September 22, 2014 — The New York Times has published a column that summarizes current evidence linking the use of SSRI antidepressants with an increased risk of birth defects.
Depression is a serious illness that can get worse during pregnancy, as a result of fluctuating hormone levels and changes in daily life. The “prevailing attitude” among doctors is that untreated depression is more dangerous than the use of an SSRI.
But if this were true, studies should show better birth outcomes in women on antidepressants who take better care of themselves than women who stop antidepressants. This is not the case, according to experts quoted in the column.
Instead, a number of studies have found evidence of fetal harm, including birth defects (especially heart defects), ADHD, complications after birth, developmental delays, and more.
The problem is that serotonin plays an important role during fetal development, and medications that inhibit serotonin signaling can have a wide range of negative effects. SSRI antidepressants pass through the placental barrier and the fetus’s blood-brain barrier. They could potentially affect fetal development in the brain, heart, gastrointestinal system, lungs, and more.
Recent studies have found evidence of psychiatric defects and premature birth:
- March 2014 — Study finds a higher rate of premature births in women taking SSRI antidepressants during the 2nd and 3rd trimesters.
- April 2014 — Study found that boys exposed to SSRIs (especially in the first trimester) were three times more likely to be diagnosed with developmental delays.
- April 2014 — Study of 51,000 children born in Norway found lower language competency in children by age 3.
- August 2014 — Study published by Harvard researchers found that the risk of ADHD (attention-deficit hyperactivity disorder) nearly doubled in babies exposed to an SSRI during pregnancy.
The FDA has also issued warnings about heart defects Paxil (paroxetine) and a birth defect known as Persistent Pulmonary Hypertension of the Newborn (PPHN).
Despite evidence of possible risks, experts do not recommend quitting SSRIs “cold turkey,” especially during pregnancy. The decision about whether to take an antidepressant is highly personal and should be carefully considered with a doctor.