New research has found that women who take an SSRI antidepressant late in pregnancy may double their baby’s risk of suffering PPHN at birth, which can lead to life-threatening complications.
Prozac (fluoxetine) is a medication in a class of drugs called Selective Serotonin Reuptake Inhibitors (SSRIs). It is one of the most effective drugs for increasing the amount of serotonin in the brain without affecting other chemicals. Some researchers believe that serotonin is used by the brain to regulate duration and intensity of moods. Prozac is most often prescribed to treat depression, obsessive-compulsive disorders, some eating disorders, and panic attack. Other popular uses include the treatment of alcoholism, social phobias, sleep disorders, Tourette’s syndrome, and more.
Prozac and PPHN
A new European study has found that women who took Prozac or SSRI antidepressant doubled their baby’s risk of developing PPHN at birth. The research was based on data from 1.6 million live births between 1996 and 2007 in several European countries (Denmark, Finland, Iceland, Norway, and Sweden). Around 30,000 took antidepressants during pregnancy — 11,000 after the 20th week of pregnancy, and 17,000 took an antidepressant early in pregnancy.
Among the 11,000 women who took an antidepressant late in pregnancy, there were 33 cases of PPHN (0.2%). The general risk of having a baby with PPHN without taking any medication is 1-2 per 1,000 live births. When a mother took an antidepressant, the risk increases to 3 per 1,000 live births. Though the risk of PPHN is twice as high when mothers took an SSRI antidepressant late in pregnancy, numerically, PPHN is still a relatively rare phenomenon. Depression is also a serious illness, and women who are taking an antidepressant have a high risk of relapse if they stop taking their medications.
The FDA also warns that the link between antidepressants and PPHN is inconclusive. In 2006, the FDA found that infants born to mothers who took SSRIs after the 20th week of pregnancy were six times more likely to have a baby with PPHN. However, studies that followed had conflicting results. Even so, because PPHN is a serious, potentially life-threatening complication, the FDA decided to update the safety labeling on Prozac and SSRI antidepressants to include information about the potential risk.
What is PPHN?
Persistent Pulmonary Hypertension of the Newborn (PPHN) is a rare complication that occurs shortly after a baby is born, when its heart-lung circulatory system fails to “switch over” from life in the womb to independent life. An estimated 5-10% of babies born with PPHN do not survive.
Before a baby is born, it receives oxygenated blood from its mother’s placenta because it obviously cannot breathe in the womb. In fact, blood circulating in an unborn baby’s body bypasses the lungs to increase efficiency, through a hole in the heart called the Patent Ductus Arteriosus (PDA). Normally, just before birth, the pressure in the baby’s lungs falls dramatically, and the vessels in the lungs fill with blood. After the baby is born, the air it breathes comes in contact with blood in the lungs, and it begins supplying its own oxygen. The PDA closes soon after birth.
When a baby is born with PPHN, however, this transition does not occur properly. The pressure in the lungs does not fall. Very little blood flows into the blood vessels in the lungs. When the baby breathes for the first time, the air does not contact very much blood. The baby’s body lacks the oxygen it needs to survive. It quickly becomes oxygen-deprived, and without emergency attention, it can die.
What are SSRI antidepressants?
Prozac is not the only drug in the class of SSRI antidepressants. All SSRI antidepressants have been linked to an increased risk of PPHN. This group of drugs includes the following medications:
- Paxil, Seroxat (paroxetine)
- Zoloft, Lustral (sertraline)
- Celexa (citalopram)
- Lexapro, Cipralex (escitalopram)
- Symbyax (fluxetine and olanzapine)
- Wellbutrin, Zyban (bupropion)
- Effexor (vanlafaxine)
If you have taken Prozac or another SSRI antidepressant, you may have a Prozac PPHN lawsuit and be entitled to compensation.