title: Selective serotonin reuptake inhibitors for depression in pregnancy.
abstract: Perinatal depression is associated with a high risk of morbidity and mortality and may have long-term consequences on child development. The US Preventive Services Task Force has recently recognized the importance of identifying and treating women with depression in the perinatal period. However, screening and accessing appropriate treatment come with logistical challenges. In many areas, there may not be sufficient access to psychiatric care, and, until these resources develop, the burden may inadvertently fall on obstetricians. As a result, understanding the risks of perinatal depression in comparison with the risks of treatment is important. Many studies of selective serotonin reuptake inhibitors in pregnancy fail to control for underlying depressive illness, which can lead to misinterpretation of selective serotonin reuptake inhibitor risk by clinicians. This review discusses the risks and benefits of selective serotonin reuptake inhibitor treatment in pregnancy within the context of perinatal depression. Whereas selective serotonin reuptake inhibitors may be associated with certain risks, the absolute risks are low and may be outweighed by the risks of untreated depression for many women and their offspring.
authors.affiliation: Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell Medical College. Electronic address: lcs7001@med.cornell.edu.
authors.forename: Leah C
authors.initials: LC
authors.lastname: Susser
authors.affiliation: Department of OBGYN, University of Pennsylvania Health System.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Sansone
authors.affiliation: Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell Medical College.
authors.forename: Alison D
authors.initials: AD
authors.lastname: Hermann
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000013:Congenital Abnormalities / Q000453:epidemiology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: antenatal depression; antenatal exposure to antidepressant; antenatal exposure to selective serotonin reuptake inhibitor; antidepressant; collaborative care; depression in pregnancy; in utero exposure to antidepressant; in utero exposure to selective serotonin reuptake inhibitor; perinatal depression; selective serotonin reuptake inhibitor