Minor depresion is common during pregnancy; but doctors warn than antidepressants should be avoided until after birth.
Pregnant women who are suffering from depression should avoid antidepressant drugs until their babies are born, two experienced doctors say in their paper published this week in the journal Human Reproduction.
After reviewing an abundance of scientific data, the medical professionals concluded that the risks of a popular class of antidepressants, selective serotonin reuptake inhibitors (SSRIs), to fetuses far outweigh any potential benefit to the mothers. More surprising, they say SSRIs — which include Prozac, Zoloft and Paxil — do little to combat depression in pregnant women anyway, even if the numerous risks were not a consideration.
Complications and Birth Defects
The authors of the controversial study are Dr. Adam Urato, obstetrician and chairman of the department of obstetrics and gynecology at MetroWest Medical Center in Framingham, Mass., and Dr. Alice Domar, a psychologist and assistant professor at Harvard Medical School.
Urato told The Telegraph: “Study after study shows increased rates of newborn complications in those babies who were exposed to SSRIs in utero. The (U.S. Food and Drug Administration) and Health Canada have put out warnings specifically regarding this issue.”
In 2006, the FDA warned consumers that SSRIs taken during pregnancy are associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). This birth defect affects a newborn’s heart and lungs and usually cannot be detected until after delivery. It is fatal in about 10 percent of cases.
A National Institutes of Health study reported that the risk of PPHN is six times higher when women take SSRIs than in the general population.
Research also has linked SSRIs to a growing number of birth defects, including heart defects, anencephaly, cleft lip and palate, and respiratory distress. These birth defects have led a number of families to sue antidepressant manufacturers.
Pre-Term Births, High Blood Pressure and Autism
In addition, Urato said at least 40 studies have linked a woman’s use of SSRIs to the pre-term birth of her baby, which can lead to a host of other complications. Four other studies show that SSRIs elevate the risk of pre-eclampsia, or high blood pressure, in the mother that can lead to liver problems, stroke and stillbirth.
A recent study has further documented some doctors’ concerns that the use of SSRIs increases the risk of babies being born with autism. This particular research indicates the antidepressants double the risk. The link has not yet been proven conclusively, but Urato says the “evidence raises serious concerns.”
“We’re not saying that every pregnant woman should go off her medication. Obviously you don’t want a pregnant woman to attempt suicide,” Domar said at the annual conference of the American Society of Reproduction in San Diego. “[But] if you add up all the potential risks, a lot of people would say they are unacceptable.”
She suggested that pregnant women should be advised that talk therapy, such as cognitive behavioral therapy, can be effective.