Neurodevelopmental effects of prenatal exposure to psychotropic medications
Abstract
Until now, studies on the reproductive safety of psychotropics have typically assessed the risk of congenital malformations and perinatal complications associated with in utero exposure to such medications. However, little is known of their inherent potential neurobehavioral teratogenicity. The objective is to analyze available data from studies investigating developmental outcome of children exposed prenatally to psychotropics. A computerized Medline/PubMed/TOXNET/ENBASE search (1960-2010) was conducted using the following keywords: pregnancy, child/infant development/neurodevelopment, antidepressants, benzodiazepines, mood stabilizers, and antipsychotics. A separate search was also run to complete the safety profile of single specific medications. Resultant articles were cross-referenced for other relevant articles not identified in the initial search. A noncomputerized review of pertinent journals and textbooks was also performed. All studies published in English and reporting primary data on the developmental outcome of infants exposed in utero to psychotropics and born without malformations were collected. As regards antiepileptic drugs, only studies that provided data on specific medications approved for psychiatric practice use (carbamazepine, lamotrigine, and valproate) were considered. Data were extracted from 41 articles (38 identified electronically and 3 nonelectronically), which met the inclusion criteria. Despite reviewed studies showing relevant methodological limitations, concordant, albeit preliminary, information seems to exclude that prenatal exposure to both selective serotonin reuptake inhibitors and tricyclic antidepressants may interfere with the infants' psychological and cognitive development. Conversely, information on valproate strongly discourages its use in pregnant women. Moreover, although data on carbamazepine remain controversial, information on whole classes of drugs and single medications is either absent (second-generation antipsychotics) or too limited (first-generation antipsychotics, benzodiazepines, lithium, and lamotrigine) to inform the decision-making process. For all classes of psychotropics, new and/or further studies are warranted to answer definitively the urgent question about the impact of prenatal exposure to such medications on infant development.
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A number of mood stabilizers have been associated with fetal malformations, including carbamazepine and valproate.
“Furthermore, a number of mood stabilizers have been associated with fetal malformations, including carbamazepine and valproate (560,561).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [561]
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
“overall prenatal exposure to antidepressants does not appear to be associated with changes in long-term neurocognitive or behavioral development in children [1128-1130] and that illness itself appears to play a role in negative outcomes (although this study examined the effects of maternal depression) [1131].”
BackgroundKocherlakota, P. (2014) · Pediatrics · doi:10.1542/peds.2013-3524 · Cited by 612 · see citing works
Prenatal SSRI exposure: Effects on later child development
Hermansen, T. K., & Melinder, A. (2015) · Child Neuropsychology · doi:10.1080/09297049.2014.942727 · Cited by 38 · see citing works
- Authors
- Gentile, S.
- Affiliations
- Azienda Sanitaria Locale Salerno (IT)
- Corresponding author
- Gentile, Salvatore
- ORCID
- Gentile, Salvatore
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2010-05-12
- Volume
- 27
- Issue
- 7
- Pages
- 675-686
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2020969042
- Cited by
- 76
- References
- 100
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 9 · 2014: 11 · 2013: 10 · 2012: 6
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- prenatal exposure, psychotropic drugs, brain development, teratogenicity, antidepressants, selective serotonin reuptake inhibitors, tricyclic antidepressants, benzodiazepines, antipsychotic drugs, mood stabilizers, valproic acid, carbamazepine, lamotrigine, antiepileptic drugs, infant cognitive development, child development, reproductive safety
- MeSH terms
- Mental Disorders, Brain, Child, Child Development, Child, Preschool, Cognition, Female, Humans, Infant, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Psychotropic Drugs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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