General Obstetrics and Gynecology: ObstetricsCitalopram use in pregnancy: Prospective comparative evaluation of pregnancy and fetal outcome
Section snippets
Objectives
The objective of our study was to determine whether citalopram use during pregnancy is associated with an increased risk of adverse pregnancy outcome, including birth defects and neonatal complications.
Patients and methods
This was a prospective comparative study with 2 matched comparison groups (a disease-matched and a nonteratogen group).
The study was conducted by the Motherisk Program at the Hospital for Sick Children in Toronto. The Motherisk Program is a teratogen information and counseling center that provides pregnant or breast-feeding women and their health care providers with evidence-based information on the safety/risk of exposures to prescription and over-the-counter medications, natural health
Maternal characteristics
The total number of pregnant women enrolled in this study was 396 (132 women in each study group). Pregnant women who were exposed to citalopram had a mean age of 31.9 ± 4.8 years (range 18-42 years). At the time of study recruitment, 108 of 132 women were already pregnant with the mean gestational age of pregnancy of 8.8 ± 7.8 weeks (range 1-39 weeks). Twenty-four women were still planning their pregnancy at the time of their first contact with Motherisk. Dosing schedule of citalopram in the
Comment
Although several published studies21, 22, 23, 24, 25, 26 did not associate SSRI antidepressants with major malformations or neurobehavioral problems, many pregnant women and their health care providers are apprehensive with regard to SSRI therapy during pregnancy.
To our knowledge, this study is the first prospective comparative study to examine the possible adverse effects of citalopram during pregnancy. We found only 1 male infant born with a major birth defect following exposure to citalopram
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Cited by (108)
Maternal use of antidepressants during pregnancy and risks for adverse perinatal outcomes: a meta-analysis
2020, Journal of Psychosomatic ResearchClinical management of medications in pregnancy and lactation
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :In addition to these large studies, which included several SSRIs, a prospective case-control study found no evidence of teratogenicity with citalopram. One pharmacokinetics study found very low serum concentrations of citalopram in lactating infants, suggesting no safety concerns for breastfed neonates.17,18 When searching online sources for information, REPROTOX confirms the primary literature findings that citalopram does not increase congenital anomalies.
Psychotropic drugs
2015, Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment: Third Edition
Supported in part by the Research Leadership for Better Pharmacotherapy During Pregnancy and Lactation.
Gideon Koren is a Senior Scientist of the Canadian Institutes for Health Research and holder of the Ivey Chair in Molecular Toxicology, The University of Western Ontario.