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Psychotropic Medications During Pregnancy: Risk to the Fetus-Reply

Gideon Koren, MD, ABMT, FRCPC; Anne Pastuszak, MSc
JAMA. 1993;270(18):2178. doi:10.1001/jama.1993.03510180047020.
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In Reply.  —We thank Dr Tueth for his comments and agree with the notion that a new era has started in clinical teratology. The prospective studies on lithium and fluoxetine organized by us could be conducted with over 100 patients each because there are now Teratology Information Services in both the United States and Canada that prospectively and systematically collect exposure data in pregnancy. We believe that in the next decade it will be possible to shed light on the reproductive safety and risk of many medications that are currently in the "gray zone" of animal studies and a few case reports. As a word of caution, however, it will be important not to overinterpret the present results to the area of behavioral teratology. It will be crucial to prove that babies exposed in utero to fluoxetine are not different in their various domains of development (cognitive, language, and the


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