A recent medical study, published in the British Medical Journal, discussed the dangers of taking antidepressants while pregnant. According to the data, women who took SSRI antidepressants like Prozac, Paxil or Zoloft during pregnancy were likely to give birth to a child with persistent pulmonary hypertension – high blood pressure in the arteries and lungs that can eventually lead to weakening of the heart or heart failure.
The condition affects 1 in 1,000 infants normally, but the numbers are more than doubled for mothers that took an SSRI during their second half of pregnancy. Mothers who took SSRIs during their first half also had an increased risk but that risk was lower when compared to women who took the antidepressants in their second half of their pregnancies.
Persistent pulmonary hypertension, or PPHN isn’t the first health complication to be linked with SSRI use during pregnancy. Other health complications in infants have been linked to SSRI use during pregnancy as well – low blood sugar, premature birth, low birth weight and even developmental abnormalities, like cleft lip and palate, have been mentioned throughout previous studies.
So the solution sounds simple. Just stop taking antidepressants when you find out you’re pregnant, right? Well, not exactly.
According to Dr. Keith Ablow, Fox News Medical A-Team member and psychiatrist the answer isn’t very simple. He also says that the data from the most recent study is “unreliable.”
“The study did not exclude other causes of pulmonary hypertension that might, for some reason, be more common in depressed women taking antidepressants but not be due to the antidepressants themselves,” stated Dr. Albow. “Mothers who are overweight, diabetic or asthmatic also deliver children at increased risk. Some studies suggest children of mothers who deliver by cesarean section are too. Is it possible that these mothers are also more likely to use antidepressants and that their other characteristics are the concerning ones – not the medicine itself?”
Dr. Albow also stated that the study seems to somewhat contradict itself because mothers hospitalized in a psychiatric hospital prior to pregnancy were also at a higher risk of delivering a baby with PPHN, regardless of whether they took an antidepressant during pregnancy or not.
Overall, Dr. Albow says that in some women, the risk of stopping antidepressants during pregnancies may outweigh the risks of continuing them.
“It is not clear whether stopping antidepressants during pregnancy might lead to withdrawal effects in women and their fetuses, with unknown consequences,” he stated. “[Additionally], it is not clear at all what the toll of untreated maternal depression might be on fetuses and newborns.”
So what does he recommend? Dr. Albow suggested that any woman planning to become pregnant talk to their psychiatrist about alternative treatments like transcranial magnetic stimulation so that they can try and discontinue SSRIs before pregnancy actually starts. He advises, however, that serious symptoms of depression may not be effectively treated by alternative methods.
For women that are already pregnant, Dr. Albow warns moms-to-be that they should never stop taking an antidepressant suddenly.
“This can cause serious symptoms that affect you and your unborn child,” he stated.
He suggests, instead, that moms-to-be talk to their psychiatrist and doctor about their SSRI use. If their symptoms are mild to moderate, they may be able to slowly decrease the dosage and eventually stop taking the medication altogether.
In the case of serious symptoms, especially suicidal thoughts, advice of a health care professional should be followed regarding SSRI use and pregnancy. This rule applies both before and during pregnancy.
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