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June 17, 1998

Use of Serotonin Reuptake Inhibitors by Women of Childbearing Potential—Reply

Author Affiliations

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


Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;279(23):1873-1874. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-23-jbk0617

In Reply.— We appreciate the work Dr Goldstein1 has published documenting fetal outcome in mothers who were treated with fluoxetine during pregnancy. As we mentioned in a previous letter, a significantly higher rate of first trimester miscarriage was found in women treated with either fluoxetine or a tricyclic antidepressant compared with controls.2 As we noted in our article this increased miscarriage rate may be due to the drug or underlying illness. On the other hand, the work of Goldstein et al supports the probable safety of this compound when used during pregnancy, comforting findings for mothers who must take antidepressant medication. Equally comforting, but not definitive, is a more recent report3 from 7 teratogen centers in North America that found no increased rate of malformations in women who took other serotonin reuptake inhibitors during pregnancy including clomipramine, paroxetine, and sertraline. The availability of these and other data will aid in establishing the relative safety of these agents for treatment of women who require antidepressant medication during pregnancy.

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