{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T13:09:39Z","timestamp":1746709779447,"version":"3.40.5"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,5,1]]},"abstract":"<jats:p>Although selective serotonin reuptake inhibitors (SSRIs) have gained wide acceptance in the off-label treatment of mental disorders in pregnant women, there seems to be an increased risk for serotonergic adverse effects in newborn infants who are exposed to SSRIs during late pregnancy. Hyponatremia as a result of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a relatively common serious side effect of the use of SSRIs in (mostly elderly) adults. Severe hyponatremia as a result of an SIADH is proposed here as part of a neonatal serotonin toxicity syndrome in a newborn infant who was exposed prenatally to an SSRI. The definite reversal to normal serum sodium levels after fluid restriction, the lack of any alternative cause for the SIADH, and the positive temporal relation with a high score on a widely used adverse drug reaction probability scale offer solid support for the hypothesis of a causal relationship between the SIADH and the prenatal sertraline exposure in our neonate. Moreover, accumulative data on the acute enhancement of serotonergic transmission by intense illumination led us to hypothesize that phototherapy used to treat hyperbilirubinemia in the newborn infant could have been the ultimate environmental trigger for this proposed new cause of iatrogenic neonatal SIADH. The speculative role of phototherapy as a physical trigger for this drug-related adverse event should be confirmed in other cases by thorough study of the serotonin metabolism, assay of SSRI levels in cord blood, and serial measurement of plasma levels in exposed neonates. As phototherapy is used frequently in jaundiced neonates and an apparently increasing number of infants are born to mothers who take SSRIs, serotonin toxicity in neonates deserves increased attention.<\/jats:p>","DOI":"10.1542\/peds.2004-2329","type":"journal-article","created":{"date-parts":[[2005,4,2]],"date-time":"2005-04-02T01:27:21Z","timestamp":1112405241000},"page":"e508-e511","source":"Crossref","is-referenced-by-count":6,"title":["Phototherapy-Mediated Syndrome of Inappropriate Secretion of Antidiuretic Hormone in an In Utero Selective Serotonin Reuptake Inhibitor\u2013Exposed Newborn Infant"],"prefix":"10.1542","volume":"115","author":[{"given":"Piet","family":"Vanhaesebrouck","sequence":"first","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freia","family":"De Bock","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Zecic","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudine","family":"De Praeter","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koenraad","family":"Smets","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kris","family":"De Coen","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linde","family":"Goossens","sequence":"additional","affiliation":[{"name":"From the Department of Neonatology, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2005,5,1]]},"reference":[{"key":"2021120819282819200_R1","doi-asserted-by":"crossref","unstructured":"Isbister GK, Dawson A, Whyte IM, Prior FH, Clancy C, Smith AJ. Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome?Arch Dis Child Fetal Neonatal Ed.\u20082001;85:F147\u2013F148","DOI":"10.1136\/fn.85.2.F145g"},{"key":"2021120819282819200_R2","doi-asserted-by":"crossref","unstructured":"Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry.\u20082003;60:720\u2013726","DOI":"10.1001\/archpsyc.60.7.720"},{"key":"2021120819282819200_R3","doi-asserted-by":"crossref","unstructured":"Zeskind PS, Stephens LE. Maternal selective serotonin reuptake inhibitor use during pregnancy and newborn neurobehavior. Pediatrics.\u20082004;113:368\u2013375","DOI":"10.1542\/peds.113.2.368"},{"key":"2021120819282819200_R4","doi-asserted-by":"crossref","unstructured":"Bouman WP, Pinner G, Johnson H. Incidence of selective serotonin reuptake inhibitor induced hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion in the elderly. Int J Geriatr Psychiatry.\u20081998;13:12\u201315","DOI":"10.1002\/(SICI)1099-1166(199801)13:1<12::AID-GPS718>3.0.CO;2-F"},{"key":"2021120819282819200_R5","doi-asserted-by":"crossref","unstructured":"Arinzon ZH, Lehman YA, Fidelman ZG, Krasnyansky II. Delayed recurrent SIADH associated with SSRIs. Ann Pharmacother.\u20082002;36:1175\u20131177","DOI":"10.1345\/aph.1A337"},{"key":"2021120819282819200_R6","doi-asserted-by":"crossref","unstructured":"Lam RW, Zis AP, Grewal A, Delgado PL, Charney DS, Krystal JH. Effects of rapid tryptophan depletion in patients with seasonal affective disorder in remission after light therapy. Arch Gen Psychiatry.\u20081996;53:41\u201344","DOI":"10.1001\/archpsyc.1996.01830010043007"},{"key":"2021120819282819200_R7","doi-asserted-by":"crossref","unstructured":"Neumeister A, Turner EH, Matthews JR, et al. Effects of tryptophan depletion vs catecholamine depletion in patients with seasonal affective disorder in remission with light therapy. Arch Gen Psychiatry.\u20081998;55:524\u2013530","DOI":"10.1001\/archpsyc.55.6.524"},{"key":"2021120819282819200_R8","doi-asserted-by":"crossref","unstructured":"Lambert GW, Reid C, Kaye DM, Jennings GL, Esler MD. Effect of sunlight and season on serotonin turnover in the brain. Lancet.\u20082002;360:1840\u20131842","DOI":"10.1016\/S0140-6736(02)11737-5"},{"key":"2021120819282819200_R9","doi-asserted-by":"crossref","unstructured":"Hendrick V, Stowe Z, Altshuler L, Hwang S, Lee E, Haynes D. Placental passage of antidepressant medication. Am J Psychiatry.\u20082003;160:993\u2013996","DOI":"10.1176\/appi.ajp.160.5.993"},{"key":"2021120819282819200_R10","doi-asserted-by":"crossref","unstructured":"Rampono J, Proud S, Hackett LP, Kristensen JH, Ilett KF. A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. Int J Neuropsychopharmacol.\u20082004;7:329\u2013334","DOI":"10.1017\/S1461145704004286"},{"key":"2021120819282819200_R11","doi-asserted-by":"crossref","unstructured":"Wisner KL, Gelenberg AJ, Leonard H, Zarin D, Frank E. Pharmacologic treatment of depression during pregnancy. JAMA.\u20081999;282:1264\u20131269","DOI":"10.1001\/jama.282.13.1264"},{"key":"2021120819282819200_R12","doi-asserted-by":"crossref","unstructured":"Goldstein BJ, Goodnick PJ. Selective serotonin reuptake inhibitors in the treatment of affective disorders. Tolerability, safety and pharmacoeconomics. J Psychopharmacol.\u20081998;12:S55\u2013S87","DOI":"10.1177\/0269881198012003041"},{"key":"2021120819282819200_R13","doi-asserted-by":"crossref","unstructured":"Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med.\u20081996;335:1010\u20131015","DOI":"10.1056\/NEJM199610033351402"},{"key":"2021120819282819200_R14","doi-asserted-by":"crossref","unstructured":"Sarrias MJ, Cabre P, Martinez E, Artigas F. Relationship between serotoninergic measures in blood and cerebrospinal fluid simultaneously obtained in humans. J Neurochem.\u20081990;54:783\u2013786","DOI":"10.1111\/j.1471-4159.1990.tb02319.x"},{"key":"2021120819282819200_R15","doi-asserted-by":"crossref","unstructured":"Casper RC, Barry E, Fleisher BE, et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr.\u20082003;142:402\u2013408","DOI":"10.1067\/mpd.2003.139"},{"key":"2021120819282819200_R16","doi-asserted-by":"crossref","unstructured":"Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther.\u20081981;30:239\u2013245","DOI":"10.1038\/clpt.1981.154"},{"key":"2021120819282819200_R17","doi-asserted-by":"crossref","unstructured":"Anderson IK, Martin GR, Ramage AG. Central administration of 5-HT activates 5-HT1A receptors to cause sympathoexcitation and 5-HT 2\/5-HT1C receptors to release vasopressin in anaesthetized rats. Br J Pharmacol.\u20081992;107:1020\u20131028","DOI":"10.1111\/j.1476-5381.1992.tb13401.x"},{"key":"2021120819282819200_R18","doi-asserted-by":"crossref","unstructured":"Greenblatt DJ, von Moltke LL, Harmatz JS, Shader RI. Drug interactions with newer antidepressants: role of human cytochromes P450. J Clin Psychiatry.\u20081998;59:19\u201327","DOI":"10.1097\/00004714-199910001-00003"},{"key":"2021120819282819200_R19","doi-asserted-by":"crossref","unstructured":"Swiecicki L, Szafranski T. Side effects after phototherapy implementation in addition to fluoxetine or sertraline treatment: a report of two cases. World J Biol Psychiatry.\u20082002;3:109\u2013111","DOI":"10.3109\/15622970209150610"},{"key":"2021120819282819200_R20","doi-asserted-by":"crossref","unstructured":"Benedetti F, Colombo C, Pontiggia A, Bernasconi A, Florita M, Smeraldi E. Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial. J Clin Psychiatry.\u20082003;64:648\u2013653","DOI":"10.4088\/JCP.v64n0605"},{"key":"2021120819282819200_R21","doi-asserted-by":"crossref","unstructured":"Zammarchi E, La Rosa S, Pierro U, Lenzi G, Bartolini P, Falorni S. Free tryptophan decrease in jaundiced infants during phototherapy. Biol Neonate.\u20081989;55:224\u2013227","DOI":"10.1159\/000242921"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/115\/5\/e508\/1028547\/zpe0050500e508.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/115\/5\/e508\/1028547\/zpe0050500e508.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T20:55:58Z","timestamp":1638996958000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/115\/5\/e508\/67593\/Phototherapy-Mediated-Syndrome-of-Inappropriate"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,5,1]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2005,5,1]]},"published-print":{"date-parts":[[2005,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2004-2329","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2005,5,1]]}}}