Antidepressants & Birth Defects

The functional or structural deformities present at birth which result to mental and physical disability are called birth defects. Current research signifies that the main causes of death during the first year of life in infancy are due to birth defects. The structural birth defects are basically physical problems such as cleft lip and palate, a club foot, heart defects, misshaped valves, neural tube defects, and problems associated with development of the spinal cord and brain etc. Moreover, the functional deformities affect the functioning of the body and they include blindness, mental retardation, movement troubles, autism, hypothyroidism, deafness, Down syndrome, and degenerative disorders etc

Birth defects may be caused by genetic problems, chromosomal problems, or environment factors such as diseases, using alcohol or drugs during pregnancy. Some of the antidepressant drugs which have been implicated in birth defects are serotonin reuptake inhibitors (SSRIs) e.g. Zoloft, Prozac, Paxil, Lexapro, and Effexor. Recent studies are pointing to the increased risks of birth defects with usage of these drugs during pregnancy.

SSRIs Antidepressant Drugs

Zoloft, Paxil, Prozac, Lexapro, and Effexor are SSRI antidepressant drugs which are prescribed mainly for the treatment of posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), depression, pain disorder, obsessive compulsive disorder (OCD), and social anxiety disorder.

Side Effects associated SSRI Antidepressant drugs:

  • dry mouth
  • insomnia
  • weight loss
  • skin rash
  • headache
  • diarrhea
  • upset stomach
  • loss of appetite
  • nausea

Birth Defects and SSRI Antidepressant Drugs

Heart Defects

The usage of SSRI antidepressant drugs during pregnancy may lead to birth defects. In a study where nearly 10,000 infants were born with birth defects, it was found that women in the first few months of pregnancy that took Zoloft (sertraline) had double risk of having babies with a heart defect, while those who took Paxil (paroxetine) had more than three times the risk.

The risk of Lexapro, Effexor, and Prozac causing a heart defect during pregnancy is considered to be small. However, a study by the European Network of Teratology Information Services reported that women’s exposure to Prozac (fluoxetine) during the first trimester of pregnancy led to an increased risk of cardiovascular malformations in babies born. This study indicates no causal relationship and no specific pattern of cardiovascular malformations.

Persistent Pulmonary Hypertension of the Newborn (PPHN)

Persistent pulmonary hypertension (PPHN) is one of the most serious birth defects that have been linked to SSRI antidepressant drugs. The severity of PPHN may lead to brain damage, multiple organ damage, and death. This birth defect is very rare and it affects the heart and lung of a newborn. According to scientists, taking SSRI antidepressant drugs during the second half of pregnancy may result to PPHN. However, FDA said in 2011 that the extent of the relationship between PPHN and SSRI antidepressant drugs was still under evaluation. A controlled study reported a 6 fold increase in the risk for developing PPHN after the 20th week of gestation for infants exposed to SSRI antidepressant drugs especially Paxil when compared to infants who had not been exposed to them.

Cleft Lip/Palate

Cleft Lip and Palate are malformations of the face. When the roof of the mouth is not closed, the condition is referred to as a cleft palate. It is a facial malformation that can affect speech, breathing, and feeding. While cleft lip is a malformation on the upper lip which may result to delay in speech. Studies have shown that mothers who are taking SSRI antidepressant drugs during pregnancy have the risk of having babies with cleft palate and cleft lip.

Neural Tube Defects (Anencephaly)

Neural tube defects occur during pregnancy at early developmental stage. They include malformation of the skull and brain, and they normally lead to death after birth. In the same vein, the use of SSRI antidepressant drugs during pregnancy has been linked to neural tube defects. A study reported that a neural tube defect (anaencephaly) was found to be in higher in babies of mothers who had taken SSRI antidepressant drugs a month prior to conception or while pregnant.

It is advisable for women who are considering pregnancy or pregnant to consult their doctors for advice on the use of SSRI antidepressant drugs to curb birth defects.

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