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These investigations described that SSRI use in general was associated with an increased risk of major congenital anomalies (MCAs) and CHD in the fetus, that sertraline use in early pregnancy was associated with an increased risk of congenital malformations such as ventricular septal defects and respiratory defects, and that the use of citalopram, fluoxetine, and paroxetine was associated with an increased risk of both MCAs and CHD

However, this medication is not available over the counter