One Baby's Heart Defect, Courtesy of the SSRI Lexapro

Bernie, MOAnn has a healthy girl, and she was born with absolutely no health problems whatsoever. But Ann suffered from depression after her baby's birth, so her doctor put her on the antidepressant lexapro. Then Ann found out she was pregnant. But she stopped taking this SSRI as soon as she found out her son was born with a heart defect.

Ann wonders if her son's heart condition could be an SSRI birth defect. "I saw an ad on TV recently, and it made me think," Ann said. She had started taking Lexapro before she got pregnant. Although she was never given any reasons to be concerned about possible birth defects associated with the drug, as soon as she found out she was pregnant, at 9 weeks, Ann stopped taking the Lexapro. "I was taking the drug all that time though, because I didn't know I was pregnant."

Ann had tests run during her pregnancy which revealed that her unborn baby had developed a heart condition – an atrioventricular canal defect , and associated pulmonary hypertension. Five months after her son was born he underwent heart surgery for the defect.

An atrioventricular (AV) canal defect is a large hole in the center of the heart. It exists where the wall between the upper chambers joins the wall between the lower chambers. AV is a serious complication in infants, and usually requires surgery. Children with AV can become undernourished. Because of the large amount of blood flowing to the lungs, high blood pressure may occur there and damage the blood vessels.

Ann was never made aware of the risks for SSRI birth defects during her pregnancy because she was never warned, and the doctors never asked her about any medications she was taking during pregnancy, after her son was born.

SSRI Birth Defects – The Facts

SSRIs – or selective serotonin reuptake inhibitors--are a class of drug used to treat depression. Lexapro, also known generically as escitalopram oxalate, is an SSRI. The manufacturer of Lexapro, Forest Pharmaceutical, downplays the drug's dangers. Nowhere on its website is there any warning of possible side effects if taking the drug while pregnant, even though SSRIs have been linked to serious birth defects in babies.

On July 19, 2006, the Food and Drug Administration (FDA) released a Health Advisory to alert the public to the risks associated with taking SSRIs while pregnant. The advisory was based on a study published in the New England Journal of Medicine that found that mothers who took SSRIs like Lexapro during the second half of their pregnancy were 6 times more likely to have a baby with Primary Pulmonary Hypertension in the Newborn (PPHN) than those who did not take SSRIs late in pregnancy.

Heart defects are also associated with SSRI birth defects, namely Zoloft, Celexa, Prozac and Paxil. In 2005 the FDA issued a public health warning regarding Paxil, based on findings from 2 studies which showed up to a 2 times greater risk of having a baby with a heart birth defect while on Paxil. In conjunction with the warning, the FDA placed Paxil in its second highest category of drugs known to cause birth defects.
Most recently, a study published in the November 2008 issue of the British Journal of Clinical Pharmacology, reported a 3 times greater risk for heart defects in babies born to mothers taking either Prozac (fluoxetine) or Paxil. The study looked at babies born to 800 women who said they took either drug during the first trimesters of their pregnancies. Comparison was then made to 1,400 expectant mothers who were not on antidepressants of any kind.

Given this information Ann has good reason to be suspicious as to the cause of her son's heart defect and pulmonary hypertension. "My daughter is as healthy as can be. Then they put me on lexapro, and my son was born with these health problems," she said. If you were Ann, what conclusions would you draw?