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Cited by 95Pregnancy and Medication ImpactMaternal Mental Health During Pregnancy and PostpartumPharmacological Effects and Toxicity Studies

Safety concerns associated with the use of serotonin reuptake inhibitors and other serotonergic/noradrenergic antidepressants during pregnancy: A review

Tuccori, Marco, Testi, Arianna, Antonioli, Luca, Fornai, Matteo, Montagnani, Sabrina, Ghisu, Narcisa, Colucci, Rocchina, Corona, Tiberio +2 more·2009·Clinical Therapeutics
DOI 10.1016/j.clinthera.2009.07.009
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Abstract

Background There is ongoing debate about the safety of selective serotonin reuptake inhibitors (SSRIs) and other serotonergic/noradrenergic antidepressants when used during pregnancy.Objective This article reviews the available literature on the main safety concerns associated with the use of SSRIs and other serotonergic/noradrenergic antidepressants (serotonin-norepinephrine reuptake inhibitors, norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic antidepressants) during pregnancy.Methods English-language reports of analytical and descriptive studies, including case reports, case series, and meta-analyses, were identified through searches of MEDLINE, EMBASE, and PsycINFO (1966-April 2009). The search terms were fluoxetine, paroxetine, sertraline, Citalopram, escitalopram, fluvoxamine, venlafaxine, mirtazapine, reboxetine, duloxetine, SSRI, SNRI, NaSSA, and NRI in association with depression, pregnancy, prenatal exposure, miscarriage, spontaneous abortion, malformation, in utero exposure, and neonatal complications.Results Paroxetine has been associated with significant risks of major malformation, particularly cardiac defects, when used during pregnancy. Significant associations between maternal exposure to SSRIs and both persistent pulmonary hypertension of the newborn and a self-limiting neonatal behavioral syndrome have been reported in a number of recent original studies and meta-analyses. Some studies have suggested a relationship between the use of SSRIs or other serotonergic/noradrenergic antidepressants and the occurrence of miscarriage, although these studies had methodologic limitations that affected the strength of the data. Evidence for a possible association between in utero exposure to SSRIs or other serotonergic/noradrenergic antidepressants and alterations in neurobehavioral development, bleeding, and QTc-interval prolongation is currently weak.Conclusion The available evidence suggests that SSRIs and other serotonergic/noradrenergic antidepressants should be used with caution during pregnancy, with careful follow-up of infants exposed to these agents in utero.

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Crossref · 10.1016/j.clinthera.2009.07.009

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  • Among antidepressants, SSRIs and, possibly, serotonin and noradrenaline reuptake inhibitors have been associated with preterm labor, respiratory distress, serotonin rebound syndrome, pulmonary hypertension and feeding problems in the neonate.

    “Among AD, SSRIs and, possibly, serotonin and noradrenaline reuptake inhibitors (SNRIs) have been associated with preterm labor, respiratory distress, serotonin rebound syndrome, pulmonary hypertension and feeding problems in the neonate (557-559).”

    From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [558]

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Authors
Tuccori, M., Testi, A., Antonioli, L., Fornai, M., Montagnani, S., Ghisu, N., Colucci, R., Corona, T., Blandizzi, C., & Tacca, M. D.
Affiliations
University of Pisa (IT)
Corresponding author
Tacca, Mario Del
ORCID
Venue
Clinical Therapeutics
Publisher
Elsevier BV
Published
2009-01
Volume
31
Pages
1426-1453
ISSN
0149-2918 (ISSN-L)
DOI
10.1016/j.clinthera.2009.07.009
OpenAlex
W2102164857
Cited by
95
References
121
Citations by year
2024: 1 · 2023: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 10 · 2015: 5 · 2014: 16 · 2013: 10 · 2012: 12
FWCI
1.98
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Therapeutics (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
Keywords
selective serotonin reuptake inhibitors, pregnancy, maternal antidepressant use, fetal malformations, cardiac defects, persistent pulmonary hypertension of the newborn, miscarriage, QTc prolongation, neurobehavioral development, antenatal depression, paroxetine, fluoxetine, venlafaxine, mirtazapine, reboxetine

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