Heart Defects & SSRIs

Selective serotonin reuptake inhibitors (SSRIs) used to treat depression and other mental disorders, may increase the risk for cardiac or heart defects in unborn fetuses when taken during pregnancy. SSRI heart defects may include patent ductus arteriosus (PDA), hypoplastic left heart syndrome, persistent pulmonary hypertension of the newborn (PPHN) and other abnormalities which may be fatal in newborn infants.

Antidepressants are used by millions of people each year to treat depression. However, these drugs can cause severe side effects when taken by pregnant women. A number of women have reported heart defects and other abnormalities in their children when antidepressants were used during pregnancy. Evidence shows that birth defects are most commonly seen when pregnant patients take selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and Zoloft.

Types of Antidepressant Heart Defects

The heart has four compartments; these are called the atria and ventricles. The most commonly reported heart defects are atrial septal wall defects (ASD) and ventricular septal defects (VSD). These are defects that cause a malformation in the wall that divides these compartments of the heart.

ASDs affect the pressure level in the heart chambers. Excessive blood volume or a hole in one of the walls of the heart can cause these types of problems. VSDs refer to a malformation of the ventricular heart wall. If an infant has a heart murmur, it might be difficult for doctors to diagnose.

Other types of heart defects from antidepressants:

  • Coarctation of aorta (CoA)
  • Double outlet right ventricle (DORV)
  • Total anomalous pulmonary venous return (TAPVR)
  • Patent ductus arteriosus (PDA)
  • Transposition of great arteries (TGA or TOGA)
  • Hypoplastic left heart syndrome
  • Tetralogy of fallot
  • Persistent pulmonary hypertension of newborn (PPHN)

Heart Defect Studies

The British Medical Journal published a study in 2009 that discussed the effects of antidepressants on pregnancy. The study concluded that use of more than one antidepressant during the pregnancy’s first trimester gave a significantly higher risk of developing heart defects. Babies were four times more likely to develop septal heart defects.

Another 2009 study examined the occurrence of heart defects in Danish children whose mothers were treated with antidepressants during pregnancy. The study examined nearly half a million Danish children who were born between 1996 and 2003. Researchers found that children exposed to SSRIs such as Prozac, Zoloft, and Celexa during early pregnancy had a higher incidence of heart defects.

Persistent Pulmonary Hypertension

There are many serious heart defects that are possible from the use of antidepressants. Persistent pulmonary hypertension of the newborn (PPHN) is one of the most serious. This is a rare condition caused by a lack of oxygen which damages the fetus’ heart, lungs, and brain. The condition is fatal 10 percent of the time. SSRIs are one of the main causes of the condition.

Studies have shown that a fetus is six times more likely to be born with PPHN if antidepressants are used in the second half of pregnancy. However, PPHN can also develop if antidepressants are used during the first trimester of pregnancy.

If the case of PPHN is not fatal, the child could be affected by lifetime disabilities. Some of the health problems that develop as a result of PPHN are hearing loss, breathing problems, seizures, and cerebral palsy.

Some of the symptoms from PPHN:

  • Sweating
  • Lethargy
  • Blue tinted skin (cyanosis)
  • Breathlessness
  • Tachycardia (rapid heart rate)
  • Tachypnea (quick breathing)

If initial symptoms are found, these additional tests are used to confirm the case:

  • Hepatomegaly (enlarged liver)
  • Edema (particularly swelling of hands or feet)
  • Weak pulse
  • Hypotension (low blood pressure
  • Hypoxia (low oxygen level in blood
  • Heart murmur

Heart Defect Case Examples

In 2009, a jury concluded that Paxil was responsible for an infant’s heart defects. GlaxoSmithKline, the manufacturer of Paxil, was ordered to pay the family $2.5 million as a result. It was determined that GlaxoSmithKline had negligently failed to warn the doctor about Paxil’s risks and was therefore responsible for the resulting antidepressant heart defect. This case was the first of over 600 against GlaxoSmithKline for birth defects resulting from Paxil use.

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