Skip to main content
SpringerLink
Log in

SSRIs in Pregnancy and Lactation

Emphasis on Neurodevelopmental Outcome

  • Review Article
  • Published:
CNS Drugs Aims and scope Submit manuscript

Abstract

The aim of this review was to assess existing information about the long-term neurocognitive development of children whose mothers took SSRIs during pregnancy and/or breastfeeding. The available literature consists of 11 studies (examining a total of 306 children) that demonstrate no impairment of infant neurodevelopment following prenatal and/or postnatal exposure to SSRIs, and two studies (examining 81 children) that suggest possible unwanted effects of fetal SSRI exposure. These unwanted effects included subtle effects on motor development and motor control.

Thus, the available data are not unanimous in excluding possible long-term detrimental neurodevelopmental sequelae of intrauterine exposure to SSRIs. However, it is clear that the research suggesting a lack of adverse events on infants’ neurocognitive development is much more numerous and methodologically better conducted than the studies showing possible unwanted effects. Nevertheless, all reviewed studies had procedural inadequacies, and the screening instruments used have limitations, especially in the evaluation of infants. Furthermore, it is not advisable to extend the generalisations emerging from the findings of a few trials to every infant. Some infants may experience difficulties in metabolising the drugs and/or their metabolites, so the benign outcome described for most infants may not occur.

Thus, the findings emerging from the reports are inconclusive and are not able to fully clarify the repercussions of maternal SSRI treatment on infants’ long-term neurocognitive development. Further large, simple and well designed, randomised, prospective studies will be required for this purpose. These should also be of adequate length and performed using reproducible neurophysiological parameters in order to firmly establish the safety of these medications

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III

Similar content being viewed by others

Notes

  1. The Motherisk Program (started in Toronto, Canada, in 1985) is a teratogen information service providing information and consultation to women, their families and health professionals on the risk/safety of drug, chemical, radiation and infectious exposures during pregnancy and lactation.

References

  1. Kumar R, Robson MK. A prospective study of emotional disorders in childbearing women. Br J Psychiatry 1984; 144: 35–47

    Article  PubMed  CAS  Google Scholar 

  2. O’Hara MW, Neubaber DJ, Zekoski EM. Prospective study of postpartum depression: prevalence, course, and predictive factors. J Abnom Psychol 1984; 93: 158–71

    Article  Google Scholar 

  3. O’Hara MW, Swain AM. Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 1996; 8: 37–54

    Article  Google Scholar 

  4. Troutman B, Cutrona C. Nonpsychotic postpartum depression among adolescent mothers. J Abnorm Psychol 1990; 99: 69–78

    Article  PubMed  CAS  Google Scholar 

  5. Korebrits C, Ramirez MM, Watson L, et al. Maternal corticotrophin-releasing hormone is increased with impending preterm birth. J Clin Endocrinol Metab 1988; 83: 1585–91

    Article  Google Scholar 

  6. Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome. Epidemiol Rev 1995; 15: 165–71

    Google Scholar 

  7. Stott DH. Follow-up study from birth of the effects of prenatal stresses. Dev Med Child Neurol 1973; 15: 770–87

    Article  PubMed  CAS  Google Scholar 

  8. Kurki T, Hiilesmaa V, Raitasalo R, et al. Depression and anxiety in early pregnancy and risk of preeclampsia. Obstet Gynecol 2000; 95: 487–90

    Article  PubMed  CAS  Google Scholar 

  9. Nulman I, Gargaun S, Koren G. Suboptimal pharmacotherapy for depression in pregnancy. Clin Pharmacol Ther 2003; 73(2): 28

    Article  Google Scholar 

  10. Einarson A, Selby P, Koren G. Abrupt discontinuation of psychotropic drugs during pregnancy: fear of teratogenic risk and impact of counselling. J Psychiatry Neurosci 2001; 26(1): 44–8

    PubMed  CAS  Google Scholar 

  11. Cohen LS, Altshuler LL, Stowe ZN, et al. Reintroduction of antidepressant therapy across the pregnancy in women who previously discontinued treatment. Psychother Psychosom 2004; 73(4): 255–8

    Article  PubMed  Google Scholar 

  12. Post RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 1992; 49: 999–101

    Google Scholar 

  13. Zuckerman B, Amaro H, Bauchner H, et al. Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol 1989; 160: 1107–11

    PubMed  CAS  Google Scholar 

  14. McElhatton PR, Garbis HM, Elefant E, et al. The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants: a collaborative study of the European Network of Teratology Information Services (ENTIS). Reprod Toxicol 1996; 10(4): 285–94

    Article  PubMed  CAS  Google Scholar 

  15. Chambers CD, Johnson KA, Dick LM, et al. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 1996; 335(14): 1010–5

    Article  PubMed  CAS  Google Scholar 

  16. Addis A, Koren G. Safety of fluoxetine during the first trimester of pregnancy. Psychol Med 2000; 30(1): 89–94

    Article  PubMed  CAS  Google Scholar 

  17. Pastusak A, Schick-Boschetto B, Zuber C, et al. Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac). JAMA 1993; 269(17): 2246–8

    Article  Google Scholar 

  18. Cohen LS, Heller VL, Bailey JW, et al. Birth outcomes following prenatal exposure to fluoxetine. Biol Psychiatry 2000; 48(10): 996–1000

    Article  PubMed  CAS  Google Scholar 

  19. Goldstein DJ, Corbin LA, Sundell KL. Effects of first-trimester fluoxetine exposure on the newborn. Obstet Gynecol 1997; 89: 713–8

    Article  PubMed  CAS  Google Scholar 

  20. Diav-Citrin O, Shechtman S, Weinbaum D, et al. Pregnancy outcome after gestational exposure to paroxetine: a prospective controlled study cohort [abstract]. Teratology 2002; 65(6): 298

    Google Scholar 

  21. Kulin NA, Pastuszak A, Sage SR, et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective multicenter controlled study. JAMA 1998; 279: 609–10

    Article  PubMed  CAS  Google Scholar 

  22. Ericson A, Kallen B, Wilholm BE. Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol 1999; 55(7): 503–8

    Article  PubMed  CAS  Google Scholar 

  23. Unfred CL, Chambers CD, Felix R, et al. Birth outcomes among pregnant women taking paroxetine (Paxil®): update presented at the Organization of Teratology Services, 14th Annual Conference; 2001 Jun, Teratology, 63 (6)

  24. Chambers CD, Dick LM, Felix RJ, et al. Pregnancy outcomes in women who use sertraline [abstract]. Teratology 1999; 59(6): 376

    Google Scholar 

  25. Hendrick V, Smith LM, Suri R, et al. Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol 2003; 188(3): 812–5

    Article  PubMed  CAS  Google Scholar 

  26. Kallen B. Fluoxetine use in early pregnancy [letter]. Birth Defects Res B Dev Reprod Toxicol 2004; 71(6): 395–6

    Article  PubMed  CAS  Google Scholar 

  27. Einarson TR, Einarson A. Newer antidepressants and rates of major malformations: a meta-analysis of prospective comparative studies. Pharmacoepidemiol Drug Saf. Epub 2005 Mar 1

  28. Hemels ME, Einarson A, Koren G, et al. Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother. Epub 2005 Mar 22

  29. Heikkinen T, Ekblad U, Kero P, et al. Citalopram in pregnancy and lactation. Clin Pharmacol Ther 2002; 72(2): 184–91

    Article  PubMed  CAS  Google Scholar 

  30. Oberlander TF, Misri S, Fitzgerald CE, et al. Is polypharmacy associated with transient neonatal symptoms following prenatal psychotropic medication exposure? [abstract]. Pediatr Res 2003; 53 (4 Pt 2): 426A

    Article  Google Scholar 

  31. Oca MJ, Donn SM. Association of maternal sertraline (Zoloft) therapy and transient neonatal nystagmus. J Perinatol 1999; 6 (Pt 1): 460–1

    Article  Google Scholar 

  32. Kent LS, Laidlaw JD. Suspected congenital sertraline dependence. Br J Psychiatry 1995; 3: 412–3

    Article  Google Scholar 

  33. Gerola O, Fiocchi S, Rondini G. Antidepressant therapy in pregnancy: a review from the literature and report of a suspected paroxetine withdrawal syndrome in a newborn. Riv Ital Pediatr 1999; 25(1): 216–8

    Google Scholar 

  34. Rampono J, Proud S, Hackett LP, et al. A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. Int J Neuropsychopharmacol 2004; 7(3): 329–34

    Article  PubMed  CAS  Google Scholar 

  35. Nordeng H, Lindemann R, Perminov KV, et al. Neonatal withdrawal syndrome after in utero exposure to selective reuptake inhibitors. Acta Pediatr 2001; 3: 288–91

    Article  Google Scholar 

  36. Dahl ML, Olhager E, Ahlner J. Paroxetine withdrawal syndrome in a neonate. Br J Psychiatry 1997; 171: 391–2

    Article  PubMed  CAS  Google Scholar 

  37. Stiskal JA, Kulin N, Koren G, et al. Neonatal paroxetine withdrawal syndrome. Arch Dis Child Fetal Neonatal Ed 2001; 84(2): F134–5

    Article  PubMed  CAS  Google Scholar 

  38. Laine K, Heikkinen T, Ekblad U, et al. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotoninergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry 2003; 60(7): 720–6

    Article  PubMed  CAS  Google Scholar 

  39. Geller B. Serotonergic symptoms in SSRIs-exposed infants. J Watch Psychiatry, MEDScape from WebMD, Psychiatry and Mental Health 2003; 2(9): 1–2

    Google Scholar 

  40. Laine K, Kytola J, Bertilsson L. Severe adverse effects in a newborn with two defective CYP2D6 alleles after exposure to paroxetine during late pregnancy. Ther Drug Monit 2004; 26(6): 685–7

    Article  PubMed  CAS  Google Scholar 

  41. Spencer MJ. Fluoxetine hydrochloride (Prozac) toxicity in a neonate. Pediatrics 1997; 5: 721–2

    Google Scholar 

  42. Mhanna MJ, Bennet II JB, Izatt SD. Potential fluoxetine chloride (Prozac) toxicity in a newborn. Pediatrics 1997; 1: 158–9

    Article  Google Scholar 

  43. Zeskind PS, Stephens LE. Association of maternal-SSRI use during pregnancy and disrupted neonatal sleep organization [Abstract]. Pediatr Res 2003; 53 (4 Pt 2): 71A

    Google Scholar 

  44. Pitfield SF, Oberlander TF, Fitzgerald CE, et al. Prolonged prenatal psychotropic medication exposure reduces T-helper (CD4+) cells in neonates at birth [abstract]. Pediatr Res 2000; 47 (4 Pt 2): 76A

    Google Scholar 

  45. Oberlander TF, Grunau RE, Fitzgerald CE, et al. Prenatal psychotropic medication exposure alters acute neonatal pain response [abstract]. Pediatr Res 2000; 47 (4 Pt 2): 31A

    Google Scholar 

  46. Oberlander TF, Grunau RE, Fitzgerald C, et al. Pain reactivity in 2-month-old infants after prenatal and postnatal serotonin reuptake inhibitor medication exposure. Pediatrics 2005; 115(2): 411–25

    Article  PubMed  Google Scholar 

  47. Costei AM, Kozer E, Ho T, et al. Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med 2002; 156(11): 1129–32

    Article  PubMed  Google Scholar 

  48. Salvia-Roiges MD, Garcia L, Gonge-Mellgren A, et al. Neonatal convulsions and subarachnoid hemorrhage after in utero exposure to paroxetine. Rev Neurol 2003; 8: 724–6

    Google Scholar 

  49. Campino GA. Cardiac arrhythmia in a newborn associated with fluoxetine use during pregnancy [letter]. Ann Pharmacother 2002; 36(3): 533–4

    Article  Google Scholar 

  50. Zeskind PS, Stephens LE. Maternal selective serotonin reuptake inhibitors use during pregnancy and newborn neurobehavior. Obstet Gynecol Surv 2004; 59(8): 564–6

    Article  Google Scholar 

  51. Vanhaesebrouck P, De Bock F, Zecic A, et al. Phototherapy-mediated syndrome of inappropriate secretaion of antidiuretic hormone in an in utero selective serotonin reuptake inhibitor-exposed newborn infant. Pediatrics 2005; 115(5): e508–11

    Article  PubMed  Google Scholar 

  52. Simon GE, Cunningham ML, Davis RL. Outcomes of prenatal antidepressant exposure. Am J Psychiatry 2002; 159: 2055–61

    Article  PubMed  Google Scholar 

  53. Kallen B. Neonate characteristic after maternal use of antidepressants in late pregnancy. Arch Pediatr Adolesc Med 2004; 158(4): 312–6

    Article  PubMed  Google Scholar 

  54. Neonatal complications after intrauterine exposure to SSRI antidepressants [editorial]. Prescrire Int 2004; 13(71): 103–4

    Google Scholar 

  55. Suri R, Altshuler L, Hendrick V, et al. The impact of depression and fluoxetine treatment on obstetrical outcome. Arch Women Ment Health 2004; 7(3): 193–200

    Article  CAS  Google Scholar 

  56. Winans EA. Antidepressant use during lactation. J Hum Lact 2001; 17(3): 356–61

    Article  Google Scholar 

  57. Gentile S. The safety of newer antidepressants in pregnancy and lactation. Drug Saf 2005; 28(2): 137–52

    Article  PubMed  CAS  Google Scholar 

  58. Weissman AM, Levy BT, Hartz AJ, et al. Pooled analysis of antidepressant levels in lactating women, breast milk, and nursing infants. Am J Psychiatry 2004; 161(6): 1066–78

    Article  PubMed  Google Scholar 

  59. Berle JA, Steen VM, Aamo TO, et al. Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome P450 genotypes. J Clin Psychiatry 2004; 65(9): 1228–34

    Article  PubMed  CAS  Google Scholar 

  60. Lester BM, Cucca J, Andreozzi L, et al. Possible association between fluoxetine hydrochloride and colic in an infant. J Am Acad Child Adolesc Psychiatry 1993; 32(6): 1253–5

    Article  PubMed  CAS  Google Scholar 

  61. Kristensen JH, Ilett KF, Hackett LP, et al. Distribution and excretion of fluoxetine and norfluoxetine in human milk. Br J Clin Pharmacol 1999; 4: 521–7

    Google Scholar 

  62. Hale TW, Shurm S, Grossberg M. Fluoxetine toxicity in a breastfed infant. Clin Pediatr 2001; 40: 681–4

    Article  CAS  Google Scholar 

  63. Chambers CD, Anderson PO, Thomas RG, et al. Weight gain in infants breastfed by mothers who take fluoxetine [abstract]. Pediatrics 1999; 104(5): e61

    Article  PubMed  CAS  Google Scholar 

  64. Shimdt K, Olesen OV, Jensen PN. Citalopram and breastfeeding: serum concentration and side effects in the infant. Biol Psychiatry 2000; 47(2): 164–5

    Article  Google Scholar 

  65. Lee A, Woo J, Ito S. Frequency of infant adverse events that are associated with citalopram use during breast-feeding. Am J Obstet Gynecol 2004; 190(1): 218–21

    Article  PubMed  CAS  Google Scholar 

  66. Merlob P, Stahl B, Sulkes J. Paroxetine during breast-feeding: infant weight gain and maternal adherence to counsel. Eur J Pediatr 2004; 163(3): 135–9

    Article  PubMed  CAS  Google Scholar 

  67. Piontek CM, Wisner KL, Perel JM, et al. Serum fluvoxamine levels in breastfed infants. J Clin Psychiatry 2001; 2: 111–3

    Article  Google Scholar 

  68. Epperson R, Czarkowski KA, Ward-O’Brien D, et al. Maternal sertraline treatment and serotonin transport in breast-feeding mother-infant pairs. Am J Psychiatry 2001; 158(10): 1631–7

    Article  PubMed  CAS  Google Scholar 

  69. Wisner KL, Perel JM, Peindl KS, et al. Prevention of postpartum depression: a pilot randomized clinical trial. Am J Psychiatry 2004; 161(7): 1290–2

    Article  PubMed  Google Scholar 

  70. Walker A, Rosemberg M, Balaban-Gil K. Neurodevelopmental and neurobehavioral sequelae of selected substances of abuse and psychiatric medications in utero. Child Adolesc Psychiatr Clin N Am 1999; 8(4): 845–67

    PubMed  CAS  Google Scholar 

  71. Lobstein R, Koren G. Pregnancy outcome and neurodevelopment of children exposed in utero to psychoactive drugs: the Motherisk experience. J Psychiatry Neurosci 1997; 22(3): 192–6

    Google Scholar 

  72. Burch KJ, Wells BG. Fluoxetine/norfluoxetine concentrations in human milk. Pediatrics 1992; 89: 676–7

    PubMed  CAS  Google Scholar 

  73. Yoshida K, Smith B, Kumar C. Fluvoxamine in breast-milk and infant development [letter]. Br J Clin Pharmacol 1997; 44: 210–1

    PubMed  CAS  Google Scholar 

  74. Yoshida K, Smith B, Craggs M, et al. Fluoxetine in breast-milk and developmental outcome of breast-fed infants. Br J Psychiatry 1998; 172: 175–9

    Article  PubMed  CAS  Google Scholar 

  75. Nulman I, Koren G. The safety of fluoxetine during pregnancy. Teratology 1996; 53: 304–8

    Article  PubMed  CAS  Google Scholar 

  76. Nulman I, Rovet J, Stewart DE, et al. Neurodevelopment of children exposed in utero to antidepressant drug. New Engl J Med 1997; 336(4): 258–62

    Article  PubMed  CAS  Google Scholar 

  77. Mattson S, Eastvold A, Jones K, et al. Neurobehavioral follow-up of children prenatally exposed to fluoxetine [Abstract]. Teratology 1999; 59: 376

    Google Scholar 

  78. Morison SJ, Grunau RE, Oberlander TF, et al. Infant social behavior and development in the first year of life following prolonged prenatal psychotropic medication exposure [Abstract]. Pediatr Res 2001; 49 (4 Pt 2 Suppl.): 28A

    Google Scholar 

  79. Nulman I, Rovet J, Stewart DE, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry 2002; 159(11): 1889–95

    Article  PubMed  Google Scholar 

  80. Oberlander TF, Misri S, Fitzgerald CE, et al. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry 2004; 65(2): 230–7

    Article  PubMed  CAS  Google Scholar 

  81. Casper RC, Fleisher BE, Lee-Ancajas JC, et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr 2003; 4: 402–8

    Google Scholar 

  82. Jacobs B, Fornal C. Serotonin and behavior, a general hypothesis. In: Bloom F, Kupfer D, editors. Psychopharmacology, the fourth generation in progress. New York (NY): Raven Press; 1995: 461–9

    Google Scholar 

  83. Mortensen JT, Olsen J, Larsen H, et al. Psychomotor development in children exposed in utero to benzodiazepines, antidepressants, neuroleptics, and anti-epileptics. Eur J Epidemiol 2003; 18: 769–71

    Article  PubMed  CAS  Google Scholar 

  84. Ernst LC, Goldberg JF. The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-spectrum psychotropics. J Clin Psychiatry 2002; 63Suppl. 4: 42–55

    PubMed  CAS  Google Scholar 

  85. Diaz-Hernandez S, de Abajo FJ. Psychomotor development in children and antenatal psychotropic and anti-epileptic drugs. Eur J Epidemiol 2003; 18: 743–4

    Article  Google Scholar 

  86. Cohen L, Altshuler L. Pharmacologic management of psychiatric illness during pregnancy and postpartum period. In: Rosembaum J, editor. Psychiatric clinics of North America: annual of drug therapy. Philadelphia (PA): WB Saunders, 1997: 21–60

    Google Scholar 

  87. Bromiker R, Kaplan M. Apparent intrauterine fetal withdrawal from clorimipramine hydrochloride. JAMA 1994; 272(22): 1722–3

    Article  PubMed  CAS  Google Scholar 

  88. Misri S, Sivertz K. Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psychiatry Med 1991; 21(2): 157–71

    Article  PubMed  CAS  Google Scholar 

  89. Addis A, Impicciatore P, Miglio D, et al. Drug use in pregnancy and lactation: the work of a regional drug information center. Ann Pharmacother 1995; 29(6): 632–3

    PubMed  CAS  Google Scholar 

  90. Wisner K, Perel J, Wheeler S. Tricyclic dose requirements across pregnancy. Am J Psychiatry 1993; 150: 1541–2

    PubMed  CAS  Google Scholar 

  91. Ali S, Buelkesam J, Newport L. Early neurobehavioral and neurochemical alterations in rats prenatally exposed to imipramine. Neurotoxicol 1986; 7: 365–80

    CAS  Google Scholar 

  92. Vorhees C, Brunner R, Butcher R. Psychotropic drugs as behavioral teratogens. Science 1979; 205: 1220–5

    Article  PubMed  CAS  Google Scholar 

  93. Vernadakis A, Parker KK. Drugs and the developing central nervous system. Pharmacol Ther 1980; 11(3): 593–647

    Article  PubMed  CAS  Google Scholar 

  94. Vartazarmian R, Malik S, Baker B, et al. Long-term effects of fluoxetine or vehicle administration during pregnancy on behavioral outcomes in guinea pig offspring. Psychopharmacol. Epub 1994 Sep 10

  95. Cohen L, Rosembaum J. Psychotropic drugs use during pregnancy: weighing the risk. J Clin Psychiatry 1998; 59Suppl. 2: 18–28

    PubMed  Google Scholar 

  96. Koren G, Pastuszak A. Drugs in pregnancy. N Engl J Med 1998; 338(16): 1128–37

    Article  PubMed  CAS  Google Scholar 

  97. Morrison JL, Riggs KW, Chien C, et al. Chronic maternal fluoxetine infusion in pregnant sheep: effects on the maternal and fetal hypothalamic-pituitary-adrenal axes. Pediatr Res. Epub 2004 May 5

  98. Xu Y, Sari Y, Zhou FC. Selective serotonin reuptake inhibitor disrupts organization of thalamocortical somatosensory barrels during development. Brain Res Dev Brain Res 2004; 150(2): 151–61

    Article  PubMed  CAS  Google Scholar 

  99. Misri S, Kostaras X. Benefits and risks to mother and infant of drug treatment for postnatal depression. Drug Saf 2002; 25(13): 903–11

    Article  PubMed  CAS  Google Scholar 

  100. Misri S, Kostaras D, Kostaras X. The use of selective serotonin reuptake inhibitors during pregnancy and lactation: current knowledge. Can J Psychiatry 2000; 45: 285–7

    PubMed  CAS  Google Scholar 

  101. Anderson GM, Czarkowski K, Ravski N, et al. Platelet serotonin in newborns and infants: ontogeny, heritability, and effect of in utero exposure to selective serotonin reuptake inhibitors. Pediatr Res. Epub 2004 Jul 7

  102. Wisner KL, James MS, Perel JM, et al. Antidepressant treatment during breast-feeding. Am J Psychiatry 1996; 153(9): 1132–7

    PubMed  CAS  Google Scholar 

  103. AACAP. Practice parameters for the psychiatric assessment of infant and toddlers (0–36 months). J Am Acad Child Adolesc Psychiatry 1997; 36(10S): S21–36

    Google Scholar 

  104. Meisels SJ, Provence S. Screening and assessment: guidelines for identifying young disabled and developmentally vulnerable children and their families. Washington, DC, 1989: Zero to Three/National Center for Clinical Infants Program

  105. Laing JG, Law J, Levin A, et al. Evaluation of a structured test and a parent led method for screening for speech and language problem: prospective population based study [abstract]. BMJ 325: 1152

  106. Wassemberg R, Max JE, Koele SL, et al. Classifying psychiatric disorders after traumatic brain injury and orthopaedic injury in children: adequacy of K-SADS versus CBCL. Brain Inj 2004; 18(4): 377–90

    Article  Google Scholar 

  107. Dienes KA, Chang KD, Blasey CM, et al. Characterization of children of bipolar parents report CBCL. J Psychiatr Res 2002; 36(5): 337–45

    Article  PubMed  Google Scholar 

  108. Gibbs MV, Reeves D, Cunningham CC. The application of temperament questionnaires to a British sample: issues of reliability and validity. J Child Psychol Psychiatry 1987; 28(1): 61–77

    Article  PubMed  CAS  Google Scholar 

  109. Crowe TK, Deitz JC, Bennett FC. The relationship between the Bayley Scales of Infant Development and preschool gross motor and cognitive performance. Am J Occup Ther 1987; 41(6): 374–8

    Article  PubMed  CAS  Google Scholar 

  110. Leonard CH, Piecuch RE, Cooper BA. Use of Bayley Infant Neurodevelopmental Screener with low birth weight infants. J Pediatr Psychol 2001; 26(1): 33–40

    Article  PubMed  CAS  Google Scholar 

  111. Huber CJ, Stangler SR, Routh DK. The BOEL test as a screening device for otitis media in infants. Nurs Res 1978; 27(3): 178–8

    Article  PubMed  CAS  Google Scholar 

  112. de Vries TW, de Jong-van de Berg LTW, Hoddlers-Algra M. Paroxetine during lactation: is it really safe for the infant? [letter]. Acta Paediatr 2004; 93: 1406–7

    Article  PubMed  Google Scholar 

  113. Sanz EJ, De-las Cuevas C, Kiuru A, et al. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005; 395(9458): 482–7

    Google Scholar 

  114. Ruchkin V, Martin A. SSRIs and the developing brain [comment]. Lancet 2005; 365(9458): 451–3

    PubMed  Google Scholar 

  115. Marcus SM, Flynn HA, Blow F, et al. A screening study of antidepressant treatment rates and mood symptoms in pregnancy. Arch Women Ment Health. Epub 2005 May 4

  116. Misri S, Reebeye P, Corral M, et al. The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: a randomized controlled trial. J Clin Psychiatry 2004; 65(9): 1236–41

    Article  PubMed  CAS  Google Scholar 

  117. Wen W, Walker M. The use of selective serotonin reuptake inhibitors in pregnancy. Obstet Gynaecol Can 2004; 26(9): 819–22

    Google Scholar 

  118. Gupta S, Masand PS, Rangwani S. Selective serotonin reuptake inhibitors in pregnancy and lactation. Obstet Gynecol Surv 1998; 53(12): 733–6

    Article  PubMed  CAS  Google Scholar 

  119. Karla S, Born L, Sarkar M, et al. The safety of antidepressant use in pregnancy. Expert Opin Drug Saf 2005; 4(2): 273–84

    Article  Google Scholar 

  120. Halberg P, Siöblom V. The use of selective serotonin reuptake inhibitors during pregnancy and breastfeeding: a review and clinical aspects. J Clin Psychopharmacol 2005; 25(1): 59–73

    Article  CAS  Google Scholar 

  121. Chisolm CA, Kuller JA. A guide to the safety of CNS-active agents during breastfeeding. Drug Saf 1997; 17(2): 127–42

    Article  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

  1. Department of Mental Health, ASL Salerno 1, Mental Health Center Operative Unit n. 4, Piazza Galdi 84013 Cava de’ Tirreni, Salerno, Italy

    Salvatore Gentile

Authors
  1. Salvatore Gentile
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salvatore Gentile.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gentile, S. SSRIs in Pregnancy and Lactation. CNS Drugs 19, 623–633 (2005). https://doi.org/10.2165/00023210-200519070-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00023210-200519070-00004

Keywords

Search

Navigation