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More Information on Antidepressants and Pregnancy
> 12/8/2005 9:36:30 PM

An excellent review article summarizes the studies that existed prior to the two studies cited in the FDA warning.
"The largest amount of information on prenatal antidepressantexposures involves fluoxetine. Neither retrospective nor prospectivestudies have found a greater risk of miscarriage or major congenitalmalformations with antidepressant treatment. Third-trimesteruse of fluoxetine has been linked with higher rates of perinatalcomplications (e.g., tachypnea, jitteriness, premature delivery)in some, but not all, studies. A study of226 prenatal exposures to sertraline, paroxetine, and fluvoxamine found the rates of major malformations and preterm laborwere no higher than those of nonexposed comparison subjects.A prospective study that used the Swedish Birth Registryreported 969 cases of prenatal exposure to antidepressants,including citalopram (375 cases), paroxetine (122 cases), sertraline(33 cases), and fluoxetine (16 cases) and reported rates ofperinatal complications and congenital malformations comparableto population norms. Among 150 women who took venlafaxine duringpregnancy, the incidence of major malformations was no higherthan the expected rate of 1%�3%."

The Experts Consensus Guideline Series for Treatment of Depression in Women 2001 has recommendations for treatment of depression in pregnant women. These are consensus recommendations and generally reflect careful usage of antidepressants even in woman with a severe recurrent history of depression. These recommendations are worth reading if you are thinking of getting pregnant and are taking antidepressants.

We have tried to provide vital information about this complicated area and hope you exercise caution in your decision making.

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