Neonatal Signs After In Utero Exposure to Selective Serotonin Reuptake Inhibitors
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blavenst@cnmc.org
Department of Neurology
Children’s National Medical Center
Washington, DC
Since this article does not have an abstract, we have provided the first 150 words of the full text.
To the Editor: In their Review of neonatal signs after late in utero exposure to SSRIs, Dr Moses-Kolko and colleagues1 discussed 13 case reports that described 18 cases of neonatal exposure. We have published a report of 3 cases of neonatal fluoxetine withdrawal secondary to maternal use during pregnancy, which we would like to add to those cited in the Review.2
Similar to other reports, we noted symptoms of a withdrawal syndrome presenting within the first 6 hours of life, not specifically at birth. In our cases, maternal use was at a dosage of 60 to 80 mg/d. The infants demonstrated tachypnea, tachycardia, jitteriness, temperature instability, poor suck, and hyperactivity, consistent with a withdrawal syndrome. Fluoxetine and norfluoxetine levels were measured in all infants prior to breastfeeding. Elevated infant serum norfluoxetine levels (1-265 ng/mL) were recorded. These levels correlated with maternal dosage. Breastfeeding was discouraged during the first …
