I am seeking any feedback on Health Canada's recent release which I have
pasted below.
August 9, 2004
For immediate release

Advisory
Health Canada advises of potential adverse effects of SSRIs and other anti-
depressants on newborns
OTTAWA - Health Canada is advising Canadians that newborns may be
adversely affected when pregnant women take Selective Serotonin Re-uptake
Inhibitors (SSRIs) and other newer anti-depressants during the third
trimester of pregnancy. This advisory is intended to increase awareness
among mothers and physicians of the possible symptoms that may occur in
the newborn, so that symptoms can be recognized and addressed quickly.

This advisory applies to the following anti-depressants: bupropion
(whether used for depression or for smoking cessation), citalopram,
fluoxetine, fluvoxamine, mirtazapine, paroxetine, sertraline and
venlafaxine.

International and Canadian reports reveal that some newborns whose mothers
took these medications during pregnancy have developed complications at
birth requiring prolonged hospitalization, breathing support and tube
feeding. Reported symptoms include: feeding and/or breathing difficulties,
seizures, muscle rigidity, jitteriness and constant crying. In most cases,
the newer anti-depressant was taken during the third trimester of
pregnancy. These symptoms are consistent with either a direct adverse
effect of the anti-depressant on the baby, or possibly a discontinuation
syndrome caused by sudden withdrawal from the drug.

When treating depression in pregnant women, physicians and patients should
carefully consider the potential risks and benefits of the various
treatment options for both the mother and the unborn baby. To date, there
is little evidence-based information on how best to treat depression
during pregnancy. However, physicians may consider slowly decreasing the
dose of these medications in the third trimester.

If a woman is pregnant and is taking an SSRI, or other newer anti-
depressant, she should discuss with the risks and benefits of the various
treatment options with her health care professional. It is very important
that patients do NOT stop taking these medications without first
consulting with their doctor.

The frequency of symptoms may vary with each drug. In the case of two of
the newer anti-depressants - bupropion and mirtazapine - discontinuation
problems appear to be less than with the other drugs. In the case of
mirtazapine, there are only two reports. Health Canada is issuing this
advisory to encompass all newer anti-depressants in order to alert
Canadians to the potential risk. Health Canada has also worked with the
manufacturers of these medications to update their labelling with new
precaution information.

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