SSRI Birth Defects: Had I Known Then What I Know Now

Fresno, CAWhen Jodie found out she was pregnant she was taking the antidepressant Zoloft. One of the first things she did was ask her doctors if it was safe for her to continue taking the drug. They told her that the benefits outweigh the risks. But her daughter was born prematurely, and with a permanent hole in her spine. Jodie wonders if that could be an SSRI birth defect.

Jodie was prescribed Zoloft to treat her bipolar disorder in January 2004. During her pregnancy, early in 2005, her doctors increased the amount of the drug she was taking. When her daughter was born, at just 33 weeks weighing 4lbs 15 oz, she suffered withdrawal symptoms such as tremors, which is not uncommon. Then magnetic resonance imaging revealed a large hole at the base of her daughter's spine. Also known as a sacral dimple or pilonidal dimple, the hole is located just above the buttocks.

And there were other, equally serious problems. "She had a herniated stomach, and she was not breathing when she was born," Jodie said. "Just 3 weeks after she was born she was hospitalized for 21 days due to necrotizing encephalitis, a very serious infection. She is delayed developmentally, and has poor immune system function. I have been going to doctors and hospitals for the last 2 years and was in the emergency room with complications every week until she was born.

The hole in her spine will never go away. It causes her pain when she sits for long periods of time. Like when we go in the car and she has to sit for some time she starts crying because it hurts her. She's only just learned to walk and she's just about to turn 3.

Had I known then the things I know now I wouldn't have taken the drugs. I kept asking the doctors if it was OK, but no one ever said to stop taking them."

Do the Benefits Really Outweigh the Risks?
Zoloft, also known as sertraline, belongs to a class of antidepressant medications known as selective serotonin reuptake inhibitors or SSSRIs. Other SSRIs include Paxil marketed by GlaxoSmithKline, Prozac by Eli Lilly, and Celexa and Lexapro sold by Forest Laboratories, along with various generic versions of the drugs. SSRIs carry a warning from the FDA that they should not be taken during the first weeks of pregnancy due to the risk of birth defects, most commonly something called PPHN – or persistent pulmonary hypertension.

The closely-related class of selective norepinephrine reuptake inhibitos – or SNRI antidepressants - also carry birth defects warnings and include Wyeth's Effexor and Lilly's Cymbalta.

Unfortunately, the information that alerted physicians and the FDA alike to the risk of birth defects from these drugs, only began to come to light until 2005, after Jodie, and hundreds of women like her, became pregnant.

And even though the information is out it would seem the message isn't. In 2007, a study of 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.