Antidepressants: paroxetine in pregnancy: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Antidepressants: paroxetine in pregnancy

Sample item

A pregnant woman with depression asks which SSRI to avoid in the first trimester because of cardiac malformation concerns. The usual answer is

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Paroxetine

First-trimester paroxetine has been linked to a small increase in cardiac malformations, so it is avoided in women planning pregnancy. Sertraline is often preferred in pregnancy and lactation. Late exposure to any SSRI can cause neonatal adaptation syndrome and persistent pulmonary hypertension of the newborn.

Option by option

  • A. Paroxetine (correct)

    Correct. Paroxetine is the SSRI most associated with cardiac malformations.

  • B. Sertraline

    Sertraline has the most reassuring data.

  • C. Escitalopram

    Escitalopram is not the main concern.

  • D. Fluoxetine

    Fluoxetine is not specifically linked to cardiac defects in this way.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Paroxetine. First-trimester paroxetine has been linked to a small increase in cardiac malformations, so it is avoided in women planning pregnancy.

Why is "Sertraline" not the answer?

Sertraline has the most reassuring data.

Why is "Escitalopram" not the answer?

Escitalopram is not the main concern.

Why is "Fluoxetine" not the answer?

Fluoxetine is not specifically linked to cardiac defects in this way.

What concept does this question test?

It tests Antidepressants: paroxetine in pregnancy in Psychiatry. Sertraline is often preferred in pregnancy and lactation. Late exposure to any SSRI can cause neonatal adaptation syndrome and persistent pulmonary hypertension of the newborn.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidepressants: paroxetine in pregnancy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.