American Academy of Pediatrics Issues Policy Revision on Effexor and SSRIs

Washington, DCIn January 2012, the American Academy of Pediatrics issued a policy revision regarding neonatal drug withdrawal and specifically mentioning the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy. Effexor, which is an SNRI antidepressant, has been linked to some issues, including such Effexor side effects and Effexor birth defects, when used during pregnancy. Because studies on the risks associated with SSRI use during pregnancy are conflicting, it is up to the individual as to whether or not she should risk the effects of a so-called Effexor pregnancy.

According to the American Academy of Pediatrics (1/30/12), SSRI medications are the most frequently used antidepressants for pregnant women. But they have been linked to an increased risk of problems in infants. [Serotonin-norepinephrine reuptake inhibitors (or SNRIs)—a class of drug that includes Effexor—are similar, but not identical, to SSRI medications. While it is believed they have similar risks and side effects—and they are often grouped together in studies—they may not have identical side effects. More studies have been done so far on SSRIs than on SNRIs.]

"Case reports, adverse drug reaction reports, and prospective studies linked third-trimester use of SSRIs in pregnant women to a constellation of neonatal signs that include continuous crying, irritability, jitteriness, and or/ restlessness; shivering; fever; tremors; hypertonia or rigidity; tachypnea or respiratory distress; feeding difficulty; sleep disturbance; hypoglycemia; and seizures," the academy noted. Most of these side effects were observed from several hours to several days after birth, although many resolved between one and two weeks. One infant reportedly displayed effects of an SSRI for up to four weeks after birth.

The policy revision notes that there is some discussion as to whether the side effects are linked more to withdrawal from the drugs or to serotonin syndrome.

One of the concerns surrounding the use of SSRIs—such as Effexor—while pregnant is the reported risk of persistent pulmonary hypertension of the newborn (PPHN). The same month that the American Academy of Pediatrics issued its revision statement, a study appeared in the British Medical Journal (1/13/12) suggesting that infants exposed to SSRIs prior to birth had double the risk of PPHN than infants not exposed to an SSRI.

Persistent pulmonary hypertension of the newborn is a serious condition in which infants cannot adapt to breathing outside the womb. According to the American Academy of Pediatrics, approximately 11 percent of infants born with the condition will die from it.

Other side effects in infants reportedly linked to the use of SSRIs while pregnant include autism, delayed development and craniosynostosis.