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Letters
June 17, 1998

Risk of Fetal Anomalies With Exposure to Selective Serotonin Reuptake Inhibitors—Reply

Author Affiliations
 

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(23):1873. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-23-jbk0617

In Reply.— In response to Dr Grush's concern about the extent of SSRI exposure, all 267 women in the study took SSRIs during embryogenesis. All 3 drugs we studied interact with the same neurotransmitters, and it makes biological sense to combine them. With the availability of larger sample sizes in the future, it will be possible to achieve enough power for each drug separately.

Dr Witlin asserts that women who call teratogen information services represent those with milder forms of depression. This does not hold true based on our recent studies in which depression was quantified.1 Moreover, because the study aimed at assessing the effects of the drugs, milder depression, even if it exists, is not necessarily a "skew" but rather occurs in a group with fewer confounding factors.

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