MHRA: SSRI/SNRI Use May Increase Risk of Postpartum Haemorrhage

Pavankumar Kamat

January 11, 2021

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a drug safety update highlighting a small increased risk of postpartum haemorrhage associated with the use of selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants in late pregnancy.

The update follows a European review of observational studies which suggests a slightly increased risk (less than two-fold) of postpartum bleeding with the use of SSRIs and SNRIs during the month preceding parturition. The risk might also be applicable to the newest agent vortioxetine. The review did not report the severity of cases, but no fatalities were recorded. The review cautions that although the overall risk is small, it may be significant in individual patients when other risk factors for postpartum haemorrhage are also considered.

The UK has received a very small number of suspected reports of postpartum haemorrhage associated with antidepressant use.

Clinicians should consider the benefits and risks when prescribing antidepressants during pregnancy, and also the risks of untreated depression in pregnancy. Health care professionals, including midwives, should enquire about the antidepressant use in the later stages of pregnancy. It is not recommended to discontinue anticoagulant therapy in women at high risk of thrombotic events in response to these data, but caution should be exercised.

The product information for these drugs is being updated to reflect the increased risk of postpartum haemorrhage.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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