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Pharmacotherapy for Perinatal Depression

LUSSKIN, SHARI I., MD*; KHAN, SABRINA J., MD; ERNST, CARRIE, MD; HABIB, SALLY, MD; FERSH, MADELEINE E., MD§; ALBERTINI, ELIZABETH S., MD

Clinical Obstetrics and Gynecology: September 2018 - Volume 61 - Issue 3 - p 544–561
doi: 10.1097/GRF.0000000000000365
Depression in the Pregnant Patient

Perinatal depression is associated with serious risks for the mother, baby, and family. When considering treating perinatal depression with a drug indicated for the treatment of depression, the major concerns are whether the drug increases the risks of teratogenicity, pregnancy complications, poor neonatal adaptation, or neurodevelopmental disorders. Although different studies have produced different results, the majority have not shown increases in risk for selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, or the noradrenergic/dopaminergic drug bupropion. In this review we will discuss the reproductive safety data for these medications as well as monoamine oxidase inhibitors and benzodiazepines.

*Departments of Psychiatry, Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai

Department of Psychiatry, New York University School of Medicine

§Department of Psychiatry, Icahn Medical School at Mount Sinai, New York

Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York

S.I.L. is the Director of Psychopharmacologic Agents for the Reproductive Toxicology Center, A Non-Profit Foundation, and is a consultant to Pfizer regarding sertraline and venlafaxine litigation and to Forest regarding escitalopram litigation. The remaining authors declare that they have nothing to disclose.

Correspondence: Shari I. Lusskin, MD, 161 Madison Avenue, Suite 10NW, New York, NY. E-mail: shari.lusskin@mssm.edu

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.