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Neonatal withdrawal syndrome after
in utero exposure to selective serotonin reuptake
inhibitors.
Nordeng H, Lindemann R, Perminov KV,
Reikvam A.
Department of Pharmacotherapeutics, University of
Oslo, Oslo, Norway. h.m.e.nordeng@farmasi.uio.no
Selective
serotonin reuptake inhibitors (SSRIs) are a new group of antidepressants
used in mild to moderate cases of depression. In studies evaluating the
safety of SSRIs during pregnancy, no increase in major anomalies has
been reported. This might have led to increasing off-label prescription
of SSRIs to pregnant women. Neonatal withdrawal syndrome commonly occurs
in infants exposed during the third trimester to drugs known to cause
addiction. We report five cases of neonatal withdrawal syndrome after
third trimester in utero SSRI exposure. In three cases the mother used
paroxetine in doses from 10 to 40 mg, one mother used citalopram 30 mg,
and one mother fluoxetine 20 mg. Withdrawal symptoms occurred within few
days after birth and lasted up to one month after birth. Four of the
infants needed treatment with chlorpromazine. Symptoms were
irritability, constant crying, shivering, increased tonus, eating and
sleeping difficulties and convulsions. CONCLUSION: Neonatal withdrawal
syndrome can occur after third trimester in utero SSRI exposure. Further
research should focus on whether it is safe to use SSRIs during the last
trimester. All neonates exposed to SSRIs during the last trimester
should be followed-up closely for withdrawal symptoms after
birth.
Publication Types:
PMID: 11332169 [PubMed - indexed for
MEDLINE]
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