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March 2009

More on rTMS
Repetitive transcranial magnetic stimulation (rTMS) may be beneficial in treating schizophrenia but probably not in anxiety disorders.

Olanzapine Pamoate
Olanzapine pamoate, a new depot formulation of olanzapine (Zyprexa) not yet approved by the US Food and Drug Administration, offers a long-acting alternative to treatment with oral antipsychotics.

Early Intervention to Prevent Psychosis
Patients at ultra-high risk of developing schizophrenia may benefit from a range of treatment options begun before their first psychotic episode.

In Brief
Lamotrigine Shows Modest Benefit for Bipolar Depression; Polypharmacy Puts Elderly at Risk of Drug-Drug Interactions

Maternal SSRIs Prolong QTc Intervals in Newborns
In one study, newborns exposed to selective serotonin reuptake inhibitors (SSRIs) in utero had prolonged QTc intervals.

Maternal SSRIs Prolong QTc Intervals in Newborns

March 2009

We recently reviewed concerns about selective serotonin reuptake inhibitors (SSRIs) taken during pregnancy (BTP 2007;30:36–38). Now comes word that antenatal use of SSRIs can prolong the QTc interval in newborns.

Dubnov-Raz and coworkers collected data on newborns treated at a tertiary care hospital in Canada over 5 years.1 They compared 51 newborns exposed to SSRIs (and 1 to venlafaxine) in the immediate antepartum period with 52 matched control subjects. Antidepressant-exposed newborns had a significantly longer mean QTc (P = .02). Five (10%) of the exposed neonates displayed clinically significant QTc prolongations compared to none in the control group. All the QTc abnormalities normalized in subsequent electrocardiographic tracings.

As the authors note, subsequent trials will be necessary to establish whether arrhythmias or other adverse clinical events could result from these electrocardiogram changes. It would be prudent, nonetheless, to monitor cardiac status in newborns of mothers who have taken SSRIs toward the end of their pregnancies.

1Dubnov-Raz G, Juurlink DN, Fogelman R, Merlob P, Ito S, Koren G, Finkelstein Y: Antenatal use of selective serotonin-reuptake inhibitors and QT interval prolongation in newborns. Pediatrics 2008;122:E710-715.