Selective serotonin reuptake inhibitor induced neonatal abstinence syndrome

Depression is common in women of childbearing age and especially during pregnancy and the postpartum period. Selective serotonin reuptake inhibitors (SSRIs) are increasingly being used to treat depression prior to and throughout pregnancy. Up to 30% of the newborn infants exposed to SSRIs may present with clinical signs during the first days after birth. Neonatal abstinence syndrome (NAS) describes this clinical syndrome resulting from prior prolonged exposure to SSRI induced by cessation of the drug. NAS includes a wide spectrum from mild to severe nonspecific symptoms which were categorized into four groups of effects: central nervous system (depression followed by excitation), gastrointestinal, autonomic and respiratory. A protocol for observation of SSRI-exposed newborns is presented including an objective method (Finnegan score) to monitor onset, progression and improvement of NAS symptoms.