[Neonatal withdrawal syndrome to selective serotonin reuptake inhibitors: case report and literature review].
BACKGROUND
The treatment with selective serotonin reuptake inhibitors (SSRIs) is widely prescribed in pregnant women. Its gestational use is not associated with an increased risk of major foetal anomalies when used in their recommended doses. A SSRI-related neonatal syndrome has been described secondary to withdrawal in infants exposed to these drugs during the last trimester of pregnancy. However, little is known about neonatal psychopharmacology.


METHODS
An infant whose mother received treatment with paroxetine (20 mg/kg/day) during the third trimester was born prematurely and presented withdrawal symptoms within few days after birth. Symptoms were irritability with constant crying, shivering, increased muscle tone, coreiform movements and feeding problems. Only supportive care was needed and symptoms disappeared by two weeks of age.


CONCLUSIONS
In utero exposure to SSRIs during the last trimester through delivery may result in a self-limited neonatal behavioural syndrome that can be managed with supportive care. Its increasing incidence in neonates may be due to a greater frequency of its gestational use. All these neonates should be followed-up closely looking forward withdrawal symptoms in the first days of life. We need a better understanding of SSRIs effects and pharmacokinetics, and further research should focus on whether it is safe to use SSRIs during the last trimester.
Agut-Quijano
T
T
Servicio de Neonatología y Pediatría, SCIAS, Hospital de Barcelona, Grup Assistència, España. tagut@hsjdbcn.org
Martínez-Nadal
S
S
Elizari-Saco
M J
MJ
Sala-Castellví
P
P
Vila-Cerén
C
C
Raspall-Torrent
F
F
D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009357:Neonatal Abstinence Syndrome; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011297:Prenatal Exposure Delayed Effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000378:metabolism*
D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors