+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome?



Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome?



Journal of Psychopharmacology 19(5): 554-557



We report a case of neonatal symptoms of irritability, increased tonus and convulsions after in-utero exposure to paroxetine 30 mg/day. The infant's symptoms commenced on the first day after birth and persisted for 10 days. Paroxetine levels were undetectable on day 6. Extensive investigations excluded infective and metabolic causes. Serotonin toxicity due to paroxetine seems the most likely mechanism, though an important differential diagnosis is a paroxetine discontinuation (withdrawal) syndrome. Differentiating between these two syndromes in the neonate presents a dilemma for clinicians. Irrespective of the mechanism, we recommend that all neonates exposed to antidepressants, particularly serotonin reuptake inhibitors (SSRIs), during the last trimester should be followed-up closely for adverse symptoms commencing in the first 10 days after birth. The possibility of such symptoms needs to be discussed with women who are considering starting or continuing antidepressant treatment in pregnancy. All neonatal adverse drug events should be reported to a pharmacovigilance centre. Further research is warranted.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 012345391

Download citation: RISBibTeXText

PMID: 16166193

DOI: 10.1177/0269881105056554


Related references

Effects of the Serotonin 1A, 2A, 2C, 3A, and 3B and Serotonin Transporter Gene Polymorphisms on the Occurrence of Paroxetine Discontinuation Syndrome. Yearbook of Psychiatry and Applied Mental Health 2011: 262-263, 2011

Effects of the serotonin 1A, 2A, 2C, 3A, and 3B and serotonin transporter gene polymorphisms on the occurrence of paroxetine discontinuation syndrome. Journal of Clinical Psychopharmacology 30(1): 11-17, 2010

Paroxetine as a sole cause of serotonin syndrome A massive overdose with documented serum paroxetine levels. Journal of Toxicology Clinical Toxicology 39(5): 491-492, 2001

Absence of discontinuation symptoms with agomelatine and occurrence of discontinuation symptoms with paroxetine: a randomized, double-blind, placebo-controlled discontinuation study. International Clinical Psychopharmacology 19(5): 271-280, 2004

Rapid response to paroxetine is associated with plasma paroxetine levels at 4 but not 8 weeks of treatment, and is independent of serotonin transporter promoter polymorphism in Japanese depressed patients. Human Psychopharmacology 24(6): 489-494, 2009

Discontinuation symptoms: comparison of brief interruption in fluoxetine and paroxetine treatment. International Clinical Psychopharmacology 17(5): 217-225, 2002

Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome?. Archives of Disease in Childhood. Fetal and Neonatal Edition 85(2): F147-F148, 2001

Physical symptoms associated with paroxetine discontinuation. American Journal of Psychiatry 151(2): 289, 1994

Adverse effects after switching to a different generic form of paroxetine: paroxetine mesylate instead of paroxetine HCl hemihydrate. Nederlands Tijdschrift Voor Geneeskunde 146(17): 811-812, 2002

Withdrawal symptoms associated with paroxetine discontinuation in a nine-year-old boy. Journal of Clinical Psychopharmacology 20(5): 586-587, 2000

Serotonin syndrome during treatment with paroxetine and risperidone. Journal of Clinical Psychopharmacology 20(1): 103-105, 2000

Prenatal maternal paroxetine treatment and neonatal mortality in the rat: a preliminary study. Neonatology 93(1): 52-55, 2008

The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms. Pain 42(2): 135-144, 1990

Comparative effects of the selective serotonin uptake inhibitors paroxetine and fluoxetine on food intake in rats and effect of paroxetine on body weight in depressed patients. Journal of Psychopharmacology 4(4): 300, 1990

Discontinuation Syndrome Associated with Paroxetine in Depressed Patients. Cns Drugs 20(8): 665-672, 2006