Neonatal complications after intrauterine exposure to SSRI antidepressants

Abstract

(1) Newborns exposed to selective serotonin reuptake inhibitor (SSRI) antidepressants towards the end of pregnancy sometimes show signs of agitation, altered muscle tone, and breathing and suction problems. Similar symptoms can occur after exposure to tricyclic antidepressants. (2) These neonatal symptoms have been noted with all five SSRI antidepressants available in France, namely citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. (3) An estimated 20% to 30% of newborns exposed to an SSRI towards the end of pregnancy are affected. (4) The symptoms are variously attributed to withdrawal or to the drug itself. (5) In practice, doctors should be aware of this risk when considering antidepressant treatment for women in the third trimester of pregnancy. There is no consensus on the treatment of affected newborns, but close monitoring is mandatory.