Researchers Argue SSRI Risks Outweigh Benefits

Baton Rouge, LAIf any class of drugs has a great deal of confusion regarding the risks versus benefits, the class that likely has the most is the SSRI antidepressant class, including the drug Zoloft. The risk of Zoloft side effects, which like the rest of the SSRI class is reported to include a risk of Zoloft birth defects, may vary depending on which study has most recently been published. A recent study suggests a risk of autism linked to the use of SSRI medications while pregnant. Meanwhile, researchers who argue that the risk of SSRI side effects outweighs the benefits have defended their position.

In the April issue of Human Reproduction, Adam Urato and Alice Domar, who previously published a study concerning the use of SSRIs during pregnancy, defended their conclusions to critics. They note in one letter, “Reply: Risks of untreated depression outweigh any risks of SSRIs,” that their three main points are that there have been risks shown when pregnant women use SSRIs; that there is no evidence that the use of SSRIs during pregnancy improves pregnancy outcomes; and that this information should be made available to pregnant women and health care providers.

“SSRI antidepressants have not been shown to improve pregnancy outcomes and they are increasingly associated with risk,” the authors wrote. “The conventional wisdom has been that depressed pregnant women, by taking SSRI antidepressants, will treat their condition and improve their pregnancy outcomes. But there is no evidence to support this view.”

The original study, published in Human Reproduction (10/31/12), examined the risks of the use of selective serotonin reuptake inhibitors (SSRIs) in infertile women and the impact the drugs have on fertility, pregnancy and neonatal health. Researchers found that antidepressant use during pregnancy was associated with “increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer-term neurobehavioral effects.”

They further found no evidence that SSRI use during pregnancy improved pregnancy outcomes. Finally, they found evidence that other forms of therapy, including psychotherapy, cognitive-behavioral therapy and exercise, improved depressive symptoms in the general population.

The findings from that study may be bolstered by another study, which suggests the use of SSRIs during pregnancy may be associated with an increased risk of autism. That study was published April 19 in the BMJ (British Medical Journal) and reported on by The New York Times (4/22/13). It found an increased risk of autism when a mother took an SSRI or tricyclic antidepressant while pregnant, leading researchers to conclude that, where appropriate, non-drug treatments might be considered.