TABLE 6

Summary of nonconvergent data

PreclinicalClinicalComments
Birth defectsNo substantial evidenceSporadic case reports and statistical evidence of increased risk in some large scale studies.Numerous potential confounds in clinical literature preclude conclusions in the presence of prolonged record of antidepressant use during pregnancy (>40 years).
Long-term outcomeNo persistent adverse effectsLimited studies from neonatal to early childhood do not demonstrate significant risk. No studies of long-term outcomes in offspring into adolescence or adulthood.Preclinical studies of postnatal exposure reveal long term behavioral alterations, however many findings are not replicable. Clinical relevancy of dosing regimens must be taken into account.
Monoamine/neuroendocrineAltered monoamineAltered salivary cortisol in childrenPreclinical studies may have questionable dosing relevancy
Altered cortisol and insulin
Behavioral outcomeSome evidence for behavioral outcomeSome studies show behavioral differences in childrenPreclinical studies of postnatal exposure reveal long term behavioral alterations
Studies often conflicting or not replicated