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Michael Monheit
Michael Monheit
Attorney • (215) 840-6573

SSRI Antidepressants and Septal Defects

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Several studies have shown that SSRIs, the most commonly prescribed antidepressant, can increase the risk for birth defects when taken by the mother during pregnancy, particularly during the early stages of pregnancy. What exactly are SSRIs and what are the risks to the mom and unborn child? Please continue reading below.

What are SSRIs

SSRIs are known as selective serotonin reuptake inhibitors which include the brand names Celexa, Lexapro, Prozac, Paxil, Zoloft and Symbyax (a combination of Fluoxetine and Olanzapine). They are used to ease symptoms of moderate to severe depression.

How do SSRIs Work

SSRIs work by blocking the reabsorption (reuptake) of the neurotransmitter serotonin in the brain. Adjusting the balance of serotonin helps brains cells send and receive chemical messages, which in turn boosts mood. SSRIs are called selective, because they primarily affect serotonin, not other neurotransmitters, according to the Mayo Clinic.

Pregnancy and SSRI Use

While SSRIs are generally considered safe, there are some things that need to be considered before and during use, especially during pregnancy.

Some antidepressants pose a risk to the unborn child if taken during pregnancy or while breast-feeding. For instance, Paxil appears to increase risk of birth defects, including heart and lung problems.

It is important to note, that if you don’t take proper care of depression during pregnancy, you may put your health – and your baby’s health – at risk. Please don’t make this decision on your own. It is best to seek advice from your medical doctor as soon as possible. And, most importantly, do not suddenly stop taking the medication before seeing your doctor.

The risk of birth defects and other problems for mom and babies who take antidepressants is low, overall. Still, there are few drugs that have been proven safe without question during pregnancy. And some antidepressants have been associated with heart problems and premature birth in babies.

What is a Septal Defect

An atrial septal defect (ASD) – referred to as “hole in the heart” – is a type of congenital defect in which the septal wall separates the upper heart chambers. Most ASDs are diagnosed and successfully treated.

In ventricle septal defect (VSD), there is a hole in the septum wall that separates the right and left ventricles of the heart.

Increased Risk of Septal Defect if Mom is on an SSRI

A study published in the July issue of the Obstetrics & Gynecology Journal suggests the use of certain SSRI medications, taken during pregnancy, can increase the risk of certain heart defects.

For the study, researchers looked at more than 600,00 births that occurred between 1996 and 2006 and found that taking certain SSRIs during the first trimester increased the risk of major cardiac defects. The drug fluoxetine (Prozac), in particular, was associated with a two-fold increased risk of VSD, while the drug paroxetine (Paxil) was associated with a four-fold increase in the right outflow.

The absolute risk for these cardiac defects is relatively low. But the fact that there is an increased risk when taking these SSRIs during pregnancy, researchers suggest clinicians not consider fluoxetine or paroxetine as the first option when prescribing an SSRI during pregnancy.

A separate study, in Denmark, looked at 216,042 women who had given birth after the 20th week of gestation. Researchers compared the prevalence of malformation in infants born to women who had taken at least one SSRI during early pregnancy to those women who had not taken an SSRI at any time during their pregnancy.

The 2,062 women with SSRI prescriptions during early pregnancy gave birth to 105 (5.1%) infants with malformations, while the 213,712 women with no SSRI prescriptions gave birth to 7,449 (3.5%) infants with malformations.

In both studies the overall risk to the fetus remained low. However, every woman is different and as such, the benefits versus the risk should be carefully weighed with the assistance of a medical professional as to continue or discontinue use of an SSRI during pregnancy.