Alert over taking Prozac during pregnancy

Women who use Prozac and similar anti-depressants during pregnancy and breastfeeding could expose their babies to withdrawal and toxic effects, a federal government drugs watchdog has warned.

The Adverse Drug Reactions Advisory Committee says it has received 26 reports of infants with withdrawal symptoms.

The effects were attributable to mothers taking the selective serotonin reuptake inhibitor (SSRI) drugs Aropax, Zoloft, Prozac and citalopram. The babies' symptoms included agitation, poor feeding, stomach upsets, convulsions, tremors, fever and respiratory disorders. They began within the first four days of birth and lasted two to three days.

There were also 13 reports of adverse effects probably resulting from the transfer of SSRIs from breastmilk to the baby.

Many of the symptoms of toxicity were similar to those of withdrawal but in two cases involved babies sleeping for prolonged periods.

The watchdog's August bulletin quoted a study published in the Archives of Paediatric Medicine which found that almost one quarter (22 per cent) of newborns who were exposed to paroxetine (marketed in Australia as Aropax) from their mother in the third trimester needed prolonged hospitalisation associated with neonatal complications.

The committee recommends the lowest dosage of the drugs be used during pregnancy and that mothers should consider not breastfeeding.

"It is probable that neonatal withdrawal effects would be minimised by using the lowest effective maternal dose," it advises.

"Breastmilk transfer can be treated by stopping or reducing the dose of SSRIs or by using formula milk."

AAP