The Source: Archives of Pediatric & Adolescent Medicine

The Study: Do Zoloft, Paxil, Prozac and other antidepressant drugs taken by pregnant women cause withdrawal symptoms in their newborn babies? That's the question Dr. Rachel Levison-Castiel of the Children's Medical Center of Israel and her colleagues set out to answer. It's a pressing issue because women are particularly vulnerable to depression, especially during and after the stress of pregnancy, and the most popular antidepressants—the so-called selective serotonin reuptake inhibitors (SSRIs)—are known to cross the placenta.

The researchers examined 120 babies born at Israel's Rabin Medical Center between January 2002 and August 2004, half of whom had been exposed to SSRIs in the womb for many months, including the last trimester. Of those 60 infants, 30% showed symptoms of withdrawal, including tremors, muscle clenching, gastrointestinal distress, disturbed sleep and high-pitched crying. Eight of the babies had symptoms described as "severe."

None of the 60 infants who weren't exposed to SSRIs in the womb were affected.

What It Means: Nobody is suggesting that antidepressants are in a class with alcohol and tobacco—drugs that all pregnant women should avoid. Severe depression doesn't do mothers—or their babies—any good, and should not be left untreated.

What the authors do suggest is that everybody involved in a pregnancy—family doctors, psychiatrists, gynecologists, pediatricians and mothers (and presumably fathers too)—should be aware of the risks. If a woman and her doctors decide that medication is necessary, they might consider reducing her dosage or changing her drug regimen, although that could spark a relapse.

In any event, babies exposed to SSRIs should be closely monitored for at least 48 hours after delivery.

Will these babies suffer in the long run? Nobody knows for sure. As the authors conclude: "Follow-up of exposed infants, particularly those who develop severe symptoms, is needed to assess the long-term effects of prolonged exposure to SSRIs."

—By Philip Elmer-DeWitt

From Our Archive: 
02/01/2006 Pregnancy Doesn't Cure Depression
12/20/2004 Drug Withdrawal
02/09/2004 Prescription For Suicide?