Letter to the Editor

We read your report of acute neonatal encephalopathy with interest [1]. We agree that the majority of neonates that are exposed to maternal selective serotonin reuptake inhibitors (SSRIs) have no abnormalities noted at birth or follow up [2]. About one in four newborn babies may have transient signs that can be attributed to the abrupt discontinuation of the transplacental transfer of maternal SSRI [2] [3]. The clinical courses of these infants have not been well defined and have been grouped under the generic phrase ”respiratory distress.” We would like to present two babies that presented with hypopnea similar to the case that was described.

References

• 1 Herbst F, Gortner L. Paroxetine withdrawal syndrome as differential diagnosis of acute neonatal encephalopathy?.  Z Geburtshilfe Neonatal. 2003;  207 232-4
• 2 Chambers C D, Johnson K A, Dick L M, Felix R J, Jones K L. Birth outcomes in pregnant women taking fluoxetine.  New Engl J Med. 1996;  335 1010-8
• 3 Costei A M, Kozer E, Ho T, Ito S, Koren G. Perinatal outcome following third trimester exposure to paroxetine.  Arch Pediatr Adolesc Med. 2002;  156 1129-32
• 4 Isbister G K, Dawson A, Whyte I M,. et al . Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome?.  Arch Dis Child Fetal Neonatal Ed. 2001;  85 F147-8
• 5 Meyer U A. Pharmacogenetics and adverse drug reactions.  Lancet. 2000;  356 1667-71