Jury Awards $2.5 Million in SSRI Birth Defect Case

Philadelphia, PAThe tragedy of SSRI birth defects was brought home last week when a jury in Philadelphia found for the plaintiff and held the manufacturer of an SSRI antidepressant responsible for the formation of heart defects in an unborn child. Given the growing concern over SSRI side effects, and the fact that selective serotonin reuptake inhibitors have become the most commonly prescribed class of antidepressants, doctors are continuing to face a dilemma with increasing frequency.

It was on October 15th that the Philadelphia jury ordered GlaxoSmithKline to pay $2.5 million to the family of Lyam Kilker. The child—now three—was born with serious heart defects. According to the October 24th issue of New Scientist the child's mother was prescribed the antidepressant paroxetine (Seroxat or Paxil), which is in the SSRI class of drugs.

GlaxoSmithKline said it would appeal the ruling, saying in a statement "The scientific evidence does not establish that exposure to [paroxetine] during pregnancy caused his condition."

However evidence is mounting that SSRIs have the potential to harm the fetus, according to New Scientist. Some studies have found no link to SSRI and heart damage in the fetus. But others have. The most recent study found an increased prevalence of septal heart defects, also known as a hole in the heart, among children whose mothers were prescribed an SSRI in early pregnancy. This was pronounced for two SSRIs, though no association was found with paroxetine.

GlaxoSmithKline maintains its position that the drug could not have caused the defect in Lyam Kilker's heart, even though the paroxetine label warns that taking the drug while pregnant may raise the risk of birth defects.

But not treating depression is also dangerous. New Scientist referred to a large study last year that revealed the offspring of mothers who had been depressed while pregnant took longer to start smiling, talking and developing motor skills.

Hence, the ongoing dilemma. While doctors are aware of the risks associated with SSRI antidepressants and pregnancy, antidepressants are nonetheless increasingly prescribed. In the US, 13 percent of pregnant women were found to have taken antidepressants in 2003.

Part of the problem is the increased use of antidepressant in the general population, which holds that the odds are increasing that a woman is already on an antidepressant when she becomes pregnant.

To address this, the American College of Obstetricians and Gynecologists and the American Psychiatric Association released a review of studies examining the effects of taking antidepressants and of being depressed during pregnancy. They concluded that women who become pregnant while on antidepressants should consider switching to psychotherapy, especially in mild cases.