nach oben

CNS Drugs

Erschienen in:

01.07.2005 | Review Article

SSRIs in Pregnancy and Lactation

Emphasis on Neurodevelopmental Outcome

verfasst von: Dr Salvatore Gentile

Erschienen in: CNS Drugs | Ausgabe 7/2005

Einloggen, um Zugang zu erhalten

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

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.

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

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

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

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

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

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

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

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

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

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): 44–8PubMed

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): 255–8PubMedCrossRef

12.

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

13.

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

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): 285–94PubMedCrossRef

15.

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

16.

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

17.

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

18.

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

19.

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

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

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: 609–10PubMedCrossRef

22.

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

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

25.

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

26.

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

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): 184–91PubMedCrossRef

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): 426ACrossRef

31.

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

32.

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

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

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): 329–34PubMedCrossRef

35.

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

36.

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

37.

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

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): 720–6PubMedCrossRef

39.

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

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): 685–7PubMedCrossRef

41.

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

42.

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

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

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

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

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): 411–25PubMedCrossRef

47.

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

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

49.

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

50.

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

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): e508–11PubMedCrossRef

52.

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

53.

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

54.

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

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): 193–200CrossRef

56.

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

57.

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

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): 1066–78PubMedCrossRef

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): 1228–34PubMedCrossRef

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): 1253–5PubMedCrossRef

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

62.

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

63.

Chambers CD, Anderson PO, Thomas RG, et al. Weight gain in infants breastfed by mothers who take fluoxetine [abstract]. Pediatrics 1999; 104(5): e61PubMedCrossRef

64.

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

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): 218–21PubMedCrossRef

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): 135–9PubMedCrossRef

67.

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

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): 1631–7PubMedCrossRef

69.

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

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): 845–67PubMed

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

72.

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

73.

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

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: 175–9PubMedCrossRef

75.

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

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): 258–62PubMedCrossRef

77.

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

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

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): 1889–95PubMedCrossRef

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): 230–7PubMedCrossRef

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

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

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: 769–71PubMedCrossRef

84.

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

85.

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

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

87.

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

88.

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

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): 632–3PubMed

90.

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

91.

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

92.

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

93.

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

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: 18–28PubMed

96.

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

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): 151–61PubMedCrossRef

99.

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

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: 285–7PubMed

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): 1132–7PubMed

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

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): 377–90CrossRef

107.

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

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): 61–77PubMedCrossRef

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): 374–8PubMedCrossRef

110.

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

111.

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

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: 1406–7PubMedCrossRef

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

114.

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

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): 1236–41PubMedCrossRef

117.

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

118.

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

119.

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

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): 59–73CrossRef

121.

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

Titel: SSRIs in Pregnancy and Lactation
Emphasis on Neurodevelopmental Outcome
verfasst von: Dr Salvatore Gentile
Publikationsdatum: 01.07.2005
Verlag: Springer International Publishing
Erschienen in: CNS Drugs / Ausgabe 7/2005
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI: https://doi.org/10.2165/00023210-200519070-00004

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2005

Rapid Cycling Bipolar Disorder

Cost-Effectiveness Analysis of Rizatriptan and Sumatriptan versus Cafergot® in the Acute Treatment of Migraine

Place of Drug Therapy in the Treatment of Carotid Stenosis