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Safety of selective serotonin reuptake inhibitors in pregnancy

Published online by Cambridge University Press:  02 January 2018

Allison Donnelly  and
Carol Paton
Allison Donnelly
Affiliation:
Oxleas NHS Foundation Trust
Carol Paton
Affiliation:
Oxleas NHS Foundation Trust, Pinewood House, Pinewood Place, Dartford, Kent DA2 7WG, email: [email protected]
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Abstract

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Aims and Method

Selective serotonin reuptake inhibitors (SSRIs) are recommended by the National Institute for Clinical Excellence as first-line drugs for the treatment of depression, but there is emerging evidence that they might not be entirely safe in pregnancy. We reviewed the literature in this area.

Results

Some data indicate an association between first-trimester SSRI exposure, particularly with paroxetine, and an increased risk of some major congenital malformations. Stronger evidence supports an association with small reductions in gestational age and neonatal withdrawal symptoms.

Clinical Implications

Risks and benefits of using SSRIs during pregnancy should be discussed with the patient, and a joint decision made between prescriber and patient regarding treatment. Limited data suggest that other SSRIs are safer than paroxetine in pregnancy.

Type
Medicines information
Information
Psychiatric Bulletin , Volume 31 , Issue 5 , May 2007 , pp. 183 - 186
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2007

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