Fluoxetine pregnancy

An open-label study of paroxetine and fluoxetine (Alonso et al, 1997) in depressed Hispanic (Mexican descent, n = 13) and non-Hispanic females (n = 13) showed no differences in response rates. At variance with the tricyclic data, Hispanic subjects complained of fewer side effects (2.2 2.0 vs. 5.1 2.5 p < 0.005), but twice as many terminated participation prior to study completion due to non-compliance, intolerable side effects or pregnancy. 

Chambers and colleagues (1996) followed 228 women who were either exposed early (first or second trimester) or late (third trimester) in their pregnancy to fluoxetine and compared them to NTECs. There was no increase in the rate of major anomalies in the fluoxetine-exposed groups, although there were a number of differences between the groups. First, there was an increased incidence of three or more minor malformations (defined as having no cosmetic or functional importance) in the fluoxetine-exposed infants compared... 

Pastuszak, A., Schick-Boschetto, B., Zuber, C., Feldkamp, M., Pinelli, M., Sihn, S., Donnefeld, A., McCormack, M., Leen-Mitchell, M., Woodland, C., Gardner, A., Horn, M., and Koren, G. (1993) Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac)./AMA 269 2246-2248. 

Pastuszak A, Schick-Boschetto B, Zuber C, et al. Pregnancy outcome following first trimester exposure to fluoxetine (Prozac). JAMA 1993 269 2246-2248. 

There was no evidence that fluoxetine or other SSRIs caused an increase in intrauterine death, significant birth defects, or growth impairment. Follow-up behavioral studies of infants exposed to SSRIs during pregnancy also showed no difference from controls. In a summary of systematic reviews of the safety of SSRIs in pregnancy and lactation the authors concluded that thus far there is little evidence that SSRIs cause birth defects... 

Fluoxetine can occasionally cause cardiac dysrhythmias in adults, and may have done so in a fetus, whose mother took fluoxetine during pregnancy. 

Fluoxetine-related withdrawal effects have been reported in a neonate whose mother had taken fluoxetine during pregnancy (SEDA-18, 21). 

Abebe-Campino G, Offer D, Stahl B, Merlob P. Cardiac arrhythmia in a newborn infant associated with fluoxetine use during pregnancy. Ann Pharmacother... 

Current patient registries of children whose mothers took fluoxetine during pregnancy do not show adverse consequences... 

Spontaneous rupture of a retroperitoneal aneurysm occurred in a 70-year-old woman who had been taking phentermine hydrochloride, 30 mg/day, for about 1 month (6). Other long-term medications included fluoxetine and amitriptyline, and she had no history of coronary artery disease, hypertension, diabetes, or complications of pregnancy. Although it is plausible that phentermine could have contributed to the ruptured aneurysm, other possibilities should be considered, particularly rupture of an anomalous retroperitoneal blood vessel. 

The SSRIs are contraindicated in patients with ahyjier-sensitivity to tlie dni and during pr nancy. The SSRIs are Pregnancy Category C dru (except for fluoxetine, winch is Pregnancy Cat ory B). SSRIs are used cautiously in patients with diabet mellitus or impaired liver or kidney function and during lactation. 

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