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Nancy Schimelpfening

SSRIs May Be Too Risky During Pregnancy

By November 1, 2012

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A popular class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be too risky for use during pregnancy, according to a new study.

These antidepressants - which include drugs such as Prozac, Paxil, Celexa and Zoloft - have been associated with problems such as increased risk of miscarriage, congenital heart defects, preeclampsia and autism, say the researchers.

SSRIs may be especially problematic for women who are having trouble conceiving, said the authors, because they seem to make it more difficult for them to get pregnant and they may be more likely to miscarry if they do become pregnant.

As far as congenital heart defects, Paxil seems to be the most risky, they said.  In fact, in 2005, the FDA changed its rating from "C" to "D" because of this risk.

An increased risk for preeclampsia, a condition in which blood pressure rises to dangerously high levels in pregnant women, was also noted.

In addition, the authors discussed a 2011 study from Kaiser Permanente Medical Care Program of Northern California that found a "twofold increased risk of autism spectrum disorders associated with maternal treatment with SSRI antidepressants during the pregnancy, with the strongest effect associated with treatment during the first trimester."

In contrast, said the senior author of the study, Dr. Adam Urato, there is no clear evidence that these medications actually benefit mothers with mild to moderate depression.

If you are pregnant or considering pregnant, however, this study does not mean that you should automatically discontinue your antidepressant.  The risks vs. the benefits of antidepressant use must be weighed for each individual patient.  You should discuss your concerns with your doctor and get her advice about what is best for you.

The study was published online Oct. 31, 2012 in the journal Human Reproduction.

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