Team of researchers says risks with SSRIs during pregnancy outweigh benefits
A team of researchers is recommending that women with past episodes of mild to moderate depression who are pregnant or are trying to get pregnant not take selective serotonin reuptake inhibitors (SSRIs), such as Zoloft, Paxil, Celexa and Prozac, because of risks to the unborn child.
“There is no evidence of improved pregnancy outcomes with antidepressant use,” the researchers wrote in the journal Human Reproduction, adding that there are established downsides to using the drugs while pregnant such as an increased risk of miscarriage, preterm birth, and behavioral problems in newborns.
The team of researchers from Boston IVF and Tufts University School of Medicine reviewed more than 100 published studies and took the controversial position. “We’re not talking about those with severe depression,” the researchers noted. “But those who have had milder episodes need to be warned of the risks in order to make an informed decision.”
Previous studies have established a connection between depression and poor pregnancy outcomes, but it has also shown that antidepressant use increases the risk of miscarriage from about 8 percent in the general population to 12 to 16 percent in those who use SSRI while pregnant. Other studies have shown that antidepressant use during pregnancy increases the risk for preterm birth, and nearly a third of newborns born to mothers who took SSRIs develop a condition known as newborn behavioral syndrome, which causes jitteriness, feeding problems and inconsolable crying during the first few days or weeks after birth. In some cases, these babies may develop severe breathing problems and require a breathing tube.
The researchers did say that their recommendation was for women who suffer from mild to moderate depression, and that women with severe symptoms of depression may be better off staying on the medications. Either way, they say, it is a decision that a woman should make only after discussing the risks and benefits with her doctor.