Women who take some types of antidepressants have an elevated risk of birth defects in their babies, shows a study published this week in The BMJ (formerly The British Medical Journal).
The meta-analysis found an overall increase of birth defects in women who took some types of SSRIs, or selective serotonin reuptake inhibitors, common antidepressants that include Prozac, Zoloft, and Paxil.
The study followed women who took SSRIs from the month leading up to conception, through the first trimester — the most critical period of fetal development during pregnancy. It did not include results of women who took SSRIs during the later stages.
In the study, the most common SSRI — Zoloft — showed no increase in birth defects, but women who took others reported defects such as cleft lips, brain damage, malformed organs, and others.
The study looked at five major SSRIs on the market, and the researchers interviewed 38,000 women between 1997 and 2009, counting 14 birth defect categories as reported in previous studies. The findings broke down the risks as follows:
- Celexa (citalopram): showed a slight risk in neural and spinal defects.
- Lexapro (escitalopram): showed no association with defects.
- Paxil (paroxetine): showed a “significant association” in brain malformations, heart and gastric defects.
- Prozac (fluoxetine): showed heart and brain malformations.
- Zoloft (sertraline): showed no significant correlations with birth defects.
Since the study sought to analyze previously published results, it’s didn’t count reports of other types of defects.
The authors wrote that these findings showed that risk of birth defects were still very low, even for Prozac and Paxil — at most, 24 babies in 10,000 for heart malformations.
Most of the defects occurred within the first weeks of pregnancy, often before a woman realizes she’s pregnant, so she may not have enough forewarning to stop taking medication before they affect her fetus adversely.
Many women who are prescribed antidepressants may not need them, considering that studies have recently shown that most people who are prescribed antidepressants may have been misdiagnosed — or at least, their symptoms may not have matched standard diagnostic criteria.
Antidepressant use in the United States has increased 400 percent between 1998 and 2008. The Centers for Disease Control reported that 10 percent of Americans took antidepressants in 2011, with use being higher in females than males. But recent research has thrown the efficacy of SSRIs into question. In a 2005 study, The BMJ reported that SSRIs show no clinical advantage over placebos.
“Claims that antidepressants are more effective in more severe conditions have little evidence to support them,” write the authors. “Antidepressants have not been convincingly shown to affect the long term outcome of depression or suicide rates. Given doubt about their benefits and concern about their risks, current recommendations for prescribing antidepressants should be reconsidered.”
A meta-analysis of six studies, published in 2010 in the Journal of the American Medical Association, similarly found that antidepressant drugs were no more effective than placebos for those with mild to moderate depression.
Given the risks of birth defects in pregnant women, the dubiousness of claims of effectiveness, and rampant misdiagnoses, women struggling with depression may want to consider other ways of alleviating their suffering than taking antidepressants.
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