MotherToBaby

Medications and More during pregnancy and breastfeeding

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Paroxetine (Paxil®)

Selected References

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  • Andrade S, et al. 2009. Antidepressant use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 18(3):246-252.
  • Berard A, et al. 2016. The risk of major cardiac malformations associated with paroxetine use during the first trimester of pregnancy: A systematic review and meta-analysis. Br J Clin Pharmacol; 81(4):589-604.
  • Berard A, et al. 2017. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: An updated analysis of the Quebec Pregnancy Cohort. BMJ Open;7:e013372.
  • Bonari L, et al. 2004. Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726-735.
  • Chambers C, et al. 2006. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 354(6)579-587.
  • Costei A, et. al. 2002. Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med 156:1129-1132.
  • Diav-Citrin O, et al. 2008. Paroxetine and fluoxetine in pregnancy: a prospective, multicentre, controlled observational study. Br J Clin Pharmacol 66(5): 695-705.
  • Einarson A, et al. 2008. Evaluation of the risk of congenital cardiovascular defects associated with use of paroxetine during pregnancy. Am J Psychiatry AiA:1-5.
  • Einarson A, et al. 2009. Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. J Obstet Gynaecol Can 31:452-456.
  • Gabriel M & Sharma V. 2017. Antidepressant discontinuation syndrome. CMAJ;189:E747.
  • Gao S, et al. 2018. Selective serotonin reuptake inhibitor use during early pregnancy and congenital malformations: a systematic review and meta-analysis of cohort studies of more than 9 million births. BMC Med. 16:205
  • Grigoriadis S et al. 2013. Antidepressant exposure during pregnancy and congenital malformations: is there an association? A systematic review and meta-analysis of the best evidence.J Clin Psychiatry. 74(4):e293-308.
  • Hansen CH, et al. 2017. The six most widely used selective serotonin reuptake inhibitors decrease androgens and increase estrogens in the H295R cell line. Toxicol In Vitro. 41:1-11
  • Hendrick V, et al. 2001. Use of sertraline, paroxetine and fluvoxamine by nursing women. Br J Psychiatry 179:163-166
  • Hernandez-Diaz S. 2007. Risk factors for persistent pulmonary hypertension of the newborn. Pediatrics 120 (2):e272-282.
  • Jordan S, et al. 2016. Selective serotonin reuptake inhibitor (SSRI) in pregnancy and congenital anomalies: Analysis of linked databases in Wales, Norway and Funen, Denmark. PLOS One; 11(12): e0165122.
  • Kallen B, et al. 2008. Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 17(8):801-806.
  • Kieviet N, et al. 2015. Risk factors for poor neonatal adaptation after exposure to antidepressants in utero. Acta Paediatr.104(4):384-91.
  • Levinson-Castiel R, et al. 2006. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 160:173-176.
  • Louik C, et al. 2007. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med 356(26):2675-2683.
  • McDonagh MS, et al. 2014. Antidepressant treatment of depression during pregnancy and the postpartum period. Evidence report/technology assessment No. 216. (Prepared by the Pacific Northwest Evidnece-based Practice Center under Contract No. 290-2007-10057-I.). Rockville, MD: Agency for Healthcare Research and Quality.
  • Misri S, et al. 2000. Paroxetine levels in postpartum depressed women, breastmik, and infant serum. J Clin Psychiatry 61(11):828-832.
  • Nakhai-Pour HR, et al. 2010. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 182(10):1031-1037.
  • Nulman I, et al. 1997. Neurodevelopment of children exposed in utero to antidepressant drugs. NEJM 336(4):258-262.
  • Nulman I, et al. 2012.Neurodevelopment of children following prenatal exposure to venlafaxine, selective serotonin reuptake inhibitors, or untreated maternal depression. Am J Psychiatry. 2012 169(11):1165-1174.
  • Ornoy A, Koren G. 2014. Selective serotonin reuptake inhibitors in human pregnancy: On the way to resolving the controversy. Semin Fetal Neonatal Med. 19(3):188-194.
  • Orsolini L, Bellantuono C. 2015. Serotonin reuptake inhibitors and breastfeeding: A systematic review. Hum Psychopharmacol. 30:4-20.
  • Pogliani L, Baldelli S, Cattaneo D et al. Selective serotonin reuptake inhibitors passage into human milk of lactating women. J Matern Fetal Neonatal Med. 2018;1-11.
  • Sanz E, et al. 2005. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 365:482-487.
  • Stowe Z, et al. 2000. Paroxetine in human breastmilk and nursing infants. Am J Psychiatry 157(2):185-189.
  • Uguz F, Arpaci N. 2016. Short-Term Safety of Paroxetine and Sertraline in Breastfed Infants: A Retrospective Cohort Study from a University Hospital. Breastfeed Med.11:487-9.
  • Uguz F. 2019. Short-term safety of paroxetine plus low-dose mirtazapine during lactation. Breastfeed Med. 14(2):131-132.
  • Wang S, et al. 2015. Selective Serotonin Reuptake Inhibitors (SSRIs) and the Risk of Congenital Heart Defects: A Meta-Analysis of Prospective Cohort Studies. Journal of the American Heart Association. 4(5).
  • Weissman AM, et al. 2004. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry June; 161(6): 1066- 1078.
  • Wichman CL, et al. 2009. Congenital heart diease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo CLin Proc 84(1):23- 27.
  • Wurst K, et al. 2010. First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies. Birth Defects Res A Clin Mol Teratol 88(3):159-170