21117 Psychoanaleptic drugs

Pharmacology and toxicology

The most commonly used analeptics, e.g. amphetamines, ampheta-minil, fenetylline. and methylphenidate, are derivatives of phenylethy-laminc. The prototype is the centrally acting drug, amphetamine, which can lead to addiction.

In about 50 pregnancies where methylphenidate had been used, no substantial indication for teratogenicity was found (e.g. Golub 2005, DeBooy 1993). However, only some of them were exposed during the first trimester. An increased incidence of prematurity and growth retardation as well as neonatal withdrawal symptoms have been reported in infants of mothers abusing methylphenidate together with other substances (DeBooy 1993). It is important to be aware that this drug is increasingly prescribed not only during childhood but also to women of reproductive age for attention deficit and hyperactivity syndrome.

Modafinil, with a different mode of action from amphetamines, is used for narcolepsy. Pemolin is an oxazolidine that has been used for attention deficit disorder.

Data are insufficient for risk evaluation of these drugs during pregnancy.

Recommendation. Psychoanaleptic drugs are contra indicated during pregnancy. Inadvertent use of these drugs during pregnancy Is not grounds for termination of pregnancy, or for invasive diagnostic procedures. Detailed fetal ultrasonography may be performed after recurrent or high-dose exposure in the first trimester. If drug treatment for narcolepsy is required, methylphenidate Is recommended.

2.11.18 Parkinson drugs

Pharmacology and toxicology

Parkinsonism is mainly seen in older patients, and is not normally a disease in pregnant women. Parkinson drugs which are given also for juvenile parkinsonism and restless leg syndrome are l-dopa/ benserazide. Some 15 exposed pregnancies have been reported, with uneventful delivery of normal children (e.g. Arai 1997, Noinoto 1997, von Graeventiz 1996).

Parkinson drugs such as the dopamine agonists bromocriptine, cabergoline, i\-dihydroergocryptine, lisuride, and pergolide, are used in women of reproductive age to inhibit prolactin secretion. For information on these drugs, see Chapter 2.15.

Additional Parkinson drugs, some of them used for extrapyramidal symptoms caused by "classical" neuroleptic drugs, are the virustatic amantadine, biperiden, benzatropin, bornaprin, budipin, carbidopa, dexetimid, entacapon, metixen, pergolide, pramipexol, pridinol, procyclidine, ropinirol, tiapride, and trihexyphenidyl, as well as the monoaminooxydase-B- (MAO-B-) inhibitors selegilin and rasigilin. With the exception of the broadly used ergotamine derivatives, data are insufficient for risk assessment in pregnancy. There is a case report of a woman treated with high doses of pramipexol during pregnancy (Mucchiut 2004).

Recommendation. Combined treatment of a neuroleptic drug with biperiden is acceptable in pregnancy when indicated. For restless leg syndrome, better-evaluated drug groups should be used. Inadvertent use of a Parkinson drug not belonging to the broadly used ergotamine derivatives is not grounds for termination of pregnancy, or for invasive diagnostic procedures. Detailed fetal ultrasonography may be considered where first-trimester exposure to less-used drugs has occurred.


Abebe-Campino G. Offer D, Stahl B el at. Cardiac arrhythmia in a newborn infant associated with fluoxetine use during pregnancy. Ann Pharmacother 2002; 36: 533-4.

Altshuler LL, Cohen L, Szuba MP et al. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines, Am j Psychiatry 1996; 153: 592-606.

Alwan S. Reefhuis J. Rasmussen S et al. Maternal use of selective serotonin re-uptake inhibitors and risk for birth defects. Birth Defects Res A 2005; 73: 291.

Anderson GM. Czarkowski K, Ravski N. Platelet serotonin in newborns and infants: ontogeny, heritability and effect on in utero exposure to selective serotonin reup take inhibitors. Pediatr Res 2004. 56: 418-22.

Arai H. Shinotoh H, Hattori T. L-dopa/benserazide during pregnancy in a patient with juvenile parkinsonism. Clin Neurol 1997; 37: 264-5.

Bamas C, Bergant A, Hummer M et al. Clozapine concentrations in maternal and fetal plasma, amniotic fluid and breast milk Am | Psychiatry 1994: 151: 945.

Biswas PN, Wilton LV. Pearce GL et al. The pharmacovigilance of olanzapine: results of a post marketing surveillance study on 8858 patients in England. J Psychopharmacol 2001; 15: 265-71.

Biswas PN. Wilton LV. Shakir SAW. The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13 554 patients in England. I Psychopharmacol 2003; 17: 121-6.

Bloem BR, Lammers GJ, Rooflhooft DW et al. Clomipramine withdrawal in newborns. Arch Dis Child Fetal Neonatal Ed 1999; 81: F77.

Bonari L, Pinto N. Ahn E et al. Perinatal risks of untreated depression during pregnancy. Can I Psychiatry 2004; 49: 726-34.

Bonnot O, Vollset SE, Godet PF et al. Maternal exposure to lorazepam and anal atresia in newborns: results from a hypothesis-generating study of benzodiazepines and malformations. | Psychopharmacol 2001: 21: 456-8.

Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation, 7th edn. Baltimore. MD: Williams & Wilkins, 2005.

Bromiker R. Kaplan M. Apparent intrauterine fetal withdrawal from clomipramine hydrochloride. J Am Med Assoc 1994: 272: 1722-3

Brunei P, Vial T, Roche I et al. Suivi de 151 grosscsses exposees a un traitement anti-deprcsseur (I MAO exclus) au cours de ¡'Organogenese. Therapie 1994; 49: 117-22.

Casper RC, Fleischer BE. Lee Ancajas )C el al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. | Pediatrics 2003; 142: 402-8.

Chambers CD, Johnson KA. Dick I.M et al. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 1996; 335: 1010-15.

Chambers CD. Dick I.M, Felix R| el al. Pregnancy outcome in women who use sertraline. Teratology 1999: 59: 6.

Chambers CD, Hernandez-Diaz S, van Marter l.| et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl I Med 2006; 354: 579-87.

Chun-Fai-Chan B. Koren G, Fayez I et al. Pregnancy outcome of women exposed to bupropion during pregnancy: a prospective comparative study. Am | Obstet Gynecol 2005; 192: 932-6.

Cohen LS, Friedman JM, Jefferson |W et al. A re-evaluation of risk of in utero exposure lo lithium. I Am Med Assoc 1994; 271: 146-50.

Cohen LS. Heller VL, Bailey JW el al. Birth outcomes following prenatal exposure to fluoxetine. Biol Psychiatry 2000: 48: 996-1000.

Cohen LS, Altshuler LL, Harlow BL et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. J Am Med Assoc 2006; 295: 499-507.

Collins KO, Comer JB. Maternal haloperidol therapy associated with dyskinesia in a newborn. Am | Health-Syst Pharm 2003; 60: 2253-5.

Costei AM, Kozer E. Ho T et al. Perinatal outcome following third-trimester exposure to paroxetine. Arch Pediatr Adolesc Med 2U02; 156: 1129-32.

Cott AD, Wisncr KL. Psychiatric disorders during pregnancy, [ntl Rev Psychiatry 2003; 15: 217-30.

Czeizcl AF„ Eros H, Rockenbauer M et al. Short-term oral diazepam treatment during pregnancy, A population-based teratological case-control study. Clin Drug Invest 2003;23:451-62.

Czeizel AE. Rockenbauer M. Sorensen HT et al. A population based ease-control study of oral chlordiazepoxide use during pregnancy and risk of congenital abnormalities. Neurotoxicol Teralol 2004; 26: 593-8.

Davis )M, Chen N. Dose response and dose equivalence of antipsychotics. I Clin Psyehopharmacol 2004: 24: 192-208.

DeBooy VD. Seshia MM, Tencnbein M et al. Intravenous pentazocine and methylphenidate abuse during pregnancy. Maternal lifestyle and infant outcome. Am J Dis Child 1993; 147: 1062-5.

Desmond MM. Schwanecke RP. Wilson GS et al. Maternal barbiturate utilization and neonatal withdrawal symptomatology. [ Pediatr 1972; 80: 190-97,

Diav-Citrin O. Okolore 1?. Lucarelli K et al. Pregnancy outcome following firsttrimester exposure to zopiclone: a prospective controlled cohort study. Am J Perinatal 1999; 16: 157-60.

Diav-Citrin O, Shechtman S, Aharonovich A et al. Pregnancy outcome after gestational exposure to loratadine or other antihistamines: a prospective controlled cohort study, j Allergy Clin Immunol 2003; 111; 1239-43.

Diav-Citrin O (A), Shechtman S. Weinbaum D et al Paroxetine and fluoxetine in pregnancy: a multiccnter, prospective, controlled study. Reprod Toxicol 2005; 20: 459.

Diav-Citrin O (B), Shechtman S, Ornoy S ct al. Safety of haloperidol and penfluridol in pregnancy: a multicenter, prospective, controlled study. J Clin Psychiatry 2005; 66: 317-22.

di Gianantonio E. Petrella M. Andrisani A et al. Venlafaxine in pregnancy: a prospective controlled study {Abstract}. Reprod Toxicol 2006; 22: 269.

Djulus |. Koren G. Elnarson TR et al. Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes. | Clin Psychiatry 2006; 67: 1280-84.

IJolovich LR. Addis A. Hegis Vaillancourl et al. Benzodiazepine use in pregnancy and major malformations or oral cleft; meta-analysis of cohort and case-control stud ies. Br Med ) 1998; 317: 839-43.

Dorn C. Pantlen A, Rohde A. Mirtazapin (Remergil®): Behandlungsoption bei thera pieresistenter tlyperemcsis gravidarum? - ein Fallbericht. Geburtsh Frauenheilk 2002; 62: 1-4.

Dubnov G. Fogelman R, Merlob P, Prolonged Q interval in an infant of a fluoxetine treated mother. Arch Dis Child 2005; 90: 972-3.

Einarson A, Bailey IS. Jung G et al. Prospective controlled study of hydroxyzine and cedrizine in pregnancy. Ann Allergy Asthma Immunol 1997: 78: 183-6.

Einarson A (A), Selby P, Koren G. Abrupt discontinuation of psychotropic drugs during pregnancy: fear of teratogenic risk and impact of counseling. J Psychiatry Neurosci 2001; 26: 44-8.

Einarson A (B), Fatoye B. Sarkar M et al. Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. Am J Psychiatry 2001; 158: 1728-30.

Einarson A, Bonari L. Voyer-Lavigne S et al. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy, Can J Psychiatry 2003; 48: 106-10.

Ellingrod VL, Perry PJ. Venflaxine: a hetercyclic antidepressant Am J Hosp Pharm 1994; 51: 3033-46.

Ericsson A. Kallin B, Wiholm BE. Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol 1999; 55: 503-8.

Ernst LC. Goldberg JF. The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-speclrum psychotropics. ) Clin Psychiatry 2002; 63: 42-55.

Eros E, Czeizel AE, Hockenbauer M el al. A population-based case-control study of nitrazepam, medazepam, tofisopam, alprazolam and clonazepam treatment during pregnancy. Eur | Obstet Gynecol Reprod Biol 2002; 101: 147-54.

Frassetto F. Tourneur Martel F. Barjhoux C-L. Goiter in a newborn exposed to lithium in utero. Ann Pharmacother 2002: 36: 1745-8.

Gentile S. Clinical utilization of atypical antipsychotics in pregnancy and lactation Ann Pharmacother 2004; 38: 1265-71.

GlaxoSmithKline. Bupropion Pregnancy Registry - Interim Report. 1 September 1997 through 28 February 2006. Issued: June 2006.

Gold EH. Treatment of depression during pregnancy. J Women's Health Gender-Based Med 1999; 8: 601-7.

Goldstein DJ. Effects of third trimester fluoxetine exposure on the newborn. J Clin Psychopharmacol 1995; 15: 417-20.

Goldstein D|, Corbin LA, Sundell KL. Effects of first-trimester fluoxetine exposure on the newborn. Obslet Gynecol 1997: 89: 713-18.

Goldstein DJ, Corbin LA, Fung MC. Olanzapine-exposed pregnancies and lactation: early experience. | Clin Psychopharmacol 2000; 20: 399-403.

Golub M, Costa L, Crofton K et al. NTP-CF.HHR Expert Panel Report on the reproductive and developmental toxicity of methylphenidale. Birth Defects Res B 2005; 74: 300-81.

Guclu S, Gol M. Dogan E, Saygili U. Mirtazapine use in resistant hyperemesis gravidarum; report of three cases and review of the literature. Arch Gynecol Obstet 2005; 272: 298-300.

Gupta N, Grover S. Safety of clozapine in 2 successive pregnancies. Can j Psychiatry 2004; 49: 865.

l-laddad PM, Pal BR, Clarke Pet al. Neonalal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome? [ Psychopharmacol 2005; 19: 554-7.

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

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

Heikkinen T, Ekblad U. Kero P et al. Citalopram in pregnancy and lactation. Clin Pharmacol Ther 2002; 72: 184-91.

Heikkinen T, Ekblad U, Palo P et al. Pharmacokinetics of fluoxetine and norfluoxc-tine in pregnancy and lactation. Clin Pharmacol Ther 2003; 73: 330-37.

Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Science Group. 1977.

Hemels MEH, Einarson A, Koren G et al. Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother 2005; 39: 803-9.

Hendrick V (Aj. Slowe ZN. Altshuler LL et al. Placental passage of antidepressant medications. Am J Psychiatry 2003; 160: 993-6.

Hcndrick V (B), Smith LM. Suri R et al. Birth outcomes after prenatal exposure to antidepressant medication. Am | Obstet Gynecol 2003; 188: 812-15.

Henke M. Schmidt KG. Aktuelle Arzneitherapie der Schizophrenie: Empfehlungen für den Allgemeinarzt. Arzneiverordnung in der Praxis 2005; 32: 20-22

Hostetter A, Stowe ZN. Strader JR et al Dose of selective serotonin reuptake inhibitors across pregnancy: clinical implications. Depress Anxiety 2000; 11: 51-7.

Iqbal MM, Sobhan T. Ryals T. Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatric Services 2002; 53: 39-49.

lsbisterGK. Dawson A, Whytc I et al. Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome? Arch Dis Child Fetal Neonatal Ed 2001; 85: F147-8.

Jablensky AV. Morgan V, Zubrick et al. Pregnancy, delivery and neonatal complications in a population cohort of women with schizophrenia and major affective disorders. Am ) Psychiatry 2005; 162: 79-91.

Jacobson S|. jones K, Johnson K et al. Prospective multicentre study of pregnancy outcome after lithium exposure during first trimester. Lancet 1992; 339: 530-33.

¡aiswal S. Coombs RC, isbister GK. Paroxetine withdrawal in a neonate with historical and laboratory confirmation. Eur J Pediatr 2003: 162: 723-4.

Kälten B. Neonate characteristics after maternal use of antidepressants in late pregnancy. Arch Pediatr Adolcsc 2004; 158: 312-16.

Kallén B. Otlerblad Olausson P, Antidepressant drugs during pregnancy and infant congenital heart defect. Reprod Toxicol 2006. 21: 221-2.

Kennedy DS. Evans N. Wang I et al. Fetal abnormalities associated with high-dose tranylcypromine in two consecutive pregnancies (Abstract), Teratology 2000; 61: 441.

Kesim M. Yaris F. Kadioglu M et al. Mirtazapine use in two pregnant women, is it safe? Teratology 2002; 66: 204.

Kirchheincr |, Berghofer A, Bolk-Weischedel D Healthy outcome under olanzapine treatment in a pregnant woman. Pharmacopsychiatry 2000; 33: 78-80.

Kozma C. Neonatal toxicity and transient neurodevelopment deficits following prenatal exposure to lithium: another clinical report and a review of the literature. Am J Med Genet 2005; I32A: 441-4,

Kulin NA, Patuszak A, Sage SR el al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors. I Am Med Assoc 1998 : 279: 609-10.

Laine K, Kytölä |, Bertilsson I.. Severe adverse effect in a newborn with two defective CYP2D6 alleles after exposure to paroxetine during late pregnancy. Ther Drug Monit 2004; 26: 685-7.

Levey L. Ragan K, Hower-Hartley A et al. Psychiatric disorders in pregnancy. Neurol Clin 2004; 22: 863-93.

Levinson AJ. Zipursky RB, Antipsychotics and the treatment of women with psychosis. In: M Steiner, G Koren (eds). Handbook of Female Psychopharmacology. London: Martin Dunitz. 2003. p. 63.

Levinson-Costiel R, Merlob P, I.inder N et al. Neonatal abstinence syncrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolcsc Med 2006; 160: 173-6.

Lieberman I, Safferman AZ. Clinical profile of clozapine: adverse reactions and agranulocytosis. In: Y Lapierre, B Jones (eds), Clozapine in Treatment Resistant Schizophrenia: A Scientific Update. London: Royal Society of Medicine, 1992.

Lieberman J, Stroup S. McEvoy | et al. Clinical antipsychotic trials of intervention effectiveness (CATIE) investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl | Med 2005: 353: 1209-23.

Lin AE, Peller AJ, Westgate M-N et al. Clonazepam use in pregnancy and the risk of malformations. Birth Defects Res A 2004: 70: 534-6.

Llewellyn A, Stowe ZN, Strader |R. The use of lithium and management of women with bipolar disorder during pregnancy and lactation. J Clin Psychiatry 1998: 59(Suppl 2): 57-64.

Lough head AM. Slowe ZN, Newport el al. Placental passage of tricyclic antidepressants. Biol Psychiatry 2006; 59: 287-90.

MacKay Fi, Wilton LV. Pearce GL et al. The safely of risperidone: a post-marketing study on 7684 patients. Hum Psychopharmacol Clin Exp 1998; 12; 413-18.

Malek Ahmadi P. Olanzapine in pregnancy. Ann Pharmacother 2001; 35: 1294-5.

Malm H, Klaukka T, Ncuvonen P. Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 2005; 106: 1289-96.

Mattson SN, F.astvold KL, [ones |A et al. Neurobehavioral follow-up of children prena-tally exposed to fluoxetine. Teratology 1999:59: 376.

Mattson SN, Calarco KE, Kao KK et al. Neurodevelopmental outcome of infants and toddlers exposed prenatally to selective serotonin reuptake inhibitors. Birth Defects Res A 2004; 70:261.

McElhatton PR. The use of phenothiazines during pregnancy and lactation. Rcprod Toxicol 1992; 6: 475-90.

McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Rcprod Toxicol 1994; 8: 461-75.

McElhatton PR, Garbis HM. Elefant E. et al. The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants. A Collaborative Study of the European Network oT Teratology Information Services (ENTIS). Rcprod Toxicol 1996; 10: 285-94.

MeKenna K. Koren G. Tetelbaum M et al. Pregnancy uutcome of women using atypical antipsychotic drugs: a prospective comparative study. | Clin Psychiatry 2005; 66: 444-9,

Mcndhekar 13N. War L, Sharma |B et al. Olanzapine and Pregnancy. Pharmacopsychiatry 2002; 35: 122-3.

Mendhekar DN (A), Sharma |B, Srilakshmi P. Use of aripiprazole during late pregnancy in a woman with psychotic illness. Ann Pharmacother 2006; 40: 575.

Mendhekar UN (B), Sunder KR, Andradc C. Aripiprazole use in a pregnant schizoaffective woman. Bipolar Disord 2006; 8: 299-300

Milkovich L, van den Berg B|. Effects of prenatal meprobamate and chlordiazepoxidc hydrochloride on human embryonic and fetal development, N Engl ) Med 1974: 29t: 1268-71.

Mohan MS. Patole SK, Whitehall )S. Severe hypothermia in a neonate following antenatal exposure to haloperidol. J Paediatr Child Health 2000; 36: 412.

Moor RA, Mourad L, Haar 1 et al. Withdrawal symptoms in a neonatal infant following exposure to venlafaxine during pregnancy. Ned Tijdschr Geneesk 2003; 147: 1370-72.

Mortola JF. The use of psychotropic agents in pregnancy and lactation. Psychiatric Clin North Am 1989; 12: 69-87.

Moses-Kolko EL. Bogen D. Perel) et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors. Literature review and implications for clinical applications. I Am Med Assoc 2005: 293: 2372-83.

Mucchiui M. Belgrado E. Cutuli D et al. Pramipexole-treated Parkinson's disease during pregnancy. Mov Disord 2004; 19: 1114 15.

Nagy A, Tenyi T, Lcnard K ct al. Olanzapine and pregnancy (in Hungarian). Orv Hetil 2001: 142: 137-8.

Neumann NU, Frasch K. Olanzapine and pregnancy. 2 case reports (in German}. Nervenarzt 2001; 72: 876-8.

Nomoto M, Kascda S, hvala S et al. Levodopa in pregnancy ¡Letter}. Mov Disord 1997: 12:261.

Nonacs R. Cohen LS. Depression during pregnancy: diagnosis and treatment options. J Clin Psychiatry 2002: 63(Suppl 7): 24-30.

Nordeng H. Spigset O. Treatment with selective serotonin reuptake inhibitors in the third trimester of pregnancy. Drug Saf 2005; 28: 565-81.

Nulman I, Rovel I, Stewart DF, et al. Ncurodevelopment of children exposed in utero to antidepressant drugs. N Engl) Med 1997: 336; 258-62.

Nulman 1, Rovet ), Stewart DE et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective controlled study. Am j Psychiatry 2O02; 159: 1889-95.

Nulman I. Knittel-Keren D. Valo S et al. Child neurodevelopment following exposure to venlafaxine in utero, unexposed siblings as comparison group: preliminary results (Abstract). Reprod Toxicol 2006:22: 280.

Überlander TF. Misri S, Fitzgerald CE et al. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. ) Clin Psychiatry 2004; 65: 230-37.

Okotore B. Einarson A, Chambers CD et al. Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. Teratology 1999; 59: 439.

Ornoy A, Arnon ), Shechtman S et al. Is benzodiazepine use during pregnancy really teratogenic? Reprod Toxicol 1998; 12: 511-15.

Patuszak A, Schick-Boschetto B, Zuber C et al. Pregnancy outcome following firsttrimester exposure to fluoxetine (Prozac). J Am Med Assoc 1993: 269: 2246-8.

Patuszak A, Milich V, Chan S el al. Prospective assessment of pregnancy outcome following first trimester exposure to benzodiazepines. Can J Clin Pharmacol 1996; 3: 167-71.

Peinemann F. Daldrup T. Severe and prolonged sedation In five neonates due to persistence of active diazepam metabolites. Eur J Pediatr 2001: 160: 378-81.

Pinelli IM. Symington AF, Cunningham KA et al. Case report and review of the perinatal implications of maternal lithium use. Am | Obstet Gynecol 2002; 187: 245-9.

Rampono J, Proud S. I lacketl P et al. A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. Intl ) Ncuropsychopharmaco! 2004; 7: 329-34.

Ratnayake T, Libretto SE. No complications with risperidone treatment before and throughout pregnancy and during the nursing period. J Clin Psychiatry 2002; 63: 76-7.

Rodriguez-Pinilla E. Prenatal exposure to benzodiazepines: a case-control study. Presentation at the 10th Annual Conference of the European Network of Teratology Information Services, 1999.

Rohde A. Dembinski j. Dorn C. Mirtazapinc (Remergils) for treatment resistant hyperemcsis gravidarum: rescue of a twin pregnancy. Arch Gynecol Obstet 2003: 268:219-21

Kosenheck K. Pcrlick D, Bingham S et al. Effectiveness and cost of olanzapine and haloperidol treatment of schizophrenia. J Am Med Assoc 2003; 290: 2693-702.

Saks BR. Mirtazapine: treatment of depression, anxiety, and hyperemcsis gravidarum in the pregnant patient. A report of 7 cases. Arch Womens Ment Health 200f; 3: 165-70.

Santos RP, Pergolizzi J J. Transient neonatal jitteriness due to maternal use of sertraline. I Perinatol 2004:24: 392-4.

Sanz EJ, de las Cuevas C. Kiuru A et al. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005; 365: 482-7.

Schatz M, Petitti D. Antihistamines and pregnancy. Ann Allergy Asthma Immunol 1997; 78: 157-9.

Schick-Boschetto B. Zuber C. Alprazolam exposure during early human pregnancy. Teratology 1992; 45:460.

Sehimmell MS, Katz EZ. Shaag Y et al. Toxic neonatal effects following clomipramine therapy. J Toxicol Clin Toxicol 1991; 29: 479-84.

Shepard TH, Brent RL, Friedman |M et al. Update on new developments in the study of human teratogens. Teratology 2002; 65: 153-61.

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

Sivojelezova A, Shushaiber S, Sarkissian L el al. Citalopram use in pregnancy: prospective comparative evaluation of pregnancy and fetal outcome. Am J Obstet Gynecol 2005; 193:2004-9.

St Clair SM, Schirmer RG. First-trimester exposure to alprazolam. Obstet Gynecol 1992; 80: 843-6.

Stoner SC, Sommi RW, Marken PA ct al. Clozapine use in two full-term pregnancies. (, Clin Psychiatry 1997; 58: 364.

Tabacova SA, McCloskey CA, Fisher |K. Adverse developmental events reported to FDA in association with maternal Citalopram treatment in pregnancy, liirth Defects Res A 2004; 70: 361.

Tabacova SA. McCloskey CA, Fisher JR. Withdrawal type adverse events reported to FDA in association with maternal Citalopram treatment in pregnancy. Birth Defects Res A 2005; 73: 299.

Taylor TM, O'Toole MS, Ohlsen R1 et al. Safety of quetiapine during pregnancy. Am J ' Psychiatry 2003: 160: 588-9.

Tenyi T, Trixler M, Keresztes Z. Quetiapine and pregnancy. Am J Psychiatry 2002; 159: 674.

Viguera AC, Nonacs R, Cohen LS et al. Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry 2000; 157: 179-84.

Viguera AC, Cohen LS, Baldessarini RJ et al. Managing bipolar disorder during pregnancy: weighing the risks and the benefits. Can | Psychiatry 2002: 47: 426-36.

von Graeventiz KS. Shulman l.M. Revell SP Levodopa in pregnancy. Mov Disord 1996; 11: 115-16.

Wilton LV, Pearce G L, Martin RM et al, The outcomes of pregnancy women exposed to newly marketed drugs in general practice in England. Br [ Obstet Gynaecol 1998; 105; 882-9.

Wisner KL, Perel JM, Wheeler SB. Tricyclic dose requirements across pregnancy. Am J Psychiatry 1993: 150; 1541-2.

Wogetius P, Norgaard M, Gislum M ct al. Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology 2006; 17: 701-4.

Yaris F (A), Kadioglu M. Kesim M et al. Newer antidepressants in pregnancy: prospective outcome of a case series. Rep rod Toxicol 2004; 19: 235-8,

Yaris F (B), Yaris E. Kadioglu M et al. Use of polypharmacotherapy in pregnancy: a prospective outcome in a case. Progress Neuropharmaeol Biol Psychiatry 2004; 28: 603-5.

Yogcv Y, Ben-llaroush A. Kaplan B. Maternal clozapine treatment and decreased fetal heart rate variability. Intl J Gynecol Obstct 2002; 79: 259-60.

Yonkers KA. Wisner KL, Stowe et al. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry 2004; 161: 608-20.

Zalzstein I, Koren G, Einarson T et al. A case-control study on the association between first trimester exposure to lithium and Ebsteins anomaly. Amer [ Cardiol 1990; 65: 817-18,

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