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Letters to the Editor |

Neonatal Risks of Maternal Treatment With Mood Stabilizers

Mark Olfson, MD, MPH; Steven Marcus, PhD
Arch Gen Psychiatry. 2007;64(7):866-867. doi:10.1001/archpsyc.64.7.866-b.
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Several of the drugs used to treat bipolar disorder are known teratogens.1 Maternal treatment with valproate sodium,2 carbamazepine,3 and lithium4 are each associated with an increased risk of major congenital abnormalities.

In their recent study of maternal antidepressant treatment and neonatal outcomes, Oberlander and colleagues5 report that prenatal selective serotonin reuptake inhibitor (SSRI) exposure is associated with an increased risk of neonatal low birth weight and respiratory distress. The authors compare neonates born of mothers who received SSRIs during their pregnancies with those of depressed pregnant women who did not receive antidepressants. Although neither group of women received benzodiazepines or antipsychotic medications during their pregnancy, women treated with mood stabilizers were not excluded from the study. Because pregnant mothers treated with SSRIs are presumably more likely to receive mood stabilizers than those who are not treated with antidepressants, it is possible that in utero exposure to mood stabilizers partially explains the observed association between maternal SSRI treatment and the adverse neonatal outcomes.

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