According to the American College of Obstetricians & Gynecology (ACOG), women of reproductive age have the highest number of major depressive disorders – in fact, 1 in 10 women will have some sort of depression during pregnancy and/or the postpartum depression.
To treat this depression, doctors for years have prescribed antidepressants.
Naturally though, large numbers of pregnant women have worried about the effects these drugs may have on their unborn child. Despite a plethora of message boards and support groups, the U.S. Food & Drug Administration has been slow in addressing these concerns.
One of the most widely prescribed antidepressants, selective serotonin reuptake inhibitors (SSRIs), have been known to cause often severe withdrawal symptoms when usage is suddenly stopped. Recent studies though have shown that staying on these drugs could harm the unborn child. Unfortunately, the public doesn’t have clear information on these risks.
Some of the more popular SSRIs include Paxil, Zoloft, Prozac, Effexor, Lexapro and others.
Medications taken during pregnancy can cross the placenta and enter the baby’s bloodstream. The effect the medication has depends on what it is and trimester it was taken.
To assist pregnant women decide whether an SSRI is safe for newborns, the FDA has developed “Use-in-Pregnancy” ratings based on information gathered from initial studies and provided by drug companies. The five categories include A, B, C, D and X with A being the weakest and X the strongest.
Most SSRIs fall into the C category but one, Paxil, is slightly more risky and falls into the D category. ACOG in fact recommends women avoid Paxil if they’re pregnant or plan to become pregnant due to risk of fetal harm.
Some birth defects or injuries linked to the use of SSRIs by pregnant women include:
- Autism
- Cerebral palsy
- Cleft lip and/or cleft palate
- Heart defects
- Respiratory distress
- Spina bifida
- …and others
Researchers are learning more each day on the various SSRI medications and their potential effects on unborn children. Many initially believed damage was limited to the lung and heart but recent studies show the potential for more debilitating effects.
Women who take antidepressants during pregnancy often are overcome with an immense feeling of guilt when they think something they ingested may have caused a birth defect. Much of the time though, the guilt needs to be placed on those who did not evaluate or disclose risks associated with their products.
If any kind of drug has the potential to harm the baby, pregnant mothers must be told up front so they can discuss medical options and have the opportunity to make a decision on their own.
We agree totally and advise expectant mothers to be very careful if they feel they need to take an antidepressant. Discuss any depression with a qualified obstetrician. Specialists at All About Women can discuss your individual case. Call our Gainesville OB offices today to schedule a consultation today.
Original story published in the Fall 2011 issue of The Safety Report
