American Journal of Obstetrics & Gynecology
Volume 193, Issue 6 , Pages 2004-2009 , December 2005

Citalopram use in pregnancy: Prospective comparative evaluation of pregnancy and fetal outcome

  • Anna Sivojelezova, BSc

      Affiliations

    • The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children
    • Department of Pharmaceutical Sciences, University of Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests: Anna Sivojelezova, BSc, The Motherisk Program, Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
    • ,
  • Samar Shuhaiber, MSc

      Affiliations

    • The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children
    • ,
  • Lorig Sarkissian, BSc

      Affiliations

    • The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children
    • ,
  • Adrienne Einarson, RN

      Affiliations

    • The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children
    • ,
  • Gideon Koren, MD

      Affiliations

    • The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children
    • Department of Pharmaceutical Sciences, University of Toronto, Ontario, Canada

Received 3 February 2005 ,Revised 1 April 2005 ,Accepted 2 May 2005.

References 

  1. Wisner KL, Zarin DA, Holmboe ES, Appelbaum PS, Gelenberg AJ, Leonard HL, et al. Risk-benefit decision for treatment of depression during pregnancy. Am J Psychiatry. 2000;157:1933–1940
  2. Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004;103:698–709
  3. Einarson A, Selby P, Koren G. Abrupt discontinuation of psychotropic drugs due to fears of teratogenic risk and the impact of counseling. J Psychiatry Neurosci. 2001;26:44–48
  4. Michel-Wolfromm H. The psychological factor in spontaneous abortion. J Psychosom Res. 1968;12:67–71
  5. Zax M, Sameroff AJ, Babigian HM. Birth outcomes in the offspring of mentally disordered women. Am J Orthopsychiatry. 1977;47:218–230
  6. Field T, Diego M, Hernandez-Reif M, Salman F, Schanberg S, Kuhn C, et al. Prenatal anger effects on the fetus and neonate. J Obstet Gynaecol. 2002;22:260–266
  7. Hoffman S, Hatch MC. Depressive symptomatology during pregnancy: evidence for an association with decreased fetal growth in pregnancies of lower social class women. Health Psychol. 2000;19:535–543
  8. Preti A, Cardacia L, Zen T, Pellizzari P, Marchetti M, Favaretto G, et al. Obstetric complications in patients with depression: a population-based case-control study. J Affect Disord. 2000;61:101–106
  9. Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C, et al. Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol. 2002;155:293–301
  10. Orr ST, James SA, Blackmore PC. Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol. 2002;156:797–802
  11. Better news on population (notice board). Lancet. 1992;339:16
  12. Willetts J, Lippa A, Beer B. Clinical development of citalopram. J Clin Psychopharmacol. 1999;19(5 Suppl 1):36S–46S
  13. 2004 IMS HEALTH Canada. Treating depression with SSRIs. Available from: http://www.imshealthcanada.com/.htmen/1_0_14.htm (Accessed November 2, 2004).
  14. Celexa product monograph. Montreal: Lundbeck Canada Inc; 1999;
  15. Heikkinen T, Ekblad U, Laine K. Transplacental transfer of citalopram, fluoxetine and their primary metabolites in isolated perfused human placenta. BJOG. 2002;109:1003–1008
  16. Hendrick V, Stowe Z, Altshuler L, Hwang S, Lee E, Haynes D. Placental passage of antidepressant medications. Am J Psychiatry. 2003;160:993–996
  17. Tabacova SA, McCloskey CA, Fisher JE. Adverse developmental events to FDA in association with maternal citalopram treatment in pregnancy. Rockville (MD): Center for Drug Evaluation and Research, U.S. Food and Drug Administration.
  18. Heikkinen T, Ekblad U, Kero P, Ekblad S, Laine K. Citalopram in pregnancy and lactation. Clin Pharmacol Ther. 2002;72:184–191
  19. Hendrick V, Smith LM, Suri R, Hwang S, Haynes D, Altshuler L. Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol. 2003;188:812–815
  20. Ericson A, Kallen B, Wiholm B-E. Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol. 1999;55:503–508
  21. Nulman I, Rovet J, Stewart DE, Wolpin J, Gardner HA, Theis JG, et al. Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med. 1997;336:258–262
  22. Nulman I, Rovet J, Stewart DE, Wolpin J, Pace-Asciak P, Shuhaiber S, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry. 2002;159:1889–1895
  23. Kulin N, Pastusazak A, Sage S, Schick-Boschetto B, Spivey G, Feldkamp M, et al. Pregnancy outcome following maternal use of the new serotonin reuptake inhibitors: a prospective multicenter study. JAMA. 1998;279:609–610
  24. Einarson A, Fatoye B, Sarkar M, Lavigne SV, Brochu J, Chambers C, et al. Pregnancy outcome following gestational exposure to venlafaxine. Am J Psychiatry. 2001;158:1728–1730
  25. Casper RC, Fleisher BG, Lee-Ancajas JC, Gilles A, Gaylor E, DeBattista A, et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr. 2003;142:402–408
  26. Pastuszak A, Schick-Boschetto B, Zuber C, Feldkamp M, Pinelli M, Donnenfeld A, et al. Pregnancy outcome following first trimester exposure to fluoxetine. JAMA. 1993;269:2246–2248
  27. Zuckerman B, Amaro H, Bauchner H, Cabral H. Depressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol. 1989;160(5 Pt 1):1107–1111
  28. Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med. 1996;335:1010–1015
  29. Costei AM, Kozer E, Ho T, Ito S, Koren G. Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med. 2002;156:1129–1132
  30. Källén B. Neonate characteristics after maternal use of antidepressants in late pregnancy. Arch Pediatr Adolesc Med. 2004;158:312–316
  31. Nordeng H, Lindemann R, Perminov KV, Reikvam A. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001;90:288–291
  32. Oberlander TF, Misri S, Fitzgerald CE, Kostaras X, Rurak D, Riggs W. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry. 2004;65:230–237
  33. Markowitz JS, DeVane CL, Liston HL, Montgomery SA. An assessment of selective reuptake inhibitor discontinuation symptoms with citalopram. Int Clin Psychopharmacol. 2000;15:329–333

 Supported in part by the Research Leadership for Better Pharmacotherapy During Pregnancy and Lactation.Gideon Koren is a Senior Scientist of the Canadian Institutes for Health Research and holder of the Ivey Chair in Molecular Toxicology, The University of Western Ontario.

PII: S0002-9378(05)00656-3

doi: 10.1016/j.ajog.2005.05.012

American Journal of Obstetrics & Gynecology
Volume 193, Issue 6 , Pages 2004-2009 , December 2005

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