A few weeks after the FDA called into question the association between SSRI exposure and persistent pulmonary hypertension of the newborn or PPHN, BMJ published another article supporting an increased risk of PPHN among infants exposed to SSRIs in utero. This large study is similar to the studies published by Kallen and colleagues using the [...]
Tag Archives: SSRIs
SSRIs and PPHN: The FDA Revises Its Warning
January 17, 2012 – 3:29 pm
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 [...]
Escitalopram (Lexapro) and Pregnancy
December 5, 2011 – 1:50 pm
Both citalopram and escitalopram are antidepressants belonging to the SSRI class. While escitalopram (marketed in the U.S. as Lexapro) contains only the S-stereoisomer (or enantiomer) of the drug citalopram, Celexa or generic citalopram is a racemic mixture of the S-citalopram and its mirror image, R-citalopram, which is less effective as an antidepressant. Thus far, there have [...]
Antidepressant Treatment During Pregnancy: One Woman’s Experience (Part IV)
October 18, 2011 – 6:02 pm
Part 4: The Postpartum Period This is a continuation of the case presented in a previous post. After discussing the risks and benefits of staying on fluoxetine after delivery versus changing to venlafaxine ER, Ms. D decided to resume venlafaxine ER while remaining on fluoxetine. Like her previous experiences with venlafaxine ER, she responded quickly [...]
Autism Spectrum Disorders and SSRIs
July 18, 2011 – 5:37 pm
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. [...]
Serotonin Reuptake Inhibitors and Fertility (Part 2): What Can Basic Science Tell Us?
July 5, 2011 – 12:42 pm
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 Reuptake Inhibitors and Fertility (Part 1): A Clinical Perspective
July 1, 2011 – 9:34 am
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. [...]
Clinical Case: Should SSRIs Be Tapered Prior To Delivery?
June 13, 2011 – 1:26 pm
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 [...]
Discontinuation of Antidepressants: Slower is Better
September 13, 2010 – 10:46 am
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 [...]
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 [...]
Do SSRIs Increase the Risk of Preeclampsia?
June 22, 2009 – 12:03 pm
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 [...]
PPHN and SSRIs: New Findings
March 31, 2008 – 9:35 am
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 [...]
SSRIs and Pregnancy: Evaluating New Reproductive Safety Data
March 31, 2008 – 9:33 am
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. [...]
SSRIs and Pregnancy: Putting the Risks into Perspective
October 7, 2007 – 5:49 pm
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 [...]
Expert Guidelines for the Treatment of PMDD
August 31, 2007 – 5:45 pm
In this review, guidelines for the treatment of PMDD are provided. Selective serotonin reuptake inhibitors (SSRIs) are the most widely used pharmacologic agents for treating depression and anxiety disorders, and several have also emerged as first-line treatment for premenstrual dysphoric disorder (PMDD). In numerous clinical trials, SSRIs have demonstrated efficacy in reducing the physical and [...]
Use of SSRIs During Pregnancy
July 30, 2006 – 1:40 pm
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 [...]
SSRIs and Neonatal Outcomes: A Population-Based Study from Finland
January 24, 2006 – 6:53 am
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 [...]
Reviewing the Safety of SSRI’s in Pregnancy
December 31, 2005 – 2:24 pm
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 [...]
Venlafaxine for Postpartum Depression
February 20, 2002 – 6:59 pm
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 [...]
Intermittent Dosing of SSRIs for PMS
April 6, 2000 – 11:32 am
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. Initially, SSRIs [...]
