Neurodevelopment of children exposed in utero to antidepressant drugs

N Engl J Med. 1997 Jan 23;336(4):258-62. doi: 10.1056/NEJM199701233360404.


Background: Many women of reproductive age have depression, necessitating therapy with either a tricyclic antidepressant drug or a drug, such as fluoxetine, that inhibits the reuptake of serotonin. Whether these drugs affect fetal neurodevelopment is not known.

Methods: We studied the children of 80 mothers who had received a tricyclic antidepressant drug during pregnancy, 55 children whose mothers had received fluoxetine during pregnancy, and 84 children whose mothers had not been exposed during pregnancy to any agent known to affect the fetus adversely. The children's global IQ and language development were assessed between 16 and 86 months of postnatal age by age-appropriate Bayley Scales of Infant Development or the McCarthy Scales of Children's Abilities (for IQ) and the Reynell Developmental Language Scales.

Results: The mean (+/-SD) global IQ scores were 118+/-17 in the children of mothers who received a tricyclic antidepressant drug, 117+/-17 in those whose mothers received fluoxetine, and 115+/-14 in those in the control group. The language scores were similar in all three groups. The results were similar in children exposed to a tricyclic antidepressant drug or fluoxetine during the first trimester and those exposed throughout pregnancy. There were also no significant differences in temperament, mood, arousability, activity level, distractibility, or behavior problems in the three groups of children.

Conclusions: In utero exposure to either tricyclic antidepressant drugs or fluoxetine does not affect global IQ, language development, or behavioral development in preschool children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / pharmacology*
  • Aptitude Tests
  • Child
  • Child Behavior / drug effects*
  • Child, Preschool
  • Depressive Disorder / drug therapy
  • Female
  • Fluoxetine / pharmacology*
  • Humans
  • Infant
  • Infant, Newborn
  • Intelligence / drug effects*
  • Language Development*
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Prospective Studies
  • Selective Serotonin Reuptake Inhibitors / pharmacology*


  • Antidepressive Agents, Tricyclic
  • Serotonin Uptake Inhibitors
  • Fluoxetine