SSRIs in Pregnancy may Affect Maternal Care giving behavior, Not Offspring Cognition, reveals study

Findings from a new study show that selective serotonin reuptake inhibitor use during pregnancy and lactation may alter maternal caregiving behaviors but does not impair offspring cognition. Selective serotonin reuptake inhibitors, such as fluoxetine, are widely prescribed for the treatment of depression and anxiety in women of reproductive age, including during pregnancy. Concerns about potential risks for neurodevelopmental impairment in children have often complicated treatment decisions, leading to hesitation among patients and clinicians.

The study offers important clarification by indicating that while maternal behaviors related to caregiving may be influenced by exposure to selective serotonin reuptake inhibitors during the perinatal period, offspring cognitive abilities remain unaffected. Maternal caregiving encompasses essential interactions such as attentiveness, emotional responsiveness, and nurturing practices, all of which are critical for healthy child development.

Pharmacological modulation of serotonin systems during pregnancy may influence these behaviors, underscoring the importance of monitoring and supporting maternal-infant bonding in women undergoing pharmacological treatment. At the same time, the absence of measurable adverse effects on offspring learning, memory, and cognitive performance provides reassurance regarding long-term neurodevelopmental outcomes.

This distinction helps shift the clinical conversation from concerns about irreversible cognitive harm in children to a more practical focus on supporting maternal caregiving capacity. Untreated maternal depression itself carries significant risks, including reduced caregiving quality and poorer child outcomes, highlighting the necessity of balancing risks and benefits when considering treatment options. The findings encourage clinicians to take an integrative approach, combining pharmacological management with psychosocial support strategies that reinforce maternal caregiving behaviors. Further longitudinal research will be important to understand whether early behavioral changes in mothers translate into long-term psychosocial impacts on offspring.

Overall, the evidence suggests that selective serotonin reuptake inhibitors remain a viable therapeutic option during pregnancy, provided maternal support systems are emphasized as part of comprehensive perinatal care.

Keywords: selective serotonin reuptake inhibitors, fluoxetine, pregnancy, lactation, maternal caregiving, offspring cognition, perinatal depression, child development

Reference:
Prado-Rivera MA, Ebbing JJ, Yurova M, Olivier JDA. Perinatal fluoxetine exposure does not impair cognition in offspring. Behavioural Brain Research. 2026;496:115812. doi:10.1016/j.bbr.2025.115812

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Health crisis in a bottle: Rajasthan govt bans cough syrup batch after patients fall ill in Bharatpur, Sikar

Jaipur: The Rajasthan Medical Services Corporation Limited (RMSCL) has imposed a ban on the distribution and use of a batch of cough syrup following reports of adverse reactions in Bharatpur and Sikar districts.

Patients reported alarming symptoms, including vomiting, drowsiness, anxiety, dizziness, restlessness, and even unconsciousness, after taking the medication.

Medical and Health Minister Gajendra Singh Khinvsar directed RMSCL to conduct an urgent probe and take immediate action upon receiving the complaints. Acting swiftly, RMSCL suspended the use of the Dextromethorphan HBr Syrup IP 13.5mg/5ml (Batch No. 440) pending test results.

Principal Secretary of the Medical and Health Department, Gayatri Rathore, confirmed that statutory samples were collected by Drug Control Officers and forwarded to the State Drug Testing Laboratory for quality analysis. She said further steps will be taken once the test results are available.

As per IANS, RMSCL has also ordered a ban on 19 other batches of the same drug supplied by the concerned manufacturer. RMSCL Managing Director Pukhraj Sain emphasised that strict quality control procedures are in place under the Chief Minister’s Free Medicine Scheme.

Every drug batch supplied is first tested in approved laboratories, and only medicines meeting prescribed standards are released for hospital use. If any batch fails, it is barred from distribution. In cases where complaints are received, drugs are retested at the State Drug Testing Laboratory to ensure public safety. Officials stressed that public health remains the government’s top priority and assured that necessary regulatory action will follow based on laboratory findings.

Patients have been advised to immediately discontinue use of the affected batches until further notice. The incident has raised concerns over drug safety standards, but authorities have reiterated their commitment to strict monitoring and swift corrective measures to protect patients.

A 5-year-old child died after reportedly consuming cough syrup supplied under the government’s free medicine scheme in Sikar district. The family alleged that the child, identified as Nityansh, stopped breathing immediately after taking the dose.

Similar incidents have surfaced in Srimadhopur and Bharatpur. In Sikar, three children reportedly fell ill after consuming the same cough syrup. In Bharatpur, even a doctor who examined the children later experienced health complications after consuming the medicine.

The most recent case occurred in Khori Brahmanan village of Sikar, where Nityansh’s family claims that the cough syrup provided at a government hospital was directly responsible for his sudden death.

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56 MBBS students of Darbhanga Medical College booked amid row over alleged ban on exams, hostel stay

Darbhanga: 56 MBBS students of Darbhanga Medical College and Hospital (DMCH) have reportedly been booked for protesting against what they termed as ”arbitrary” academic decisions. According to the Careers360 report, they were opposing the alleged ban on exams, classes, and stay in hostels.

The students have alleged that “false” First Information Reports (FIRs) have been filed against them.

According to the students, the issue arose when the college administration barred around 60-70 students from appearing for the sent-up examinations despite their 75% attendance recorded on the biometric app.

Also Read: ‘Assaulted, blackmailed’- MBBS student alleges ragging, 3 medicos booked

Careers 360 has reported that the stand-off between the DMC management and students escalated after an order was issued by the principal announcing that all classes for 2021, 2023, and 2024 MBBS batches had been cancelled and the medical students would not be allowed to stay in the hospital.

Thereafter, a meeting was held on September 26 with the department heads and the college authorities decided that the girl students enrolled in MBBS 2025 batch would be allowed to stay in the hostel as well as attend classes. Meanwhile, it was also decided that the MBBS students of the 2022 batch would be allowed to attend classes and stay in the hostel from October 7. Regarding the MBBS students of the 2023 and 2024 batches, it was decided that they could appear for the University’s written, departmental, practical and oral examinations while staying outside the DMC hostel.

“All classes for the 2021, 2023, and 2024 batches are cancelled until further notice, and they will not be allowed to stay in the hostel. Therefore, all concerned students are directed to ensure compliance with the above decisions and will be responsible for any action taken against them in the future if they do not follow these rules,” read the notification.

The students started protesting against this decision and consequently, the college administration lodged FIRs against them, the students alleged.

“This is not just an attack on students — it is an attack on the future of medical education and an attempt to silence genuine voices. Criminalizing young medical students for demanding their rights is unacceptable and sets a dangerous precedent,” remarked the medicos.

The Daily has reported that the students have demanded immediate withdrawal of the false FIRs against 56 DMCH students, fair treatment in academics by allowing them to take exams, and accountability of the administration for “misusing” power against students.

“Doctors are the backbone of our healthcare system. Today’s students are tomorrow’s healers. If they are silenced, harassed, and criminalized, what future does healthcare in Bihar hold?” asked the medicos.

Also Read: J P Nadda inaugurates 210-bed super speciality block at Darbhanga Medical College Hospital

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Telangana HC seeks response on hospitals’ plea over biomedical waste fee

Private hospitals in the state have taken their fight against the new bio-medical waste fee system to the Telangana High Court. The petitioners alleged that the system unfairly penalises bedded facilities while non-bedded institutions pay strictly in proportion to the waste they generate.

While hearing the matter, a division bench comprising Justices Abhinand Kumar Shavili and Vakiti Ramakrishna Reddy directed the state and central governments, along with the Telangana Pollution Control Board (TGPCB) and the Central Pollution Control Board, to respond to the plea filed by private hospitals and doctors’ bodies regarding bio-medical waste charges.

For more details, check out the full story on the link mentioned below:

Telangana HC issues notice on hospitals’ plea over biomedical waste fee

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Philippines MD degree not compliant with NMC FMGL regulations- Students raise concerns, seek NMC, Govt intervention

Alleging that the medical education programme in the Philippines does not comply with the three major Foreign Medical Graduates Licentiate (FMGL) Regulations 2021, a group of students has sought intervention from the Union Health Ministry and the National Medical Commission (NMC).

The appeal has been addressed to the Union Health Minister, External Affairs Minister, Home Minister, officials of the National Medical Commission (NMC), state medical councils, and the Embassy of India in Manila. It has also been sent to the Commission on Higher Education (CHED) officials in the Philippines, including its Legal and International Affairs Directors.

For more details, check out the full story on the link mentioned below:

Philippines MD degree not compliant with NMC FMGL regulations- Students allege violations, seek NMC, Govt intervention

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Former AIIMS Rishikesh Director booked over alleged irregularities

Rishikesh: The Uttarakhand Anti-Corruption Bureau (ACB) has registered an FIR against the former director of AIIMS Rishikesh and three others for alleged financial irregularities in the establishment of a Coronary Care Unit (CCU) at the institute.

The tender for the 16-bed CCU project was floated in December 2017, but it is still incomplete.

Apart from the former director of the institute, two other FIRs have been registered against the then additional professor, Radiation Oncology, AIIMS Rishikesh, and the then store keeper-cum-clerk of the institute, ACB sources said, news agency PTI reported. 

Also Read:AIIMS Rishikesh doctor distributes sweets after Pahalgam attack, booked

The fourth FIR has been registered against unidentified public servants and private persons, they said.

They were booked under different sections of the IPC, including 120B (criminal conspiracy), 201 (causing disappearance of evidence), 409 (criminal breach of trust), 420 (cheating and dishonestly inducing the delivery of property) and section 7 of the Prevention of Corruption Act (public servant accepting undue advantage, such as a bribe, etc).

It has been found that the accused abused their official position, conspired with Delhi-based contractor-supplier Puneet Sharma and did him undue favours to cheat the AIIMS Rishikesh and caused wrongful loss to it to the tune of Rs 2,73,29,355.

The accused also made corresponding wrongful gains in the process, the ACB sources said.

The FIRs, which were lodged on September 26, followed raids conducted by the CBI and ACB at AIIMS, Rishikesh, in connection with the case, during which many irregularities and documentary discrepancies were found, reports PTI.

As per a media report in The Indian Express, in the FIR, the CBI said that a payment of Rs 8.08 crore was released to the contractor/supplier of a Delhi-based company on November 1, 2019 and January 13, 2020, by the AIIMS, Rishikesh, against “contingent bill no 1 and 2”. In 2022, the CBI registered two separate cases against faculty members of AIIMS-Rishikesh and private companies for alleged corruption in setting up of a chemist shop on the AIIMS campus, among other malpractices.

The construction of the CCU, in whose name all the alleged wrongful transactions were done with the involvement of the top functionaries of AIIMS, Rishikesh, is still incomplete.

Also Read:AIIMS Rishikesh doctor ends life, note cites dissatisfaction with life

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Lupin bags USFDA approval for Rivaroxaban for Oral Suspension for thromboprophylaxis in pediatric patients

Mumbai: Global pharma major Lupin Limited has announced that it
has received approval from the United States Food and Drug Administration (USFDA) for its Abbreviated
New Drug Application (ANDA) for Rivaroxaban for Oral Suspension, 1 mg/mL which is bioequivalent to Xarelto for Oral Suspension, 1 mg/mL of Janssen Pharmaceuticals, Inc.

The product will be manufactured at Lupin’s
Chhatrapati Sambhajinagar facility in India.
Rivaroxaban for Oral Suspension is indicated for:
• Treatment of venous thromboembolism (VTE) and reduction in the risk of recurrent VTE in pediatric
patients from birth to less than 18 years after at least 5 days of initial parenteral anticoagulant
treatment.
• Treatment of thromboprophylaxis in pediatric patients 2 years and older with congenital heart disease
after the Fontan procedure.

In addition to the oral suspension approval, Lupin received approval for its ANDAs for 10 mg, 15 mg, and 20 mg strengths of Rivaroxaban Tablets USP in May.

Read also: Lupin Rivaroxaban Tablets approved by USFDA

Rivaroxaban for Oral Suspension, 1 mg/mL (RLD Xarelto) had estimated annual sales of USD 11 million
in the U.S. (IQVIA MAT July 2025).
Lupin Limited is a global pharmaceutical leader headquartered in Mumbai, India, with products distributed in
over 100 markets. Lupin specializes in pharmaceutical products, including branded and generic formulations,
complex generics, biotechnology products, and active pharmaceutical ingredients. The company has a strong position in India and the U.S. across multiple
therapy areas, including respiratory, cardiovascular, anti-diabetic, anti-infective, gastrointestinal, central
nervous system, and women’s health. Lupin has 15 state-of-the-art manufacturing sites and 7 research centers
globally.

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Andhra Pradesh PHC doctors announce hunger strike from October 3

Vijayawada: Upset and frustrated over the government’s continued ignorance towards their basic demands, doctors working at Primary Health Centres (PHCs) across the state have announced a hunger strike on October 3, suspending outpatient services if their demands, on issues such as promotions, allowances, increments, and other service-related concerns, are not addressed.   

Calling the doctors’ demands ‘unjustifiable’, the health department has deployed doctors from district and teaching hospitals to the PHCs to ensure zero disruption in providing medical services to the patients. The department has also urged the doctors to resume their duties and call off the strike. 

This comes after talks between the doctors and the Commissioner of Health and Family Welfare failed to yield a resolution. Recently, the Commissioner of Health and Family Welfare invited APPHCDA leaders for a discussion regarding their concerns. However, when the meeting did not yield any results, the doctors decided to intensify their protest. 

Also read- Andhra Pradesh doctor suspended over patient death at PHC

Doctors under the Andhra Pradesh Primary Health Centres Doctors Association (APPHCDA) recently submitted a strike notice to the Director of Public Health, Dr P Padma Sasidhar, and higher authorities, giving the government a five-day window to address their demands before launching agitation.

The association has planned a series of protests, including sit-ins at the district centres on September 30, October 1, and 2, to step up pressure on the government.

“Our demands are genuine and repeatedly ignored. Without immediate resolution, we will escalate with a hunger strike in Vijayawada beginning on October 3,” APPHCDA President Ravindra Naik told PTI.

He said that for 2025–26, the in-service PG quota was reduced to 15 per cent in only seven branches, compared to 20 per cent across all branches last year.

The doctors have demanded a uniform 15 per cent in-service quota across all specialities for the next three years to ensure fairness for Primary Health Centre (PHC) doctors pursuing postgraduate courses.

Another demand is time-bound promotions, noting that PHC doctors have served 20 years without advancement. In comparison, District Speciality Hospital (Andhra Pradesh Vaidya Vidhana Parishad) doctors were promoted within just three years of service.

The association also highlighted the absence of tribal allowances for PHC doctors working in remote forest areas, while District Speciality Hospital doctors have been receiving these benefits for two years.

Further demands include a mobile medical services allowance and other service-related issues, the association said.

However, the state government mentioned that a recent GO has allotted 15% clinical and 30% non-clinical PG seats for in-service doctors. Therefore, the government claimed that the protest is unjust. Approximately 1,000 PG doctors will join duties from November, vacancies in secondary hospitals will be filled by 2027, and teaching hospitals by 2028, said the government. 

In case the doctors continue with their hunger strike on October 3, the services at the PHCs will be severely hit, as 1 lakh patients a day on average, particularly in rural and tribal areas, receive their treatment from these centres, report TNIE

To ensure that the centres run smoothly without disruption, the health department deployed 1,014 PG students, senior residents, and MBBS tutors, and 1,017 MBBS doctors from other hospitals to the PHCs. 

Also read- Madras HC rejects plea for doctor’s appointment at PHC, says it’s a departmental matter

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Overweight and obesity patients have improve survival against chronic total occlusion: BMJ

A new study published in the British Medical Journal showed that diabetes mellitus (DM) and low BMI have negative influence on long-term survival in individuals with chronic total occlusion (CTO).

One of the more difficult subtypes of coronary artery disease (CAD) is chronic complete occlusion. About one-fourth of individuals with chronic coronary syndrome and 16% to 30% of patients undergoing coronary angiography have CTO. Diabetes mellitus (DM), which is characterized by insulin resistance, β-cell dysfunction, and chronic hyperglycemia, is a primary contributor to vascular problems.

Another important factor influencing cardiovascular outcomes in individuals with CAD is body mass index (BMI), as obesity is becoming much more common in the general population. Thus, this study assessed how body mass index (BMI) and diabetes mellitus affected the long-term all-cause mortality of patients with CTO.

The Swedish Coronary Angiography and Angioplasty Registry was a part of this retrospective, countrywide cohort research, which ran from June 2015 to December 2021. 24,284 patients had CTO that was verified by angiography. Excluded is previous coronary artery bypass graft surgery. DM status and BMI classifications (underweight, healthy weight, overweight, and obesity) were used to create subgroups. 

A 31% increased risk of death was associated with DM, which was present in 30.3% of patients (HR: 1.31, 95% CI: 1.20 to 1.42; p<0.001). Diabetes patients who used insulin had a 52% higher risk (HR: 1.52; 95% CI: 1.38 to 1.67; p<0.001).

BMI showed that the risk was lower for overweight (HR: 0.70, 95% CI: 0.64 to 0.77; p<0.001) and obese (HR: 0.74, 95% CI: 0.68 to 0.81; p<0.001) groups than for the healthy-weight group, while the risk was higher for underweight people (HR: 1.61, 95% CI: 1.25 to 2.08; p<0.001).

An asymmetric U-shaped correlation was found using a continuous BMI spline: mortality increased sharply below 23 kg/m2, reached its lowest risk (nadir) at 32 kg/m2, and increased moderately beyond 35 kg/m2.

Overall, insulin treatment further increased risk, and diabetes mellitus (DM) independently predicted higher long-term mortality in this national CTO population, along with more severe comorbidities and greater CTO complexity. The patients who were overweight or obese fared better, whereas those who were underweight fared the worst. 

Source:

Mohammed, M., Sundström, J., Louca, A., Hellsen, G., Rawshani, A., Olivecrona, G. K., Mohammad, M. A., Ioanes, D., Jensen, U., Erlinge, D., MD, PhD, Angerås, O., Petursson, P., Myredal, A., Völz, S., Dworeck, C., Odenstedt, J., Rawshani, A., & Råmunddal, T. (2025). Impact of diabetes mellitus and body mass index on long-term survival in chronic total occlusion patients: a nationwide cohort study from the SCAAR registry. BMJ Open, 15(9), e100074. https://doi.org/10.1136/bmjopen-2025-100074

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Fortified foods and dietary supplements key to bone health in vegan diets, suggests research

A study conducted at the University of Helsinki found that children and adults who follow a vegan diet had on average adequate intakes of calcium and vitamin D, nutrients important to bone health, but their bone metabolism differed from those who follow an omnivorous diet.

The MIRA2 study conducted at the University of Helsinki investigated bone metabolism and the intakes of nutrients critical to bone health, such as calcium, vitamin D and protein. The study involved children residing in Helsinki aged between two and seven who followed a vegan, vegetarian or omnivorous diet, as well as their caregivers.

The study subjects following a vegan diet adhered almost without exception also to the recommendations on the consumption of dietary supplements and fortified foods, and they had on average adequate vitamin D and calcium intakes. The children on a vegan diet had higher vitamin D intake than those on an omnivorous or a vegetarian diet due to more active consumption of vitamin D supplements with higher doses. On average, vitamin D status measured from blood was also adequate in all diet groups.

The study found that the more plant-based diets, namely vegan and vegetarian ones, were in adults associated with higher concentrations of bone formation and resorption markers, which may indicate accelerated bone metabolism. In contrast, more plant-based diets among children were associated with higher parathyroid hormone concentrations, which have been associated with more active bone resorption. While these observations can indicate long-term adverse effects on bone health, their clinical significance is unclear.

“The calcium naturally occurring in plant-based foods is fairly poorly absorbed. In fact, the widespread vitamin D and calcium fortification of plant-based dairy alternatives in Finland is important for the adequate intake of these nutrients among vegans and, consequently, for their bone health,” says Docent Suvi Itkonen from the Faculty of Agriculture and Forestry, University of Helsinki.

Many international studies have raised concerns about the potential adverse effects of vegan diets on bone health. However, these studies have typically targeted populations where vitamin D intake is low, the selection of vegan products on the market is narrow, and the consumption of fortified foods or dietary supplements is less widespread than in Finland.

Vegan diets require careful planning especially for children

The researchers found that vegans and vegetarians had lower protein intake compared to those who followed an omnivorous diet, although on average it was adequate. Proteins are composed of amino acids.

“It’s possible that the poorer absorption and different amino acid composition of plant-based proteins compared to animal proteins partly explain the observed differences in bone metabolism, but more research is needed on the topic. In fact, we will next investigate amino acid intake among the MIRA2 subjects and the amino acid composition of vegan diets,” Itkonen says.

The MIRA2 dataset was collected in Helsinki, where vegan food in daycare centres and various vegan food products are abundantly available. The families who participated in the study were well versed in guidelines for vitamin D supplementation and fortified food consumption.

“People in the Helsinki Metropolitan Area live in a kind of veggie bubble. Due to that one has to keep in mind that the findings of the study are not directly applicable to the populations of other regions or countries,” Itkonen points out.

The nutrition recommendations published last autumn emphasise a predominantly plant-based diet, restricting meat consumption and moderating milk consumption. If a food is entirely excluded from the diet, it is important to replace it with nutritionally comprehensive alternatives. When planning a vegan diet for children and adolescents, a visit to a registered dietitian is recommended.

“In terms of bone health, it is essential when consuming plant-based drinks and yoghurt-like products to choose the option fortified with calcium and vitamin D. Children should take a daily vitamin D supplement throughout the year. If the daily diet contains no margarines, dairy products or plant-based drinks fortified with vitamin D, and if fish is eaten less than 2–3 times per week, it’s important to ensure adequate vitamin D intake, especially during the dark season, by taking a vitamin D supplement. Among vegans, the need for vitamin D supplementation is common,” Itkonen notes.

Reference:

Itkonen, S.T., Hovinen, T., Kettunen, E. et al. Bone and mineral metabolism in 2–7-year-old Finnish children and their caregivers following vegan, vegetarian, and omnivorous diets. Eur J Nutr 64, 276 (2025). https://doi.org/10.1007/s00394-025-03758-y

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