Antidepressant Use In Pregnancy May Cause Miscarriage

An emerging study just published in the Canadian Medical Association Journal (CMAJ) says that a 68 percent increase in the incidence of miscarriage was seen in pregnant women taking <"">antidepressants, wrote Science Daily. Of note, we recently wrote that women taking antidepressants, such as the SSRIs Paxil (paroxetine) and Zoloft (sertraline), as well as Wellbutrin and Zyban (bupropion), have seen an increase in serious birth defects.

SSRIs seem to relieve symptoms of depression by blocking the reabsorption of serotonin by certain nerve cells in the brain, leaving more serotonin available in the brain. Increased serotonin enhances neurotransmission—the sending of nerve impulses—and improves mood. SSRIs are called selective because they seem to affect only serotonin, not other neurotransmitters.

SSRIs, specifically paroxetine and venlafaxine, and higher daily doses of either, were connected with an increased risk of miscarriage, said Science Daily. A combination of different antidepressants doubled miscarriage risk.

The study was conducted by researchers from the University of Montreal and the CHU Ste-Justine, which looked at data on 5124 women in Quebec from a large population-based cohort of pregnant women who experienced clinically verified miscarriages during their pregnancies up to the first 20 weeks of gestation; a large sample of women from the same Registry who did not suffer from miscarriage were also included. Of the 284 miscarriages, 5.5 percent involved taking antidepressants during pregnancy.

According to Science Daily, antidepressants are often used during pregnancy and up to 3.7 percent of pregnant women take an antidepressant during the first trimester; stopping treatment can lead to depressive relapse, placing both the mother and developing baby at risk. As we have often warned, the researchers also urge that physicians who have patients of childbearing age taking antidepressants or have pregnant patients who require antidepressant therapy early in pregnancy discuss the drugs’ risks and benefits.

Science Daily wrote that prior studies that looked at antidepressant use during pregnancy did not study miscarriages or were looking at smaller samplings or showed some contradictions; however, this study looked at the drugs’ use during pregnancy. Drug class, types, and doses were studied along with the suicide risk. “These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied,” wrote senior author Dr. Anick Bérard, from the University of Montreal and the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine, quoted Science Daily.

Since 2005, information has been emerging that certain SSRIs may cause birth defects, including cardiac (heart), pulmonary (lung), neural-tube defects (brain and spinal cord), craniosynostosis (abnormally shaped skull) infant omphalocele (abdominal wall defects), club foot (one or both feet turn downward and inward), and anal atresia (complete or partial closure of the anus).

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