title: Safety of escitalopram in pregnancy: a case series.
abstract: BACKGROUND
  The aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding.
  
  
  METHODS
  Women enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items) and Hamilton Rating Scale for Anxiety (14 items). Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded.
  
  
  RESULTS
  The case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems.
  
  
  CONCLUSIONS
  Our experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding.
authors.affiliation: Psychiatric Unit and DEGRA Center, United Hospital and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 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
keywords: breastfeeding; escitalopram; major malformations; perinatal complications; pregnancy
references.citation: Birth Defects Res A Clin Mol Teratol. 2007 Apr;79(4):301-8
references.pmid: 17216624
references.citation: Am J Obstet Gynecol. 2008 Nov;199(5):e9-e12
references.pmid: 18984074
references.citation: Obstet Gynecol Int. 2012;2012:698947
references.pmid: 22190957
references.citation: Mol Psychiatry. 2009 Nov;14(11):1051-66
references.pmid: 18427559
references.citation: Paediatr Child Health. 2011 Nov;16(9):562-3
references.pmid: 23115498
references.citation: Gen Hosp Psychiatry. 2009 Sep-Oct;31(5):403-13
references.pmid: 19703633
references.citation: JAMA. 2006 Feb 1;295(5):499-507
references.pmid: 16449615
references.citation: Hum Psychopharmacol. 2012 Nov;27(6):534-9
references.pmid: 23044635
references.citation: Can J Psychiatry. 2009 Apr;54(4):242-6
references.pmid: 19321030
references.citation: J Clin Pharmacol. 2012 May;52(5):766-70
references.pmid: 22075232
references.citation: Int J Psychiatry Med. 2001;31(4):355-65
references.pmid: 11949734
references.citation: Lancet. 2009 Feb 28;373(9665):746-58
references.pmid: 19185342