Lexapro

[fridgejo]

Lexapro safety

[admin]

Fridgejo:

As far as I've seen, there are minor short term problems at birth (perhaps lower birth weight), but as for long-term complications, I don't see anything published. See review below. You might go to a medical library and get a copy of this article.

Tom Hale Ph.D.

Send to ([url]https://www.ncbi.nlm.nih.gov/pubmed/24441517#[/url])

Riv Psichiatr. ([url]https://www.ncbi.nlm.nih.gov/pubmed/24441517#[/url]) 2013 Nov-Dec;48(6):407-14. doi: 10.1708/1379.15335. [The safety profile of escitalopram in pregnancy and breastfeeding].

[Article in Italian]
Bellantuono C ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Bellantuono%20C%5BAuthor%5D&cauthor=true&cau thor_uid=24441517[/url]), Orsolini L ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Orsolini%20L%5BAuthor%5D&cauthor=true&cautho r_uid=24441517[/url]), Bozzi F ([url]https://www.ncbi.nlm.nih.gov/pubmed/?term=Bozzi%20F%5BAuthor%5D&cauthor=true&cauthor_u id=24441517[/url]). Abstract

INTRODUCTION:

Escitalopram (ESC) is considered one of the most effective selective serotonin reuptake inhibitors (SSRI) for the treatment of major depression disorder. However, little is known on its potential risk of inducing major malformations (MM) and/or perinatal complications (PC). Aim of the present study is to provide a review of the available literature on the safety profile of ESC during pregnancy and breastfeeding and to compare data with the maternal and neonatal outcomes of 8 cases of the DEGRA Center. METHODS:

MEDLINE and PubMed databases were searched for English language articles by using the following keywords: "escitalopram", "selective serotonin reuptake inhibitors", "major malformations", "perinatal complications", "pregnancy", "breastfeeding". We also reported 8 cases of women treated with ESC during their pregnancy and breastfeeding at the Clinic of Affective Disorders in Pregnancy and Postpartum of the United Hospital of Ancona (DEGRA Center). RESULTS:

Although some cases of MM have been reported in the literature after maternal exposure to ESC during early pregnancy, the rate of MM is substantially in the range of those reported in unexposed women. ESC exposure seems to be significantly associated with some PC such as lower rates of live births and higher rates of newborns with low birth weight. On the contrary, no short-term adverse effects in newborns were reported in the 5 studies evaluating the safety of ESC during breastfeeding. Data coming from DEGRA Center are consistent with the literature: all pregnancy were full term, all newborns were healthy and obtained normal APGAR score; no MM or miscarriage were reported. Only one case of mild withdrawal syndrome was reported in a newborn who was also exposed to benzodiazepines and paroxetine late in pregnancy. Two infants exposed to ESC also during the lactation did not reported any adverse effects at short-term. CONCLUSIONS:

Data coming from published studies and from our cases seem to support the notion that ESC might be considered safe during pregnancy and breastfeeding, particularly as far as MM is concerned. As well as other SSRI it could be associated with an increased risk of PC. Nevertheless, given the few cases here analysed and the paucity of the studies so far published, no definitive conclusions should be drawn. PMID: 24441517

[fridgejo]

Can you also explain the total transfer that would happen re: RID? I am confused by this.

[admin]

fridgejo:

We estimate from several studies that 5.2% - 7.9% of the MATERNAL dose of escitalopram reaches the infant via milk.

As for plasma levels, I've not seen any study that reports "plasma levels" in infants.

Side effects in infants have not been yet reported. I'd guess they look like Sedation or irritability, not waking to feed, poor feeding and weight gain.


Tom Hale Ph.D.

[fridgejo]

Thank you. One question

[fridgejo]

One other question I had is the age of the baby. LactMed states that adverse effects would not be expected if the baby is older than 2 months of age.

[admin]

Probably, but who knows for sure. Certainly, the most risk is in newborns, or young infants. Older infants are much less sensitive to most any drug. But there are always exceptions.