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To the Editor: The pharmacologic treatment of depression during pregnancy presents a therapeutic dilemma for physicians. Prospective data are sparse and decisions regarding which agents to prescribe are made based on retrospective reviews and anecdotal reports. The review by Dr Wisner and colleagues¹ of the pharmacologic treatment of depression during pregnancy is a welcome synthesis based on prospective data regarding pregnancy outcomes for women treated with antidepressants. However, their discussion of pharmacologic agents used in the treatment of depression is limited.

Wisner et al based their review on only 4 studies, all of which relate to the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) during pregnancy. Other agents are briefly mentioned, but the authors state that prospective data are lacking. However, bupropion has had a pregnancy registry in place since September 1997.² This registry follows bupropion exposures prospectively and accepts retrospective reports of anomalies and adverse . . . [Full Text of this Article]

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Pharmacologic Treatment of Depression During Pregnancy
Katherine L. Wisner, Alan J. Gelenberg, Henrietta Leonard, Deborah Zarin, and Ellen Frank
JAMA. 1999;282(13):1264-1269.
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