What's More Harmful? Depression or SSRI?

DenmarkIt's been about a year since the latest research came out linking selective serotonin reuptake inhibitor (SSRI) antidepressants with heart defects in newborns. The study, conducted by researchers at Aarhaus University in Denmark, compared the risk of SSRI birth defects in 1,370 children born to women having taken at least one SSRI drug during pregnancy, against 400,000 children whose mothers had not taken SSRI antidepressants.

The results revealed that certain SSRI drugs triggered SSRI birth defects in some of the infants—specifically, a defect in the septum that separates the two halves of the heart.

The study was published in the medical journal BMJ and drew comment from Cathy Ross of the British Heart Foundation. "Anyone who is pregnant or considering becoming pregnant and has any concerns about the treatment for depression should speak to their doctor," Ross was quoted as saying in a Reuters report.

The concern over SSRI Side Effects continues to fuel a debate amongst doctors and health care professionals. Depression is a widespread condition, and while treatment options are constantly expanding, many of those treatment options come in pill form.

While there is a risk to a developing fetus if SSRI antidepressants are continued during the important first trimester, there is an equal risk to both mother and fetus if SSRI drugs are discontinued.

The lack of foreign chemicals in the mother's bloodstream proves a benefit to the developing fetus.

And yet, doctors and psychologists acknowledge depression that's left untreated can also trigger stress and emotional disquiet that could negatively impact the baby.

Should women suffering from depression avoid getting pregnant in the first place? The debate continues to rage, and a definitive resolution may never be found.

What is known are the results of research that finds the risk of heart defects or PPHN in babies sits at 0.5 percent of women who did not ingest SSRI drugs at all, v. a 0.8 percent risk in mothers prescribed one SSRI. For women taking two or more SSRI drugs concurrently, that risk balloons to 2.1 percent—an increased risk of 80 percent, and 300 percent respectively.

The Denmark study noted that one extra heart defect (to the septum) was found to develop for every 246 women prescribed and using an SSRI within a window extending from 28 to 112 days following conception.

The SSRI birth defects were found to range from minor issues with blood vessels, to outright holes in the heart. The latter often requires surgery, can be life threatening, and can impact a child for the remainder of his or her natural life. The tragedy, say child advocates, is the fact that some women are medicated for relatively minor bouts of depression. While SSRI drugs are necessary to treat serious depression, SSRI birth defects in children borne of mothers taking SSRI drugs for mild depression remains the most tragic of outcomes.