Paxil Birth Defects vs. Mother's Health

May 22, 2010, 6:00AM. By Gordon Gibb

Atlanta, GABirth defects that allegedly result from the use of Paxil and other selective serotonin reuptake inhibitors (SSRI) antidepressants during pregnancy continue to be the subject of hot debate, given the potential risk to the expectant mother who is denied medication essential to her emotional health and wellbeing.

The European Medicines Agency (EMA) in the UK recently released a study showing that the potential for heart defects in newborns increases slightly when women use SSRI antidepressants during pregnancy. The EMA has advised doctors to carefully weigh the pros and the cons when prescribing the medication to their patients.

According to the EMA, recent studies show that SSRIs may cause birth defects in five out of 1000 newborns, as compared with two out of 1000 births among mothers who did not take antidepressants in any form.

"The absolute risk of birth defects is small but still exists," says Katherine Stone, a 40-year-old mother of two from Atlanta and the founder of Postpartum Progress, a website and blog dedicated to postpartum depression issues. In an e-mail to ParentDish.com, Stone says that antidepressant use during pregnancy "can impact birth weight and preterm delivery, but so can depression and anxiety during pregnancy."

Postpartum depression, according to ParentDish, is a serious condition that affects five to 25 percent of women. Pre-partum depression, known medically as antenatal depression, is considered just as serious and common, affecting anywhere from 10 to 20 percent of pregnant women.

The lack of convincing evidence that antidepressant use during pregnancy can be harmful to the fetus has a polarizing effect on doctors. Some will take that lack of convincing evidence and be ultra-cautious with their patients, advocating the reduction or even eradication of antidepressant use in all but the most serious cases, or counseling women to avoid pregnancy when they are taking the medication.

However, given the lack of convincing evidence and, in some cases, the certainty of serious consequences if a woman is denied antidepressants, some feel that it is better for both mother and unborn child to remain on medication.

"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," says Shell Fruscione, a 21-year-old mom of a five-month-old boy in Las Vegas. Fruscione had been taking a generic version of Zoloft for a year before her pregnancy.

"He assured me that he personally had had many patients who took antidepressants throughout their pregnancies and had no complications whatsoever," Fruscione continued in an e-mail to ParentDish."There doesn't seem to be a general consensus throughout the medical field regarding this. Most of my own research confirmed that many antidepressants are Class B drugs (which are presumed safe for pregnant women), but still I had a lot of doctors look at me like I had three heads when I listed my current medications. I wish that the medical associations would at least address the issue because in those situations I was made to feel guilty or less than worthy for 'subjecting' my unborn son to the medication even though the risks of discontinuing use greatly outweighed the risks, in my case, of continuing."

Nonetheless, the Paxil lawsuits continue. The risk may be low and the evidence scarce and inconclusive, but for a handful of parents, a statistical possibility can turn into very real heartbreak .