Skip to main content
Log in

Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy

  • Review Article
  • Published:
CNS Drugs Aims and scope Submit manuscript

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly used medications, with a prescription frequency of 2.3% in pregnant women. Although most babies born to women who take SSRIs during pregnancy are normal, there is accumulating evidence that maternal SSRI treatment during pregnancy may cause adverse reproductive outcomes. Maternal SSRI treatment during the first trimester has been implicated in increased risks of birth defects, specifically cardiac abnormalities, in the infant, whereas third-trimester treatment has been linked to various neonatal complications, including symptoms of neonatal withdrawal and toxicity, prematurity, low birth weight and persistent pulmonary hypertension of the newborn. Although data on neurobehavioural and long-term cognitive problems among children of women who were treated with SSRIs during pregnancy remain limited, the possibility of such functional abnormalities is an additional concern.

On the other hand, untreated maternal depression also carries serious risks for both the mother and the baby, and SSRIs are one of the best available treatments. Thus, pregnant women who require treatment for depression and their physicians often face a difficult choice regarding the use of SSRIs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II

Similar content being viewed by others

References

  1. Wisner KL, Gelenberg AJ, Leonard H, et al. Pharmacologic treatment of depression during pregnancy. JAMA 1999; 282: 1264–9

    Article  PubMed  CAS  Google Scholar 

  2. Ryan D, Milis L, Misri N. Depression during pregnancy. Can Fam Physician 2005 Aug; 51: 1087–93

    PubMed  Google Scholar 

  3. Wadhwa PD, Sandman CA, Porto M, et al. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol 1993; 169: 858–65

    PubMed  CAS  Google Scholar 

  4. Chung TK, Lau TK, Yip AS, et al. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 2001; 63(5): 830–4

    PubMed  CAS  Google Scholar 

  5. Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol 2008; 51(2): 333–48

    Article  PubMed  Google Scholar 

  6. Moses-Kolko EL, Roth EK. Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Womens Assoc 2004; 59(3): 181–91

    PubMed  Google Scholar 

  7. Mann JJ. The medical management of depression. N Engl J Med 2005; 353: 1819–34

    Article  PubMed  CAS  Google Scholar 

  8. Reefhuis J, Rasmussen SA, Friedman JM. Selective serotonin-reuptake inhibitors and persistent pulmonary hypertension of the newborn. N Engl J Med 2006; 354: 2188–90

    Article  PubMed  CAS  Google Scholar 

  9. Preskorn SH. Antidepressant drug selection: criteria and options. J Clin Psychiatry 1994; 55 Suppl. A: 6–22

    PubMed  Google Scholar 

  10. Morrison JL, Riggs KW, Rurak DW. Fluoxetine during pregnancy: impact on fetal development. Reprod Fertil Dev 2005; 17(6): 641–50

    Article  PubMed  CAS  Google Scholar 

  11. Hiemke C, Hartter S. Pharmacokinetics of selective serotonin reuptake inhibitors. Pharmacol Ther 2000; 85: 11–28

    Article  PubMed  CAS  Google Scholar 

  12. US Food Drug Administration. FDA Public Health Advisory: paroxetine 2005 [online]. Available from URL: http://www.fda.gov/cder/drug/advisory/paroxetine200512.htm [Accessed 2008 Jan 18]

  13. Kallen B, Otterblad Olausson P. Antidepressant drugs during pregnancy and infant congenital heart defect. Reprod Toxicol 2006; 21: 221–2

    Article  PubMed  Google Scholar 

  14. Cole JA, Ephross SA, Cosmatos IS, et al. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf 2007; 16(10): 1075–85

    Article  PubMed  Google Scholar 

  15. US Food Drug Administration. FDA Public Health Advisory: treatment challenges of depression in pregnancy and the possibility of persistent pulmonary hypertension in newborns 2006 [online]. Available from URL: http://www.fda.gov/cder/drug/advisory/SSRI_PPHN200607.htm [Accessed 2008 Jan 18]

  16. Pastuszak A, Schick-Boschetto B, Zuber C, et al. Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac). JAMA 1993; 269: 2246–8

    Article  PubMed  CAS  Google Scholar 

  17. Chambers CD, Johnson KA, Dick LM, et al. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 1996; 335: 1010–5

    Article  PubMed  CAS  Google Scholar 

  18. Kulin NA, Pastuszak A, Sage SR, et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA 1998; 279: 609–10

    Article  PubMed  CAS  Google Scholar 

  19. Diav-Citrin O, Shechtman S, Weinbaum D, et al. Paroxetine and fluoxetine in pregnancy: a prospective, multicenter, controlled, observational study. Br J Clin Pharmacol 2008; 66(5): 695–705

    PubMed  CAS  Google Scholar 

  20. Davis RL, Rubanowice D, McPhillips H, et al. Risks of congenital malformations and perinatal events among infants exposed to antidepressant medications during pregnancy: HMO Research Network Center for Education, Research in Therapeutics. Pharmacoepidemiol Drug Saf 2007; 16(10): 1086–94

    Article  PubMed  Google Scholar 

  21. Simon GE, Cunningham ML, Davis RL. Outcomes of prenatal antidepressant exposure. Am J Psychiatry 2002; 159: 2055–61

    Article  PubMed  Google Scholar 

  22. Wogelius P, Norgaard M, Gislum M, et al. Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology 2006; 17(6): 701–4

    Article  PubMed  Google Scholar 

  23. Wen SW, Yang Q, Garner P, et al. Selective serotonin reuptake inhibitors and adverse pregnancy outcomes. Am J Obstet Gynecol 2006 Apr; 194(4): 961–6

    Article  PubMed  CAS  Google Scholar 

  24. Källén BA, Otterblad Olausson P. Maternal use of selective serotonin re-uptake inhibitors in early pregnancy and infant congenital malformations. Birth Defects Res A 2007; 79(4): 301–8

    Article  Google Scholar 

  25. Malm H, Klaukka T, Neuvonen PJ. Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 2005; 106: 1289–96

    Article  PubMed  CAS  Google Scholar 

  26. Berard A, Ramos E, Rey E, et al. First trimester exposure to paroxetine and risk of cardiac malformations in infants: the importance of dosage. Birth Defects Res B Dev Reprod Toxicol 2007; 80(1): 18–27

    Article  PubMed  CAS  Google Scholar 

  27. Alwan S, Reefhuis J, Rasmussen SA, et al. Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects: National Birth Defects Prevention Study. N Engl J Med 2007; 256(26): 2684–92

    Article  Google Scholar 

  28. Louik C, Lin AE, Werler MM, et al. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med 2007; 356(26): 2675–83

    Article  PubMed  CAS  Google Scholar 

  29. Oberlander TF, Warburton W, Misri S, et al. Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population-based health data. Birth Defects Res B 2008; 83: 68–76

    Article  CAS  Google Scholar 

  30. Ramos E, St-Andre M, Rey E, et al. Duration of antidepressant use during pregnancy and risk of major congenital malformations. Br J Psychiatry 2008; 192: 344–50

    Article  PubMed  Google Scholar 

  31. Wichman CL, Moore KM, Lang TR, et al. Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc 2009; 84(1): 23–7

    Article  PubMed  Google Scholar 

  32. Ericson A, Kallen B, Wiholm B. Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol 1999; 55: 503–8

    Article  PubMed  CAS  Google Scholar 

  33. Kallen B. Fluoxetine use in early pregnancy. Birth Defects Res B 2004; 71: 395–6

    Article  Google Scholar 

  34. Daniel WA. Mechanisms of cellular distribution of psychotropic drugs: significance for drug action and interactions. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27: 65–73

    Article  PubMed  CAS  Google Scholar 

  35. Hansen D, Lou HC, Olsen J. Serious life events and congenital malformations: a national study with complete follow-up. Lancet 2000; 356(9233): 875–80

    Article  PubMed  CAS  Google Scholar 

  36. Carmichael SL, Shaw GM. Maternal life event stress and congenital anomalies. Epidemiology 2000 Jan; 11(1): 30–5

    Article  PubMed  CAS  Google Scholar 

  37. Nimby GT, Lundberg L, Sveger T, et al. Maternal distress and congenital malformations: do mothers of malformed fetuses have more problems? J Psychiatr Res 1999 Jul–Aug; 33(4): 291–301

    Article  PubMed  CAS  Google Scholar 

  38. Bar-Oz B, Einarson T, Einarson A, et al. Paroxetine and congenital malformations: meta-analysis and consideration of potential confounding factors. Clin Ther 2007; 29(5): 918–26

    Article  PubMed  CAS  Google Scholar 

  39. Bellantuono C, Migliarese G, Gentile S. Serotonin reuptake inhibitors in pregnancy and the risk of major malformations: a systematic review. Hum Psychopharmacol 2007; 22(3): 121–8

    Article  PubMed  Google Scholar 

  40. Greene MF. Teratogenicity of SSRIs: serious concern or much ado about little? N Engl J Med 2007 Jun; 356(26): 2732–3

    Article  PubMed  CAS  Google Scholar 

  41. Diav-Citrin O, Shechtman S, Weinbaum D. Pregnancy outcome after gestational exposure to paroxetine: a prospective controlled study cohort. Teratology 2002; 65(6): 298

    Google Scholar 

  42. Rahimi R, Nikfar S, Abdollahi M. Pregnancy outcomes following exposure to serotonin reuptake inhibitors: a meta-analysis of clinical trials. Reprod Toxicol 2006 May; 22(4): 571–5

    Article  PubMed  CAS  Google Scholar 

  43. Hemels ME, Einarson A, Koren G, et al. Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother 2005 Mar; 39(5): 803–9

    Article  PubMed  Google Scholar 

  44. Costei AM, Kozer E, Ho T, et al. Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med 2002; 156(11): 1129–32

    Article  PubMed  Google Scholar 

  45. Oberlander TF, Warburton W, Misri S, et al. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiatry 2006 Aug; 63(8): 898–906

    Article  PubMed  Google Scholar 

  46. Kallen B. Neonate characteristics after maternal use of anti-depressants in late pregnancy. Arch Pediatr Adolesc Med 2004; 158: 307–8

    Article  Google Scholar 

  47. Casper RC, Fleisher BE, Lee-Ancajas JC, et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr 2003; 142(4): 402–8

    Article  PubMed  CAS  Google Scholar 

  48. Cohen LS, Heller VL, Bailey JW, et al. Birth outcomes following prenatal exposure to fluoxetine. Biol Psychiatry 2000; 48(10): 996–1000

    Article  PubMed  CAS  Google Scholar 

  49. Laine K, Heikkinin T, Ekblad U, et al. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry 2003; 60(7): 720–6

    Article  PubMed  CAS  Google Scholar 

  50. Oberlander TF, Misri S, Fitzgerald CE, et al. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry 2004; 65(2): 230–7

    Article  PubMed  CAS  Google Scholar 

  51. Moses-Kolko EL, Bogen D, Perel J, et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 2005; 293(19): 2372–83

    Article  PubMed  CAS  Google Scholar 

  52. Levinson-Castiel R, Merlob P, Linder N, et al. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 2006 Feb; 160(2): 173–6

    Article  PubMed  Google Scholar 

  53. Austin MP. To treat or not to treat: maternal depression, SSRI use in pregnancy and adverse neonatal effects. Psychol Med 2006 Dec; 36(12): 1663–70

    Article  PubMed  Google Scholar 

  54. Oberlander TF, Warburton W, Misri S, et al. Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: population-based study. Br J Psychiatry 2008; 192: 338–43

    Article  PubMed  Google Scholar 

  55. Isbister GK, Dawson A, Whyte IM, et al. Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome? Arch Dis Child Fetal Neonatal Ed 2001 Sep; 85(2): F147–8

    Article  PubMed  CAS  Google Scholar 

  56. Haddad PM. Antidepressant discontinuation syndromes. Drug Saf 2001; 24(3): 183–97

    Article  PubMed  CAS  Google Scholar 

  57. Coupland NJ, Bell CJ, Potokar JP. Serotonin reuptake inhibitor withdrawal. J Clin Psychopharmacol 1996 Oct; 16(5): 356–62

    Article  PubMed  CAS  Google Scholar 

  58. Sistonen J, Sajantila A, Lao O, et al. CYP2D6 worldwide genetic variation shows high frequency of altered activity variants and no continental structure. Pharmacogenet Genomics 2007; 17(2): 93–101

    PubMed  CAS  Google Scholar 

  59. Miksys S, Rao Y, Hoffmann E, et al. Regional and cellular expression of CYP2D6 in human brain: higher levels in alcoholics. J Neurochem 2002 Sep; 82(6): 1376–87

    Article  PubMed  CAS  Google Scholar 

  60. Laine K, Kytölä J, Bertilsson L. Severe adverse effects in a newborn with two defective CYP2D6 alleles after exposure to paroxetine during late pregnancy. Ther Drug Monit 2004 Dec; 26(6): 685–7

    Article  PubMed  CAS  Google Scholar 

  61. Pollock BG, Ferrell RE, Mulsant BH, et al. Allelic variation in the serotonin transporter promoter affects onset of paroxetine treatment response in late-life depression. Neuropsychopharmacology 2000; 23(5): 587–90

    Article  PubMed  CAS  Google Scholar 

  62. Oberlander TF, Bonaguro RJ, Misri S, et al. Infant serotonin transporter (SLC6A4) promoter genotype is associated with adverse neonatal outcomes after prenatal exposure to serotonin reuptake inhibitor medications. Molecular Psychiatry 2008 May; 13: 65–73

    Article  PubMed  CAS  Google Scholar 

  63. Suri R, Altshuler L, Hellemann G, et al. Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth. Am J Psychiatry 2007 Aug; 164(8): 1206–13

    Article  PubMed  Google Scholar 

  64. Maschi S, Clavenna A, Campi R, et al. Neonatal outcome following pregnancy exposure to antidepressants: a prospective controlled cohort study. BJOG 2008 Jan; 115(2): 283–9

    Article  PubMed  CAS  Google Scholar 

  65. Pearson KH, Nonacs RM, Viguera AC, et al. Birth outcomes following prenatal exposure to antidepressants. J Clin Psychiatry 2007 Aug; 68(8): 1284–9

    Article  PubMed  CAS  Google Scholar 

  66. Hendrick V, Stowe ZN, Altshuler LL, et al. Placental passage of antidepressant medications. Am J Psychiatry 2003; 160: 993–6

    Article  PubMed  Google Scholar 

  67. Chambers CD, Hernandez-Diaz S, Van Marter LJ, et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 2006; 354: 579–87

    Article  PubMed  CAS  Google Scholar 

  68. Kallen B, Olausson PO. Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 2008; 17(8): 801–6

    Article  PubMed  Google Scholar 

  69. Zeskind PS, Stephens LE. Maternal selective serotonin reuptake inhibitor use during pregnancy and newborn neurobehavior. Pediatrics 2004; 113(2): 368–75

    Article  PubMed  Google Scholar 

  70. Oberlander TF, Eckstein Grunau R, Fitzgerald C, et al. Prolonged prenatal psychotropic medication exposure alters neonatal acute pain response. Pediatr Res 2002; 51: 443–53

    Article  PubMed  CAS  Google Scholar 

  71. Oberlander TF, Grunau RE, Fitzgerald C, et al. Pain reactivity in 2-month-old infants after prenatal and postnatal serotonin reuptake inhibitor medication exposure. Pediatrics 2005; 115: 411–25

    Article  PubMed  Google Scholar 

  72. Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome: review of the literature and preliminary findings. Epidemiol Rev 1995; 17: 165–71

    PubMed  CAS  Google Scholar 

  73. Nulman I, Rovet J, Stewart DE, et al. Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 1997; 4: 258–62

    Article  Google Scholar 

  74. Nulman I, Rovet J, Stewart DE, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry 2002; 159(11): 1889–95

    Article  PubMed  Google Scholar 

  75. Heikkinen T, Ekblad U, Kero P, et al. Citalopram in pregnancy and lactation. Clin Pharmacol Ther 2002 Aug; 72(2): 184–91

    Article  PubMed  Google Scholar 

  76. Heikkinen T, Ekblad U, Palo P, et al. Pharmacokinetics of fluoxetine and norfluoxetine in pregnancy and lactation. Clin Pharmacol Ther 2003 Apr; 73(4): 330–7

    Article  PubMed  CAS  Google Scholar 

  77. Misri S, Reebye P, Kendrick K, et al. Internalizing behaviors in 4-year-old children exposed in utero to psychotropic medications. Am J Psychiatry 2006 Jun; 163(6): 1026–32

    Article  PubMed  Google Scholar 

  78. Oberlander TF, Reebye P, Misri S, et al. Externalizing and attentional behaviors in children of depressed mothers treated with a selective serotonin reuptake inhibitor anti-depressant during pregnancy. Arch Pediatr Adolesc Med 2007 Jan; 161(1): 22–9

    Article  PubMed  Google Scholar 

  79. Herlenius E, Lagercrantz H. Neurotransmitters and neuro-modulators during early human development. Early Hum Dev 2001 Oct; 65(1): 21–37

    Article  PubMed  CAS  Google Scholar 

  80. Buznikov GA, Lambert HW, Lauder JM. Serotonin and serotonin-like substances as regulators of early embryogenesis and morphogenesis. Cell Tissue Res 2001; 305: 177–86

    Article  PubMed  CAS  Google Scholar 

  81. Moiseiwitsch JR, Lauder JM. Serotonin regulates mouse cranial neural crest migration. Proc Natl Acad Sci U S A 1995; 92: 7182–6

    Article  PubMed  CAS  Google Scholar 

  82. Yavarone MS, Shuey DL, Tamir H, et al. Serotonin and cardiac morphogenesis in the mouse embryo. Teratology 1993; 47: 573–84

    Article  PubMed  CAS  Google Scholar 

  83. Shuey DL, Sadler TW, Tamir H, et al. Serotonin and morphogenesis: transient expression of serotonin uptake and binding protein during craniofacial morphogenesis in the mouse. Anat Embryol (Berl) 1993; 187: 75–85

    Article  CAS  Google Scholar 

  84. Choi DS, Kellermann O, Richard S, et al. Mouse 5-HT2B receptor-mediated serotonin trophic functions. Ann N Y Acad Sci 1998; 861: 67–73

    Article  PubMed  CAS  Google Scholar 

  85. Sari Y, Zhou FC. Serotonin and its transporter on proliferation of fetal heart cells. Int J Dev Neuroscience 2003; 21: 417–24

    Article  CAS  Google Scholar 

  86. Davies TS, Kluwe WM. Preclinical toxicological evaluation of sertraline hydrochloride. Drug Chem Toxicol 1998; 21: 521–37

    Article  PubMed  CAS  Google Scholar 

  87. Baldwin JA, Davidson EJ, Pritchard AL, et al. The reproductive toxicology of paroxetine. Acta Psychiatr Scand 1989; 80 Suppl. 350: 37–9

    Article  CAS  Google Scholar 

  88. Byrd RA, Markham JK. Developmental toxicology studies of fluoxetine hydrochloride administered orally to rats and rabbits. Fundam Appl Toxicol 1994; 22: 511–8

    Article  PubMed  CAS  Google Scholar 

  89. Stewart JD, Rayburn WF, Gonzalez CL, et al. Impact of antenatal paroxetine (Paxil) exposure on perinatal and neonatal outcomes of mice. Neurotoxicol Teratol 1998; 20(3): 365–6

    Google Scholar 

  90. Vorhees CV, Acuff-Smith KD, Schilling MA, et al. A developmental neurotoxicity evaluation of the effects of prenatal exposure to fluoxetine in rats. Fundam Appl Toxicol 1994 Aug; 23(2): 194–205

    Article  PubMed  CAS  Google Scholar 

  91. Hallberg P, Sjoblom V. The use of selective serotonin reuptake inhibitors during pregnancy and breast-feeding: a review and clinical aspects. J Clin Psychopharmacol 2005; 25: 59–73

    Article  PubMed  CAS  Google Scholar 

  92. Hansson SR, Mezey E, Hoffman BJ. Serotonin transporter messenger RNA expression in neural crest-derived structures and sensory pathways of the developing rat embryo. Neuroscience 1999; 89(1): 243–65

    Article  PubMed  CAS  Google Scholar 

  93. Singh Y, Jaiswal AK, Singh M, et al. Effect of prenatal diazepam, phenobarbital, haloperidol and fluoxetine exposure on foot shock induced aggression in rats. Indian J Exp Biol 1998 Oct; 36(10): 1023–4

    PubMed  CAS  Google Scholar 

  94. Crowley JM, Dopheide M, Countryman RA, et al. Early developmental exposure to fluoxetine (Prozac): enduring effects on learning, memory, and aggression. Neurotoxicol Teratol 2001; 23(3): 289

    Google Scholar 

  95. Coleman FH, Christensen HD, Gonzalez CL, et al. Behavioral changes in developing mice after prenatal exposure to paroxetine (Paxil). Am J Obstet Gynecol 1999 Nov; 181(5 Pt 1): 1166–71

    Article  PubMed  CAS  Google Scholar 

  96. Nonacs R, Cohen LS. Assessment and treatment of depression during pregnancy: an update. Psychiatr Clin North Am 2003; 26: 547–62

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Sura Alwan is the recipient of a predoctoral fellowship from the Child & Family Research Institute. No other sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jan M. Friedman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alwan, S., Friedman, J.M. Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy. CNS Drugs 23, 493–509 (2009). https://doi.org/10.2165/00023210-200923060-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00023210-200923060-00004

Keywords

Navigation