Author's reply

doi:10.1136/bmj.b4295

Published 21 October 2009, doi:10.1136/bmj.b4295
Cite this as: BMJ 2009;339:b4295

Letters

SSRIs and congenital defects

Author’s reply

The first 150 words of the full text of this article appear below.

I did not intend my comments to be interpreted as minimisingthe risk.¹ ² Rather, I intended to place the risks in contextin terms of both size (which is estimated to be comparativelysmall compared with other known teratogens such as isotretinoin,which can affect more than 20% of exposed pregnancies) and theconcomitant risks of no treatment or undertreatment.

Healy mentions our California data on pregnancy outcomes withprenatal exposure to paroxetine.² This is a perfect exampleof the difficulty in drawing conclusions from studies with inadequatesample sizes. Our data on paroxetine were drawn from an ongoingopen cohort study with an increasing but still extremely smallsample size. Preliminary results were published in abstractform several years ago,³ and updated results were provided forand included in the meta-analysis recently published by Wurstet al.⁴ These same data were also included in a published paperon the . . . [Full text of this article]

Christina Chambers, associate professor¹

¹ Division of Dysmorphology and Teratology, Departments of Pediatrics and Family and Preventive Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0828, La Jolla, CA 92093-0828, USA

chchambers@ucsd.edu