title: The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review.
abstract: OBJECTIVE
  Escitalopram (ESC) is considered one of the most effective selective serotonin reuptake inhibitors for the treatment of major depression. However, little is known on its potential risk of inducing major malformations (MMs) and perinatal complications (PCs). Hence, aim of the present study is to provide a comprehensive review of the available literature on the safety profile of ESC during pregnancy and breastfeeding.
  
  
  METHODS
  MEDLINE and PubMed databases were searched for English language articles by using the following keywords: escitalopram, selective serotonin reuptake inhibitors, major malformations, perinatal complications, pregnancy, and breastfeeding.
  
  
  RESULTS
  Although some cases of MMs have been reported after maternal exposure to ESC during early pregnancy, the rate of these adverse events is substantially in the range of those reported in unexposed women. On the contrary, exposure to ESC seems to be significantly associated with some PCs. No adverse effects have been reported in the few studies evaluating its safety during breastfeeding.
  
  
  CONCLUSIONS
  The available data seem to support the notion that ESC might be considered safe during pregnancy, in particular as far as MMs is concerned. However, similar to other selective serotonin reuptake inhibitors, it could be associated with an increased risk of PCs. Given the paucity of the studies published so far, no definitive conclusions can be drawn on its safety profile during breastfeeding.
authors.affiliation: Psychiatric Unit, United Hospital of Ancona, Ancona, Italy.
authors.forename: Cesario
authors.initials: C
authors.lastname: Bellantuono
authors.forename: Francesca
authors.initials: F
authors.lastname: Bozzi
authors.forename: Laura
authors.initials: L
authors.lastname: Orsolini
authors.forename: Mario
authors.initials: M
authors.lastname: Catena-Dell'Osso
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D001942:Breast Feeding / Q000009:adverse effects; D015283:Citalopram / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors