Pills now linked to birth defects risk

The study found that many popular antidepressants – Celexa, Lexapro or Zoloft – were not associated with birth defects and only two in the study, Prozac, sold generically as paroxetine, and Paxil, sold generically as fluoxetine, were implicated.

A new study suggests that only older antidepressants, particularly Prozac and Paxil, could increase a pregnant woman’s risk of delivering a baby with birth defects.

The researchers combined results from independent published analyses with data from the US National Birth Defects Prevention Study (NBDPS) to give a more balanced estimate of any association between individual SSRIs and birth defects.

Reefhuis said that the research team acknowledges how serious depression and other mental health issues can be and that many women may need to take medications during pregnancy but that they should be in close contact with their providers to determine whether any modifications need to be made. The researchers say physicians should take their findings into account when making treatment decisions. Any decision around treatment in pregnancy needs to weigh up the potential small risks of birth defects against the benefits of treatments including helping a mother get better from depression.

The analysis showed that women who took Prozac and Paxil were up to 3.5 times more likely to deliver babies with birth defects compared to those who were taking other drugs.

The links between antidepressants and birth defects have been subject of much discussion.

The link between antidepressants and birth defects has been confirmed in some SSRIs (selective serotonin reuptake inhibitors), but not in all of them. The researchers could not say whether or not the antidepressants are the direct cause of the birth defects, only that there is some connection between the two, but not a big enough one to pose a significant risk.

“The overall risk is still small”, Jenna Reefhuis, an epidemiologist and lead researcher in the study, told NPR.

The question of whether antidepressants can cause birth defects has been debated for years, and studies have been all over the map. They include low birth weight, pre-eclampsia and poor nutrition during pregnancy, and a tendency to pay less attention or engage in creative play with babies and toddlers. That included heart defects, abdominal wall defects, and missing brain and skull defects with paroxetine, and heart wall defects and irregular skull shape with fluoxetine.

This study looked at the effects of five SSRIs: paroxetine, fluoxetine, citalopram, escitalopram and sertraline.

The findings also suggest that one antidepressant, Zoloft, may be safer than other medications.

“A woman’s chance of having a child with the heart defect we described is about 10 per 10,000”. They put flesh and blood on the estimated 14 to 23 percent of women who will experience depression symptoms during their pregnancy, according to the American Congress of Obstetricians and Gynecologists.