Mood and anxiety disorders are common and show an increasing trend.1
In the Netherlands, life-time prevalences of depression and anxiety among adults are approximately 30%. About 10% of participants of the NEMESIS study, a repeated follow-up survey representative of the Dutch adult general population, reported having had a mood disorder, and 15% reported an anxiety disorder, in the preceding 12 months.2
The most recent annual health data survey from Statistics Netherlands indicates that half of adult women experienced symptoms of anxiety or depression in the preceding four weeks, with the highest prevalence among young adults (<30 years).3
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used drugs prescribed for anxiety and depression. Information on the safety of SSRIs and other drugs used during pregnancy can be found on the website of the Dutch "Moeders van Morgen - Dutch Pregnancy Drug Register". They conclude that SSRIs are generally considered safe for use during pregnancy as there is no clear evidence for teratogenic effects. However, a small increase in the risk of congenital heart defects cannot entirely be ruled out. Nonetheless, SSRIs do cross the placenta, and infants exposed to SSRIs are at increased risk of requiring treatment for symptoms of abstinence in neonatal care.4
A literature review showed that research results regarding long-term offspring depressive or anxiety symptoms are inconclusive, and further studies are needed to clarify these effects.4
Eurocat collects data on medication dispensed at pharmacies and on self-reported use, based on standardized questionnaires.
Between 1997 and 2024, among mothers for whom drug use information was available, 64% used at least one medication in the first trimester of pregnancy, excluding folic acid and other vitamins.
A total of 4.3% of mothers who completed the questionnaire reported having experienced depression, of whom 59% received pharmacological treatment.
Among those who reported a depression for which an “antidepressant” was used, 55% continued their medication during pregnancy, while 40% discontinued use and 5% switched to a different medication. SSRIs were used by 1.6% of all mothers during the first trimester of pregnancy with citalopram and paroxetine being the most frequently used agents.
Each year, EUROCAT Northern Netherlands evaluates whether medications reported to Lareb as being used by mothers of children with congenital anomalies during the first trimester of pregnancy are associated with specific anomalies. To date, our analyses have found no evidence that SSRIs are linked to a relatively high number of cases of any specific type of congenital anomaly.
