The Use of Selective Serotonin Reuptake Inhibitors During Pregnancy and Breast-feeding

Abstract

Mood and anxiety disorders are common in women during their childbearing years. The prevalence of depression has been reported to be between 10% and 16% during pregnancy. The use of selective serotonin reuptake inhibitors during pregnancy or lactation is, to date, not promoted because of lack of safety documentation. However, the off-label use of these drugs has been common for several years. In the treatment of mood and anxiety disorders during pregnancy, the serotonin reuptake inhibitors are often preferred over tricyclic antidepressants because of their relatively few adverse effects and safety in overdose. This has created concern among women planning pregnancies and pregnant women, as well as among their families and physicians. Several studies and reports of the use of serotonin reuptake inhibitors during both pregnancy and lactation have been published and advanced our knowledge. We here review and discuss those studies which have been published so far on this subject.

First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: A meta‐analysis of epidemiological studies

“…When there were multiple reports based on the same data source (Ericson et al, 1999;Unfred et al, 2001;Alwan et al, 2005;Diav-Citrin et al, 2005;Hallberg and Sjoblom, 2005;Cole et al, 2006;Kallen and Otterblad, 2006;Oberlander et al, 2007), only the most recent report was included (Alwan et al, 2007;Chambers, 2007;Cole et al, 2007;Kallen and Otterblad, 2007;Diav-Citrin et al, 2008;Oberlander et al, 2008). The only exceptions occurred when two reports from the same data source reported results for different outcomes (combined cardiac and aggregated congenital birth defects); both reports were included (Louik et al, 2006;Louik et al, 2007).…”

Da ópera-bufa ao caos nosológico: pica

“…Coincidentemente, as mesmas medicações indicadas na gestação são aquelas com menor acúmulo de resíduos no leite humano. Paralelamente, as gestantes e lactantes costumam ter uma visão negativa sobre medicação psicotrópica, e o médico deve estar alerta para a possibilidade de fraca adesão e abandono de tratamento [36][37][38] . A terapia comportamental tem sido descrita incluindo técnicas de exposição, manipulação ambiental, vigilância, prevenção de respostas, correção e técnicas aversivas 18,20 .…”

Efficient Genome-wide Association in Biobanks Using Topic Modeling Identifies Multiple Novel Disease Loci

“…Then we test those topics for association with common genetic variation and compare this approach to capture a given diagnosis varies widely, even when diagnosis-specific classifiers are applied to augment single codes (2,3). As such, approaches that focus on individual diagnostic codes are limited by inaccurate, missing or heterogeneous diagnoses; eg, where individuals with cystic fibrosis might be represented by male infertility, diabetes and chronic rhinosinusitis even in the absence of a diagnostic code for cystic fibrosis (4). Second, under conditions of pleiotropy, where a single variant contributes to risk for multiple disorders, as in some autoimmune and neuropsychiatric disorders, standard phenome-wide approaches do not make efficient use of the correlation structure…”