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 antidepressant exposures involves fluoxetine. Neither retrospective nor prospective studies have found a greater risk of miscarriage or major congenital malformations with antidepressant treatment. Third-trimester use of fluoxetine has been linked with higher rates of perinatal complications (e.g., tachypnea, jitteriness, premature delivery) in some, but not all, studies. A study of 226 prenatal exposures to sertraline, paroxetine, and fluvoxamine found the rates of major malformations and preterm labor were no higher than those of nonexposed comparison subjects. A prospective study that used the Swedish Birth Registry reported 969 cases of prenatal exposure to antidepressants, including citalopram (375 cases), paroxetine (122 cases), sertraline (33 cases), and fluoxetine (16 cases) and reported rates of perinatal complications and congenital malformations comparable to population norms. Among 150 women who took venlafaxine during pregnancy, the incidence of major malformations was no higher than 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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