updated to include the following warning: “Infants exposed [...]
Tag Archives: medication during pregnancy
In Utero Exposure to Antipsychotics
May 17, 2011 – 4:47 pm
May 2011, ObGyn News, Lee S. Cohen, MD Reprinted with permission from Ob. Gyn. News Copyright by International Medical News Group, an Elsevier company Previous columns on the reproductive safety of psychiatric medications have focused on the attendant risks of fetal exposure to antidepressants, benzodiazepines, and mood stabilizers such as lithium and sodium valproate. [...]
New FDA Warning on the Use of Antipsychotic Medications in Pregnancy
March 9, 2011 – 11:00 am
On February 22, 2011, the U.S. Food and Drug Administration (FDA) informed healthcare professionals that drug labels for the entire class of antipsychotic drugs have been updated to include warnings regarding the use of antipsychotic drugs during pregnancy. The new drug labels now contain more details on the potential risk for abnormal muscle movements (extrapyramidal [...]
Zolpidem (Ambien) in Pregnancy: Is it Safe?
November 22, 2010 – 5:04 pm
It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy. While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function. While zolpidem (Ambien), [...]
Should SSRIs Be Tapered Prior To Delivery?
September 8, 2010 – 10:35 am
Increased muscle tone, jitteriness, sleep disturbance, irritability, feeding problems, mild respiratory distress and myoclonus have been reported as symptoms of a potential neonatal distress syndrome related to exposure to SSRIs in late pregnancy. The average duration of symptoms reported is 48 hours. It is estimated that between 25-30% of SSRI-exposed infants are at risk for [...]
Antidepressants and Risk of Spontaneous Abortion
June 21, 2010 – 11:42 am
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 [...]
Valproic Acid and the Risk of Major Malformations
June 14, 2010 – 1:41 pm
Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects. While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations. To [...]
Anticonvulsant Use in Pregnancy and Nursing: Differences in Recommendations from Psychiatrists vs. Neurologists
February 3, 2010 – 11:39 am
There are strong parallels between the clinical management of bipolar disorder and epilepsy, and women with these disorders face significant challenges while pregnant or planning to conceive. In this setting, treatment decisions must balance the risks of recurrence of severe illness with the risks of potential harm to the fetus when certain medicines are taken [...]
Use of the Emsam Patch (Selegiline) in Pregnancy
December 14, 2009 – 10:56 am
A clinician asks: “Is there any data on the use of the Emsam patch in pregnancy?” There is very little information on the reproductive safety of the MAOI-B inhibitor, selegiline, which is the active ingredient of the Emsam patch. While animal studies have failed to reveal any evidence of teratogenicity, the medical literature includes only [...]
What Would You Do? A Pregnant Women on Duloxetine (Cymbalta)
June 29, 2009 – 1:25 pm
Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta). She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day. She has had four previous episodes of major depressive disorder (most untreated) and has been [...]
Long-term Effects of Fetal Exposure to Antidepressants
March 31, 2003 – 12:25 pm
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 [...]
