Efeitos do tratamento neonatal com inibidor seletivo de recaptura da 5-HT sobre o desenvolvimento anatômico crânio-encefálico Neonatal treatment effect with selective inibitor of 5-HT recapture over the cranium-encephalic anatomic development

Pesquisadas repercussões neonatais do tratamento crônico com inibidores seletivos de recaptura da serotonina (ISRS) sobre crescimento somático, do encéfalo e crânio. Ratos machos foram divididos em grupos: controle (NaCl) e Cit (10 µL/Kg citalopram 10 mg). Durante 21 dias pós-natais, foram aferidos peso corporal, eixo látero-lateral, ântero-posterior e circunferência do crânio. Aos 8, 15 e 22 dias pós-natais, os animais foram sacrificados para retirada do encéfalo para avaliar as medidas citadas acima. A utilização de ISRS provocou déficit de crescimento corporal, diminuição das medidas craniais e do encéfalo. O retardo é possivelmente decorrência de alteração na magnitude da ação trófica da serotonina sobre morfogênese crânio-facial, reforçando a participação do sistema serotoninérgico sobre o crescimento somático e ontogenético. O possível efeito hipofágico dos ISRS não é descartado.<br>Neonatal repercussion researched of the serotonin selective recapture inibitor (SSRI) chronic treatment about the somatic growth, of the encephalon and skull. Male rats were divided into groups: control (NaCl) and Cit (10 µL/Kg citalopram 10 mg). In 21 post birth days were measured body weight, side axle , front and rear and skull circle. At 8, 15, 22 days after birth, animals were sacrified for the encephalon withdrawal to evaluate the measurements mentioned above. SSRI use caused body growth deficit, skull and encephalon reduction. The retard is possibly caused by the magnitude change of the trophic serotonin action over the skull-facial morphogenesis, reinforcing the serotoninergic system participation over the somatic and ontogenic growth. The SSRI possible hypophagic effects are not discarded

Rate of Chiari I Malformation in Children of Mothers with Depression with and without Prenatal SSRI Exposure

Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to pregnant women. Therefore, research on in utero exposure to SSRIs can be helpful in informing patients and clinicians. The aim of this retrospective two-cohort study was to determine whether there is a statistically significant increase in Chiari I malformations (CIM) in children exposed to SSRIs during pregnancy. A total of 33 children whose mothers received a diagnosis of depression and took SSRIs during pregnancy (SSRI-exposed cohort) were matched to 66 children with no history of maternal depression and no SSRI exposure. In addition, 30 children whose mothers received a diagnosis of depression, but did not receive antidepressants during pregnancy (history of maternal depression cohort), were matched to 60 children with no history of maternal depression and no SSRI exposure. Main outcome was presence/absence of CIM on MRI scans at 1 and/or 2 years of age. Scans were reviewed by two independent neuroradiologists who were blind to exposure status. The SSRI-exposed children were significantly more likely to be classified as CIM than comparison children with no history of maternal depression and no SSRI exposure (18% vs 2%, p=0.003, OR estimate 10.32, 95% Wald confidence limits 2.04–102.46). Duration of SSRI exposure, SSRI exposure at conception, and family history of depression increased the risk. The history of maternal depression cohort did not differ from comparison children with no history of maternal depression and no SSRI exposure in occurrence of CIM (7% vs 5%, p=0.75, OR estimate 1.44, 95% Wald confidence limits 0.23–7.85). Replication is needed, as is additional research to clarify whether SSRIs directly impact risk for CIM or whether this relationship is mediated by severity of depressive symptoms during pregnancy. We would discourage clinicians from altering their prescribing practices until such research is available