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1 Physicians were advised to taper the dosage of antidepressants in pregnant women during the last trimester so that the fetus receives no drug for at least 7-10 days before delivery. A month later, Health Canada followed suit; the Canadian advisory 2 similarly suggested that "Physicians may consider slowly decreasing the dose of these medications in the third trimester." These advi- sories were based on "reports reveal(ing) that some new- borns whose mothers took these medications during preg- nancy have developed complications at birth." 2 These complications were seen as consistent with withdrawal symptoms or a direct adverse effect by the antidepressant on the baby. We believe those recommendations are only partially evidence-based and may put the depressed mother-to-be and her baby at an unreasonable health risk. This paper presents a brief discussion of the pattern of neonatal symp- toms observed after maternal use of selective serotonin or serotonin-norepinephrine reuptake inhibitors (SSRIs or SNRIs, respectively).

Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates?