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Thread: Antidepressant Use During Pregnancy Appears Associated with Withdrawal Symptoms in Newborns




Antidepressant Use During Pregnancy Appears Associated with Withdrawal Symptoms in Newborns
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2006-02-17 04:07:44
Antidepressant Use During Pregnancy Appears Associated with Withdrawal
Symptoms in Newborns

CHICAGO, IL -- February 16, 2006 --Almost one-third of 60 newborn
infants whose mothers took antidepressants during pregnancy
experienced neonatal abstinence syndrome, a type of withdrawal with
symptoms that include high-pitched crying, tremors and disturbed
sleep, according to a study in the February issue of Archives of
Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Between one-tenth and one-fourth of women will develop depression in
their lifetimes, according to background information in the article.
The stress of pregnancy can worsen the condition and increase the need
for medications. Selective serotonin reuptake inhibitors (SSRIs) are a
commonly used class of antidepressants; they are known to cross the
placenta, prompting research into their effects on infants.

Rachel Levinson-Castiel, MD, of the Children's Medical Center of
Israel, Petah Tiqwa, and colleagues examined 120 babies born between
Jan. 1, 2002, and Aug. 31, 2004, at Rabin Medical Center in Israel.
Sixty of the infants' mothers took SSRIs for prolonged periods of
time, including during the third trimester. These infants and 60
control infants without exposure to SSRIs were assessed two hours
after birth and again at regular intervals if they displayed
withdrawal symptoms.

Of the 60 infants with exposure to SSRIs, 18 (30%) had neonatal
abstinence syndrome and eight of those cases were severe. The most
common symptoms were tremor, gastrointestinal problems, an abnormal
increase in muscle tone (hypertonicity), sleep disturbances and
high-pitched cries. None of the infants with symptoms required
treatment, and none of the 60 infants without exposure to SSRIs
developed the syndrome.

"The high prevalence of neonatal abstinence syndrome in infants
exposed to SSRIs in utero should be brought to the attention of family
physicians, psychiatrists, gynecologists, pediatricians and mothers,"
the authors write. "Because maternal depression during pregnancy also
entails a risk to the newborn, the risk-benefit ratio of continuing
SSRI treatment should be assessed." If a mother and physician decide
medication is necessary, she should be prescribed the minimum dose and
number of drugs that would be effective for her condition.

In addition, the authors conclude, the infants of mothers taking SSRIs
should be monitored closely after birth for a minimum of 48 hours
"Follow-up of exposed infants, particularly those who develop severe
symptoms, is needed to assess the long-term effects of prolonged
exposure to SSRIs."

Arch Pediatr Adolesc Med. 2006;160:173-176.


SOURCE: American Medical Association



--
Regards,
Catherine
"Life is not an exact
science, it is an art."
-- Samuel Butler --
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