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Antenatal use of antidepressants and risks of teratogenicity and adverse pregnancy outcomes: Drugs other than selective serotonin reuptake inhibitors

Donna Stewart, CM, MD, FRCPC
Simone Vigod, MD, MSc, FRCPC
Section Editors
Peter P Roy-Byrne, MD
Charles J Lockwood, MD, MHCM
Deputy Editor
David Solomon, MD


Pregnant women with psychiatric illnesses are often treated with antidepressant drugs. As an example, studies of pregnant women in Europe have found that antidepressants were used by approximately 3 percent [1-4], and in the United States by 8 percent [5-8]. Compared with selective serotonin reuptake inhibitors (SSRIs), other antidepressants have been used and studied less frequently [1,2,5-12].

Antidepressants cross the placenta and fetal blood brain barrier. Prenatal exposure thus involves potential risks of teratogenesis, preterm birth, low birth weight, and pregnancy complications (eg, spontaneous abortion and postpartum hemorrhage), as well as postnatal effects (eg, persistent pulmonary hypertension of the newborn).

This topic reviews the potential adverse antenatal consequences that may be associated with the use of antidepressant drugs other than SSRIs. The potential adverse effects of using SSRIs during pregnancy, postnatal outcomes among infants exposed in utero to antidepressants, principles of teratology, choice of treatment for depressed pregnant patients, safety of antidepressants in lactating women, and treatment of postpartum depression are discussed separately:

(See "Antenatal use of antidepressants and risk of teratogenicity and adverse pregnancy outcomes: Selective serotonin reuptake inhibitors (SSRIs)".)

(See "Infants with antenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 11, 2017.
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