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Original Article
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Volume 336:258-262 January 23, 1997 Number 4
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Neurodevelopment of Children Exposed in Utero to Antidepressant Drugs
Irena Nulman, M.D., Joanne Rovet, Ph.D., Donna E. Stewart, M.D., Jacob Wolpin, Ph.D., H. Allan Gardner, M.D., Jochen G.W. Theis, M.D., Nathalie Kulin, B.Sc., and Gideon Koren, M.D.

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ABSTRACT

Background Many women of reproductive age have depression, necessitating therapy with either a tricyclic antidepressant drug or a drug, such as fluoxetine, that inhibits the reuptake of serotonin. Whether these drugs affect fetal neurodevelopment is not known.

Methods We studied the children of 80 mothers who had received a tricyclic antidepressant drug during pregnancy, 55 children whose mothers had received fluoxetine during pregnancy, and 84 children whose mothers had not been exposed during pregnancy to any agent known to affect the fetus adversely. The children's global IQ and language development were assessed between 16 and 86 months of postnatal age by age-appropriate Bayley Scales of Infant Development or the McCarthy Scales of Children's Abilities (for IQ) and the Reynell Developmental Language Scales.

Results The mean (±SD) global IQ scores were 118±17 in the children of mothers who received a tricyclic antidepressant drug, 117±17 in those whose mothers received fluoxetine, and 115±14 in those in the control group. The language scores were similar in all three groups. The results were similar in children exposed to a tricyclic antidepressant drug or fluoxetine during the first trimester and those exposed throughout pregnancy. There were also no significant differences in temperament, mood, arousability, activity level, distractibility, or behavior problems in the three groups of children.

Conclusions In utero exposure to either tricyclic antidepressant drugs or fluoxetine does not affect global IQ, language development, or behavioral development in preschool children.


Source Information

From the Motherisk Program (I.N., J.W., J.G.W.T., N.K., G.K.), the Division of Clinical Pharmacology and Toxicology (I.N., J.G.W.T., N.K., G.K.), the Department of Pediatrics (I.N., J.R., J.G.W.T., G.K.), Research Institute (J.R., G.K.), and the Department of Psychology (J.R.), Hospital for Sick Children and University of Toronto, Toronto; Women's Health Program, Toronto Hospital and University of Toronto, Toronto (D.E.S.); and Oshawa General Hospital, Oshawa, Ont., Canada (H.A.G.).

Address reprint requests to Dr. Koren at the Division of Clinical Pharmacology, the Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada.

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