SSRI Birth Defects – Ignorance Is Bliss – Really?

Overbrook, KASuzy (not her real name pending legal action) was taking SSRI (selective serotonin reuptake inhibitor) antidepressants, namely Paxil and Lexapro, on and off during both of her pregnancies. She now has 2 sons, both with heart defects that may be SSRI birth defects.

Her eldest son, who is nearly 5, was born with a number of heart defects, specifically atrial septal defect, or ASD, ventral septal defect (VSD), and transposition of the great vessels. Her younger son was born with truncus arteriosus.

ASD refers to a hole in the wall of the heart between the upper 2 chambers. If the hole is large it makes the child's lungs and heart work harder than normal, which gradually causes damage to the heart. This hole can be closed with surgery, which prevents more serious problems occurring later in the child's life.

VSD refers to a hole between the 2 lower chambers of the heart, and because this also causes the heart to work hard, it can lead to the heart becoming enlarged. Some babies with VSD can develop severe symptoms or high blood pressure in their lungs, and surgery is required to make the child's circulation normal. If surgery cannot completely correct the VSD, then the child runs the risk of developing an infection known as endocarditis.

Transposition of the great arteries refers to a defect in which the aorta and the pulmonary artery are reversed. And in a bizarre twist of fate, newborns who survive this defect do so if they have access to oxygen rich blood for their bodies, and 2 such situations that would allow for that would be ASD or VSD.

As for truncus arteriosus, it is a complicated heart malformation also requiring surgery. A child who has undergone surgery for this defect will still need lifelong monitoring to make sure his heart continues to work properly.

So it's all very serious – and an awful lot for a young mother and 2 newborns to have to face. In addition to the shock of finding out both your children have serious if not life threatening congenital heart defects, you must navigate your way through the decision making process regarding surgeries, and bear the expense of it all, which can be considerable, all in the hope that your children will survive at least and do well at best. To add insult to injury, you find out that these defects may be SSRI related and possibly could have been prevented.

SSRI Birth Defects

In July 2006, the Food and Drug Administration (FDA) ordered manufacturers of SSRIs and SNRIs (selective norepinephrine reuptake inhibitors) to carry warnings on their labels about the risk for persistent pulmonary hypertension (PPHN). The 2006 warning was precipitated by a public health warning issued by the FDA in 2005, based on findings from 2 studies which showed an increased risk for birth defects in babies born to women taking Paxil during pregnancy.

In fact, the studies showed a 1 to 2 times greater risk of having a baby with a heart birth defect while on Paxil. In conjunction with the warning, the FDA placed Paxil in its second highest category of drugs known to cause birth defects.

But Paxil isn't the only drug that has been linked with birth defects. The SSRIs Prozac by Eli Lilly, Zoloft by Pfizer, and Celexa and Lexapro sold by Forest Laboratories, along with various generic versions of the drugs are also controversial. And the closely-related class of SNRI antidepressants, which include Wyeth's Effexor and Lilly's Cymbalta, also carry birth defects warnings.

Now one could reasonably conclude that given the strength and seriousness of the warnings, people would be more aware of the dangers, and ask their doctors when they're being prescribed these drugs about the risks associated with pregnancy. That is assuming the doctor doesn't bring the subject up. But it turns out that the message isn't really being heard. Results from another study published in 2007, which involved 500,000 women, published in the Annals of Internal Medicine, found that 50 percent of women taking a prescription drug during pregnancy were not aware that those drugs could cause birth defects, because they had not been warned about getting pregnant while on the drugs.

It would seem that Suzy was one of those women. Who said ignorance is bliss? Hers boys will likely never be able to play sports like baseball or soccer, or do many activities that most of us take for granted. Their heart defects are a life sentence, through no fault of their own.