Antidepressants once seen as miracle drugs: now risks are becoming evident

Since the horror of the Thalidomide scandal in the 1960s, pharmaceutical companies and medicines regulators have been acutely aware of the dangers drugs may pose to the unborn child.

Establishing what the effect of a drug may be on a foetus, however, is no simple task. Companies must rely on animal studies in the early stages of research and hope that the drug will behave in humans in the same way. Trials on pregnant women are rarely carried out, for obvious reasons.

Depression and anxiety became big business for the pharmaceutical industry in the 1990s as doctors became better at diagnosing the problems, exposing a population of over-achieving, highly-stressed, worried-well.

Women, always more willing to see a doctor than men, were a large proportion of those diagnosed and put on SSRIs (selective serotonin reuptake inhibitors) such as Prozac and the British drug Seroxat, known as Paxil in the US. For a while, these seemed to be the new miracle drugs. They were safer than older antidepressants because the severely depressed could not overdose on them.

But in court cases about to begin in the US, it will be argued that insufficient attention was paid to the possible dangers for young women who were pregnant or might become pregnant and more particularly, for their babies.

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Birth Defects and SSRIs—How's a Mother to Know?

In 2006, Elissa's doctor prescribed Cymbalta to help with her depression. Shortly after starting on the antidepressant Elissa became pregnant. On her doctor's advice she continued taking Cymbalta. But it soon became apparent her baby was developing life-threatening defects.

"I had my first ultrasound at 3 months," Elissa said. "That's when I found out something wasn't right. The doctor explained that my baby appeared to have a heart defect, a hole in her heart. Shortly after Elissa's baby girl was born, prematurely, the infant had to undergo heart surgery to repair the damage that could have been induced by the antidepressant. But Elissa was not aware of the association between SSRIs—or selective serotonin reuptake inhibitors—and birth defects.

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Not Enough Research on SSRIs and Pregnancy

Kerri T. wants women to know that antidepressants and pregnancy don't mix. Kerri says that she was never told about the link between SSRIs and birth defects and she believes her daughter's health problems are the result of exposure to an SSRI antidepressant.

"During my whole pregnancy, I took 300 mgs of Effexor XR," Kerri says. "My psychiatrist never told me about any of the warnings and I never saw any of the sample packets where it said that if the baby was exposed to Effexor in the third trimester there could be problems and longer hospital stays.

"I delivered Caroline at full term. She had no seizures during the pregnancy. She was born via C-section and immediately after birth started having seizures. The doctor took her out and took her right to NICU (neonatal intensive care unit). I couldn't even hold Caroline right away; they just took her away. She was put on 4 seizure medications and on the ventilator.

"At 3 days old, Caroline basically died. They had tried to take her off the ventilator and she died. The doctors did 2 minutes of chest compressions and intubated her. She was hypotonic from the medicine. Luckily, they brought her back. The following week they tried to take her off the ventilator again and she coded again."

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No Link Found Between Antidepressants And Birth Defects, According To New Study

Expectant mothers can safely use prescribed antidepressants during their first trimester, according to a new study from the Université de Montréal and Ste. Justine Hospital published in the May edition of the British Journal of Psychiatry.

Dr. Anick Bérard and her team found that antidepressants have no effect on foetal development. "This is the first study to investigate the impact of antidepressant use during the first trimester of pregnancy in mothers with psychiatric disorders," she said. "In terms of birth malformations in this population, we found no difference between women who used antidepressants and those who did not use antidepressants during their first trimester.

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Antidepressant studies find low birth-defect risk

Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found.

The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.

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