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Related Concept Videos

Antidepressant Drugs: MAOIs and Other Agents01:23

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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Related Experiment Video

Updated: Sep 12, 2025

Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage
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First trimester antidepressant use and miscarriage: a population-based cohort study using Clinical Practice Research

Florence Zoe Martin1,2,3, Paul C Madley-Dowd4,2,3,5, Viktor H Ahlqvist4,6,7

  • 1Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK flo.martin@bristol.ac.uk.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|August 7, 2025
PubMed
Summary

Antidepressant use in early pregnancy shows a small, clinically insignificant miscarriage risk increase. Continued use before and into the first trimester does not elevate miscarriage risk compared to unexposed pregnancies.

Keywords:
antidepressantscohort studiesdepressionepidemiologyobstetrics and maternal healthprimary health care

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Area of Science:

  • Obstetrics and Gynecology
  • Psychiatry
  • Pharmacoepidemiology

Background:

  • Antidepressant prescribing during pregnancy is increasing.
  • Uncertainties persist regarding the safety of antidepressant use in pregnancy.
  • Existing evidence on antidepressant use and miscarriage risk is variable.

Purpose of the Study:

  • To investigate the association between first-trimester antidepressant use and miscarriage.
  • To quantify the absolute and adjusted risk of miscarriage in relation to early pregnancy antidepressant exposure.

Main Methods:

  • Population-based cohort study utilizing UK Clinical Practice Research Datalink (CPRD) GOLD data (1996-2018).
  • Identified pregnancies with antidepressant prescriptions overlapping the first trimester ('exposed') versus unexposed pregnancies.
  • Used Cox models to calculate adjusted hazard ratios (aHR) and absolute risks, controlling for confounders.

Main Results:

  • Over 1 million pregnancies analyzed; 7.2% had first-trimester antidepressant exposure.
  • Adjusted analysis showed a small increased miscarriage risk (aHR 1.04) with first-trimester antidepressant use.
  • Absolute adjusted miscarriage risk was 13.6% for exposed vs. 13.1% for unexposed pregnancies.
  • No increased miscarriage risk observed for those on antidepressants prior to and into the first trimester (aHR 1.00).

Conclusions:

  • First-trimester antidepressant use is associated with a small, clinically insignificant increase in miscarriage risk.
  • No evidence suggests that antidepressant use prior to and into the first trimester increases miscarriage risk.
  • Findings contribute to understanding antidepressant safety during early pregnancy.