Association of Neural Tube Defects with SSRI Medications

Selective Seratonin Reuptake Inhibitors (SSRIs) are among the most commonly used types of drugs to treat depression. But the safety of these same drugs, more commonly known by their brand names Celexa, Paxil, Prozac, Lexapro and Zoloft, during pregnancy has been questioned by some studies. Specifically, although the research to date is not conclusive, studies indicate a concern that SSRI medications are linked to potential birth defects for the children of women who have taken the drugs during pregnancy. Among the most severe types of birth defect that some studies link to SSRIs are neural tube birth defects.

The neural tube is a narrow tube which forms early in pregnancy and is the first part of the development of the central nervous system. A neural tube defect is a malformation that refers to the failure of the neural tube to close completely while the fetus is developing in the womb, which means that there is an opening in the spinal cord or the brain. Neural tube defects include a range of possible conditions, including Anencephaly, which is a condition where parts of the brain and skull are simply missing, and Spina bifida. Neural tube defects are, perhaps obviously, also accompanied by damage to the brain and spinal cord. Of course, this leads to serious cognitive and developmental issues.

A study published in the New England Journal of Medicine in 2007 that involved over 9500 infants found that there was a significant association between SSRI use and anencephaly; 214 infants in the study suffered from this birth defect and 9 of them had been exposed to SSRIs while in the womb. The specific drugs that were most linked with anencephaly included sertraline and paroxetine. The findings of the 2007 study are consistent with previous studies in finding significant associations between paroxetine and neural tube defects. As with other studies that examine SSRI use and birth defects, the absolute risk of neural tube defects remains low. Yet, any amount increased risk is certainly likely to cause concern to a woman who is considering pregnancy while prescribed an SSRI medication. Talking about these issues with your treating physicians prior to becoming pregnant is key to ensuring the health and safety of your baby.