SSRI Birth Defect Risk Not Easy to Weigh

Washington, DCThe issue of pregnancy and antidepressants continues to be an oft-debated area of natal care that pits those concerned with SSRI birth defects and the related SSRI birth defect risk, with those worried about the mental health of the pregnant woman. An SSRI drug (selective serotonin reuptake inhibitor) is often thought of as a lifesaver for women battling depression.

The question remains, however: are antidepressants safe for pregnant women?

A recent issue of Women's Health continued the debate when summarizing a joint report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists.

The report's conclusion? Pregnant women who are on antidepressants and who experience psychotic episodes, suffer from bipolar disorder, are suicidal or having a history of suicide attempts should not be taken off their antidepressants.

However, what if a woman who is taking an SSRI antidepressant becomes pregnant?

The August 22nd issue of Women's Health put forward the statement that for many, the risks vs. benefits of continuing treatment are unclear.

According to one study, the rate of antidepressant use during pregnancy more than doubled between 1999 and 2003. The study found that in 2003, one in eight women took an antidepressant at some point during her pregnancy.

"We know that untreated depression poses real risks to babies. That is not conjecture," Yale University School of Medicine ob-gyn Charles Lockwood, MD, told WebMD in a statement. "We know much less about the risks associated with antidepressant use. It is clear that more study is needed."

The jury is still out on SSRI birth defect risk

Women's Health reported that separate studies from Sweden and the US suggested an increased risk for congenital heart defects in babies born to women who took Paxil during pregnancy.

The reports led the US Food and Drug Administration (FDA) to issue an advisory in December 2005 warning about the potential risk based on early results of two studies.

Greater use of selective serotonin reuptake inhibitor (SSRI) antidepressants like Prozac, Paxil, and Zoloft were largely responsible for the increase of antidepressant use during pregnancy in the four years between 1999 and 2003.

It should be noted that a joint panel of the FDA found that evidence linking Paxil use during pregnancy to heart problems in newborns, was inconclusive.

Lockwood told WebMD that if the risk is real, it is probably not limited to Paxil alone.

"It is very likely to be a class effect and not just this one drug," he says.

The debate over SSRI birth defect risk continues.