Common Antidepressants Too Risky During Pregnancy, Researchers Say
Not everyone agreed with the researchers' conclusions, however. Dr. Beatriz Currier is associate professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine.
She said there is no blanket recommendation as to how best to treat depression during pregnancy and "every woman who presents to a clinician has to undergo a case-by-case analysis of the benefits and risks of antidepressant therapy."
Currier also said that there is "no conclusive data about an increased risk of miscarriage being associated with antidepressants." Nor is there any reason to conclude the rate of preeclampsia or birth defects is higher, she said, although there is some evidence that antidepressant use may be associated with low birth weight babies.
According to background information in the study, antidepressants are the most widely prescribed medications among adults aged 18 to 44. Up to 13 percent of pregnant women take an antidepressant. Many of these may be women undergoing treatment for infertility, a condition which is often accompanied by depression.
In 2010, up to almost 7,000 babies conceived by in vitro fertilization (IVF) may have been exposed to an antidepressant, the study authors said.
In their research, Urato and his team looked at the existing literature on women who had fertility problems and were also taking SSRIs. They say they found a number of concerns.
First of all, some studies suggest that SSRIs may actually undermine women's efforts to get pregnant, the researchers said. And for those who do get pregnant, the drugs may increase the risk for miscarriage as well as congenital problems in their children. The most striking association was for use of Paxil (paroxetine) during pregnancy and the risk for congenital heart defects, they said.
The study authors noted that, in 2005, the U.S. Food and Drug Administration requested that Paxil's maker, GlaxoSmithKline, change Paxil's pregnancy category from a "C" to a "D" rating, indicating that it poses a risk to the fetus.
