Study Suggests Use of SSRIs During Pregnancy Puts Baby in Danger, Are SNRIs Included?

Waltham, MAA new study suggests that the use of selective serotonin reuptake inhibitor (SSRI) medications during pregnancy could put the baby and mother at risk of serious complications. Because the study only examined SSRI medications, it is not clear if the results extend to serotonin-norepinephrine reuptake inhibitors and SNRI side effects. Because they are similar to SSRI medications, there is a possibility that SNRI antidepressants may have similar side effects to SSRI antidepressants.

The SSRI was published online in Human Reproduction and found that women who used SSRI antidepressants while pregnant were at an increased risk of miscarriage and preterm delivery. Meanwhile, researchers also found an increased risk of developmental problems for the infants. Those developmental problems included persistent pulmonary hypertension of the newborn, preeclampsia, neonatal prolonged QT syndrome and newborn behavioral syndrome. Newborn behavioral syndrome includes persistent crying, difficulty with feeding, seizures and difficulty with breathing.

Researchers found the risk of persistent pulmonary hypertension of the newborn was more than double in infants exposed to SSRI medications prior to birth, compared with infants with no such exposure. The risk of preeclampsia was found to increase 28 percent when SSRIs were used early in pregnancy and 38 percent when SSRIs were used late in pregnancy. When SSRIs were used both early and late in the pregnancy, the risk went up 50 percent.

Along with the suggested side effects, researchers noted that there was no evidence that SSRI use during pregnancy was any more effective than use of a placebo.

Furthermore, researchers noted that of 74 FDA-registered studies, 38 had positive results and 36 had negative or questionable results. But of the studies that had negative or questionable (not clearly positive or negative) results, 22 went unpublished and 11 were ultimately published, but in such a way as to highlight positive results. Only one study with positive results went unpublished.

When it comes to treating women of childbearing age with SSRI antidepressants, the researchers are clear in their recommendations. "There is little evidence of benefit from the antidepressants prescribed for the majority of women of childbearing age—and there is ample evidence of risk," researchers concluded.

SNRI medications are not identical to SSRI medications because they affect both serotonin and norepinephrine levels in the brain, whereas SSRI medications affect only serotonin levels. Because of that, it cannot automatically be assumed that study results regarding SSRIs will extend to SNRIs.