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[Neonatal convulsions
and subarachnoid hemorrhage after in utero exposure to
paroxetine]
[Article in
Spanish]
Salvia-Roiges MD, Garcia L, Gonce-Mellgren A,
Esque-Ruiz MT, Figueras-Aloy J, Carbonell-Estrany X.
Servei
de Neonatologia, Institut Clinic de Ginecologia, Obstetricia, i
Neonatologia, Unitat Integrada de Pediatria, (ICGON), Barcelona, Espana.
dsalvia@clinic.ub.es
INTRODUCTION: Selective serotonin reuptake
inhibitors (SSRIs) are often used as antidepressants in pregnant women.
SSRIs do not appear to increase the teratogenic risk when used in their
recommended doses. However, not enough information is available at this
time about the risk of toxicity and complications in newborns, after
mother treatment with SSRI during the third trimester of pregnancy. We
are limited to the existing reports that describe newborns with symptoms
due to hyperserotoninemia or withdrawal. CASE REPORT: One newborn whose
mother had been treated with paroxetine 20 mg/day during pregnancy,
presented convulsions and subarachnoid haemorrhage in the first six
hours of life. The newborn did not present symptoms of hypoxic ischaemic
encephalopathy, withdrawal syndrome, infection, metabolic alterations,
cerebral malformations or coagulopaties. DISCUSSION: The most probable
etiology is that the paroxetine could decrease the seizure threshold,
taking place the first seizure during delivery. The difficult fetal
extraction would have provoked the subarachnoid haemorrhage in a patient
with an impaired haemostatic function due to a depletion of platelet
serotonin and may also contribute the increased vascular fragility due
to paroxetine and reported in adults or in animals. CONCLUSION: Neonatal
convulsions and subarachnoid haemorrhage may occur after paroxetine
treatment in the third trimester of pregnancy. An accurate follow up of
these newborns in the firsts days of life is strongly
recommended.
Publication Types:
PMID: 12717649 [PubMed - indexed for
MEDLINE]
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