Study: Potential for Significant Risks with SSRIs and Pregnancy

A new study suggests that there is the potential for risks when taking SSRIs during pregnancy. SSRIs, or selective serotonin reuptake inhibitors include medications sold under the names Paxil, Prozac, Celexa, Lexapro, and Zoloft. SSRIs block the reabsorption (reuptake) of the neurotransmitter, serotonin, in the brain to boost mood.

The emerging study suggests that there is too much of a risk with taking SSRIs during pregnancy, including potential increased risks for miscarriage, pre-term births, neonatal health complications, and long-term neurobehavioral abnormalities, said Medical Xpress. Neurobehavioral abnormalities include autism, which suggests that SSRIs should be used to treat depression with great care as well as sufficient counseling to those women who are diagnosed with depression and who are trying to become pregnant, said the researchers at Beth Israel Deaconess Medical Center, Tufts Medical Center, and MetroWest Medical Center.

“Depression and infertility are two complicated conditions that more often than not go hand in hand. And there are no definitive guidelines for treatment,” said lead author Alice Domar, Ph.D, Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Executive Director of the Domar Center for Mind/Body Health at Boston IVF. “We hope to provide a useful analysis of available data to better inform decisions made by women and the providers who care for them,” she added, according to Medical Xpress.

The team reviewed published studies that had evaluated women diagnosed with depressive symptoms and who had taken antidepressants while they were pregnant. Study results were published, online, in the October 31 issue of the journal Human Reproduction, said Medical Xpress.

“There are three main points that stand out from our review of the scientific studies on this topic,” senior author Adam Urato, MD, Chairman of Obstetrics and Gynecology at MetroWest Medical Center and a Maternal-Fetal Medicine specialist at Tufts Medical Center, noted. “First, there is clear and concerning evidence of risk with the use of the SSRI antidepressants by pregnant women, evidence that these drugs lead to worsened pregnancy outcomes. Second, there is no evidence of benefit, no evidence that these drugs lead to better outcomes for moms and babies. And third, we feel strongly that patients, obstetrical providers, and the public need to be fully aware of this information,” he explained, wrote Medical Xpress.

We recently wrote that a growing body of research has linked SSRIs to birth defects and other issues when used by pregnant women, especially in the early months of pregnancy when many women don’t realize they are pregnant. For example, a study published in January by researchers at Sweden’s Karolinska Institute found that taking an SSRI antidepressant during pregnancy was associated with a two-fold increased risk of neonatal pulmonary hypertension (PPHN). Another report published in the Archives of General Psychiatry in March found that babies exposed to SSRI antidepressants before birth exhibit reduced head growth at birth, and are more likely to be born prematurely.

According to Medical Xpress the continuing rise in antidepressant use—400 percent over the past two decades, making the drugs the most commonly prescribed in the United States for patients 18-44 years of age—is worrisome. Consider that these are childbearing years for the majority of women. Also, as many as 11 percent of women undergoing fertility treatment report taking an SSRI to combat depression.

The team found no evidence that these women experienced improved pregnancy outcomes when taking SSRIs, but did see just the opposite and also discovered that many SSRI studies found the medications to be no more effective—and only slightly more effective than a placebo—in the treatment of depression. “More broadly, there is little evidence of benefit from the antidepressants prescribed for the majority of women of childbearing age–and there is ample evidence of risk,” the authors write, Medical Xpress reported.

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