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Prophylactic SSRI treatment for women suffering from mood and anxiety symptoms undergoing in vitro fertilization—a prospective placebo-controlled study

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Abstract

To explore the mood protective effect of prophylactic SSRI treatment on women undergoing IVF suffering from moderate affective and anxiety symptoms. In a randomized double blind, placebo-controlled, parallel design study, 41 women diagnosed with an Adjustment Disorder, who were undergoing IVF treatments, were randomized into two groups; a study group (n = 22) administered escitalopram 10 mg/day, and a control group (n = 19) administered placebo for a total of 8 weeks before and during the IVF treatment cycle. Patients were assessed at the onset of drug treatment and at embryo transfer. The main outcome measure was the difference in mean score severity rating of depression and anxiety symptoms on the CES-D and Zung questionnaires between groups at the time of embryo transfer. Secondary outcome measures included the MHI rating subscales addressing aspects of psychological distress and coping. At the day of embryo transfer (6 weeks of drug treatment), the CES-D average score for the treatment group was 6.40 (6.71) and 27.47 (4.29) on the Zung Self-Rating Anxiety Scale, while the placebo group scored an average of 15.83 (8.69) and 33.17 (6.95) receptively. These findings were significant (p = .004, p = .015 receptively) and were endorsed by the scoring on the MHI questionnaire subscales. Short-term treatment with SSRI may serve as a prophylactic treatment against the perpetuation and possible worsening of depressive and anxiety symptoms in women undergoing IVF treatments. Further studies concerning pharmacological interventions in larger samples and studies addressing screening for psychological stress indicators in this population are warranted.

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Funding

This work was supported by a grant from (1) The National Institute for Psychobiology in Israel-Founded by The Charles E. Smith Family, Young Investigator Research Grant; and (2) The Dr. Leo Mintz Research Fund in Obstetrics and Gynecology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel.

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Authors and Affiliations

  1. Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel

    Gabi Aisenberg Romano, Inbar Fried Zaig, Anat Halevy & Miki Bloch

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel

    Gabi Aisenberg Romano, Foad Azem, Ami Amit & Miki Bloch

  3. IVF Unit, Lis Women′s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel

    Foad Azem & Ami Amit

Authors
  1. Gabi Aisenberg Romano
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  2. Inbar Fried Zaig
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  3. Anat Halevy
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  4. Foad Azem
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  5. Ami Amit
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  6. Miki Bloch
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Corresponding author

Correspondence to Gabi Aisenberg Romano.

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All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Aisenberg Romano, G., Fried Zaig, I., Halevy, A. et al. Prophylactic SSRI treatment for women suffering from mood and anxiety symptoms undergoing in vitro fertilization—a prospective placebo-controlled study. Arch Womens Ment Health 22, 503–510 (2019). https://doi.org/10.1007/s00737-018-0911-5

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  • DOI: https://doi.org/10.1007/s00737-018-0911-5

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