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Pharmacopsychiatry 2009; 42(3): 95-100
DOI: 10.1055/s-0028-1103296
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Placental Transfer of SSRI and SNRI Antidepressants and Effects on the Neonate

J. Rampono 1 , K. Simmer 2 , 3 , K. F. Ilett 4 , 5 , L. P. Hackett 5 , D. A. Doherty 3 , R. Elliot 2 , C. H. Kok 2 , A. Coenen 6 , T. Forman 2
  • 1Department of Psychological Medicine, King Edward Memorial Hospital for Women, Subiaco, Australia
  • 2Neonatology Clinical Care Unit, King Edward Memorial Hospital for Women, Subiaco, Australia
  • 3School of Women's and Infants’ Health, University of Western Australia, Crawley, Australia
  • 4Pharmacology and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia
  • 5Clinical Pharmacology and Toxicology Laboratory, Path West Laboratory Medicine, Nedlands, Australia
  • 6Department of Physiotherapy, King Edward Memorial Hospital for Women, Subiaco, Australia
Further Information

Publication History

received 28.08.2008 revised 15.10.2008

accepted 20.10.2008

Publication Date:
18 May 2009 (online)

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Abstract

Introduction: We investigated placental transfer and neurobehavioural effects in neonates exposed to citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine or sertraline (SSRI's), or to venlafaxine (an SNRI).

Methods: Women receiving antidepressants during pregnancy and their neonates were studied. Cord and maternal drug concentrations were measured at birth and in the neonates plasma on day 3. Neonates were also assessed using a range of neurobehavioral tests and compared to controls.

Results: Median cord/maternal distribution ratio was 0.7–0.86 (range) for SSRIs, 0.72 for the SNRI venlafaxine and 1.08 for the O-desmethyl metabolite. Neonatal abstinence scores were significantly higher (p<0.05) in exposed infants than controls on day 1. Brazelton scores for habituation, social-interactive, motor and autonomic clusters, and serotonin scores were significantly greater (p<0.05) in exposed infants.

Discussion: Transfer of SSRIs and SNRIs across the placenta was substantial. Neonates developed mild behavioral symptoms in the early perinatal period but these were self-limiting and similar for both SSRIs and the SNRI venlafaxine.

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1 Previous presentation: An abstract of this manuscript was presented as a poster at the 12th Annual Congress of The Perinatal Society of Australia and New Zealand (PSANZ08), 20 to 23 April 2008, Gold Coast Convention and Exhibition Centre, Queensland, Australia.

Correspondence

E/Prof K. F. Ilett

Pharmacology & Anaesthesiology Unit

School of Medicine and Pharmacology

M510

University of Western Australia

6009 Crawley

Western Australia

Phone: +61/8/9346 29 85

Fax: +61/8/9346 34 69

Email: Ken.Ilett@uwa.edu.au

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