Weighing the Benefits and Risks of Lexapro Birth Defects

Las Vegas, NVSince at least 2009, research has shown that all SSRIs—and that includes Lexapro—put developing infants at risk for a wide range of birth defects and serious illnesses after birth. Lexapro is now considered a pregnancy Category C medication, meaning the antidepressant may not be safe to use during pregnancy. Yet it takes some searching on the manufacturer's website to find any Lexapro birth defect warnings.

The Lexapro website states that "There have been no studies done that show Lexapro is safe to use in pregnant women," which can be interpreted as saying that studies show it is unsafe to use Lexapro while pregnant. In other words, the manufacturer doesn't address documented studies, nor does it mention that Lexapro labeling includes a Category C. But it does say that "Lexapro should be used during pregnancy only if the potential benefit justifies the potential risk to the unborn child. Be sure to talk to your doctor about this important decision…and notify their physician if they are breastfeeding an infant."

Danish researchers studied pregnant women receiving prenatal care from 1989 to 2006 and concluded in the Archives of Pediatrics & Adolescent Medicine, October 2009, the following: "Exposure to SSRIs during pregnancy was associated with an increased risk of preterm delivery, a low 5-minute Apgar score, and neonatal intensive care unit admission, which was not explained by lower Apgar scores or gestational age. The study justifies increased awareness to the possible effects of intrauterine exposure to antidepressants."

Unfortunately, a number of women taking Lexapro are advised by their doctor not to stop taking the drug when they become pregnant. "I was prepared to stop as soon as I learned of my pregnancy, but my doctor told me it would be more dangerous to stop than to just keep taking them," said a 21-year-old mom of a five-month-old boy in Las Vegas, who had been taking an SSRI for a year before she got pregnant. "My doctor assured me that he personally has many patients who took antidepressants throughout their pregnancies and had no complications whatsoever."

Fortunately, the Las Vegas doctor's opinion isn't the consensus, as studies such as the above show. However, untreated depression is dangerous for mother and the fetus, particularly in women with severe depression (meaning suicide attempts and weight loss). As well, "Pregnancy Category C" means that the benefits from the use of the drug in pregnant women may be acceptable despite its potential risks. Ultimately, it is a tough decision, especially with doctors unwilling (possibly due to liability issues) to advise their patients whether or not to take antidepressants during pregnancy. So for now, the decision must be made by the mom-to-be.