Antidepressants in Pregnancy
An article in BusinessWeek’s HealthDay News, entitled, Antidepressants in Pregnancy May Delay Developmental Milestones, dated February 23, 2010, reported on a study published in the March issue of Pediatrics. The study was based on more than 81,000 babies born in Denmark. The report confirmed that babies whose mothers took antidepressants in the second or third trimester sat up 16 days later and walked about a month later than mothers who did not take antidepressants. Nineteen month old children were not able to occupy themselves for more than 15 minutes.
The same article states:
“In the British Medical Journal, women who take certain antidepressants during the first three months of pregnancy were at a slightly increased risk of giving birth to babies with septal heart defects, or malformations in the wall separating the right side of the heart from the left. The risks were seen in sertraline (trade names Zoloft, Lustral) and in citalopram (brand-names Celexa and Cipramil).”
That being stated, now the public is aware that the last trimester is not the only time these drugs are found dangerous. The article also reports:
‘The U.S. Food and Drug Administration and the American College of Obstetricians and Gynecologists (ACOG) have issued warnings about an increased risk of heart defects associated with the use of the Paxil during pregnancy.”
NewsWeek’s article above suggested obtaining further information from the March of Dimes.
March of Dimes explains that it is very challenging to understand the risks of any drugs prescribed to pregnant women because there are actually two patients: the woman and the unborn fetus. Because of this complication, researchers have not yet studied many drugs in pregnant women.
March of Dimes, does, however, suggest the possibility of taking St. John’s Wort for treating mild to moderate depression, according to the National Center for Complementary and Alternative Medicine. It is noted that"
“…herbal products, such as St. John's wort, vary in strength and quality from product to product. We need more research to help us know whether St. John's wort is useful and safe for treating depression in pregnant women.
‘IMPORTANT: We know very little about the effect of St. John's wort on the fetus. Do no [not] take this herb or other herbal remedies without first speaking to your health provider.”
Wikipedia reported in an article entitled, “Selective serotonin reuptake inhibitor” [SSRI], that SSRIs do enter beyond the placenta and may affect a newborn. Some newborns have experienced Neonatal abstinence syndrome, a withdrawal syndrome in newborn babies. A total of 93 cases had been reported by 2003. The authors of a Lancet study suggested that doctors should avoid or cautiously manage the prescribing of these drugs to pregnant women with psychiatric disorders.
Another study showed that 4-year old children who had prenatally been exposed to SSRIs were normal, however they were concerned about permanent neuropsychological changes since the lab studies showed that mice and rats developed behavioral disturbances in adolescents.
Wikipedia references the FDA (Food and Drug Administration), therefore, we went right to the source. In 2006 the FDA alerted us on the possible side effects of SSRI use in pregnancy in an article entitled, “SSRIs and Treatment Challenges of Depression in Pregnancy”, reporting additional warnings which we list below.
Another study on newborns with persistent pulmonary hypertension (PPHN), (abnormally high blood pressure in the arteries of the lungs) reported that PPHN was discovered six times more in mothers who took an SSRI antidepressant after the 20th week of pregnancy compared to babies whose mothers did not take an antidepressant. This caused concern because of the prior reports of just warning mothers about the risks in the second half of pregnancy. Those warnings were: difficulties such as irritability, difficulty feeding and in very rare cases, difficulty breathing.
The FDA reported in 2006
“Additionally, the labeling for paroxetine (Paxil) was recently changed to add information about findings in an epidemiologic study that suggests that exposure to the drug in the first trimester of pregnancy may be associated with an increased risk of cardiac birth defects.”
The FDA has requested that manufacturers of SSRIs include a label suggesting that you should speak with your physician to weigh the risks and benefits prior to taking SSRIs or antidepressants.
Can drug studies be trusted?
You will find many articles stating that SSRIs and antidepressants are found safe for use in pregnancy, but can these studies be trusted?
Per a CNN report, Companies pledge more transparency in drug trials in 2005:
“Drug makers are currently required to register information on clinical trials in an online government database, but only if those trials deal with life-threatening conditions.
‘…while critics call it another industry attempt to stave off regulation.
‘The new industry policy is still voluntary…
‘Without a mandatory registration system, the companies would still have it in their interest to not publish certain trials,’ Goozner [Director of the Integrity in Science Project at the Center for Science in the Public Interest] said.”
CCHR Florida suggests that you do your own research and ensure that your physicians are providing you with Informed Consent. You and your unborn child deserve the very best.