While medications have allowed humans to control disease and alleviate pain, some beneficial drugs may become harmful in certain circumstances. Two new studies show possible links between antidepressants and birth defects; while these are not harmful drugs in normal circumstances, during pregnancy they may be.
Link Between Antidepressants and Autism?
A recent study published in the Archives of General Psychiatry and led by Dr. Lisa Croen, director of autism research at Kaiser Permanente Northern California, found that selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that includes Zoloft and Prozac, may increase the risk of autism in newborns when taken by expectant mothers.
The study found that the biggest risk to children occurred when mothers took SSRIs during the first trimester of pregnancy — this increased the risk that a baby would be born on the autism spectrum disorder (ASD) by nearly four times.
Larger studies, however, need to be conducted to verify this research. The study only included approximately 300 children, born between 1995 and mid-1999 and diagnosed with ASD. Based on a sample size this small, researchers are unable to conclusively state that SSRIs taken during pregnancy cause ASD.
More importantly, this study should influence pregnant women and women who might become pregnant to speak with their doctors about the possible dangers of autism and SSRIs. Women should not just stop taking SSRIs, as this may be more of a danger to the expectant mothers and babies than taking SSRIs. According to CNN, women who leave their depression untreated during pregnancy risk going into labor prematurely.
Tim Oberlander, M.D., told CNN that the mental health of pregnant women "is a major public health issue." Further, he stated that: "Nontreatment is not an option. While some children might be at risk from an SSRI exposure — and we don't know who and how that works — there are many mothers and their children as well who will benefit [from treatment]."
If you took antidepressants during pregnancy and expect a link between your medication and your child's autism, a West Palm Beach birth injury attorney or lawyer in your area can help you understand your legal options.
Link Between Antidepressants and Heart Defects?
Another recently published study purports to show a link between antidepressants and birth defects. The study, authored by Dr. Heli Malm, uses data from Finland to show a slight link between pregnant women who take particular SSRIs — either Prozac (fluoxetine) or Paxil (paroxetine) — and children born with specific heart defects.
According to Reuters, the study showed a small link between Prozac taken early in pregnancy and babies born with isolated ventricular septal defects (a hole between the two halves of the heart). Further, the study indicated a link between Paxil taken early in pregnancy and babies born with right ventricular outflow tract defects (this affects how blood flows from the heart to the rest of the body).
Like the study linking SSRIs to ASD, this study does not conclusively prove that SSRIs cause these particular heart defects. The results of the study only showed a very small link between the SSRIs and the birth defects — only 105 of 10,000 babies whose mothers took Prozac were born with defects, and only 31 of 10,000 babies whose mothers took Paxil were born with a heart defect.
Again, expectant mothers who take SSRIs should discuss the risks to themselves and their babies if they continue or discontinue taking SSRIs.
Food and Drug Administration Recommendations
The Food and Drug Administration (FDA) is the government entity tasked with keeping Americans safe, including pregnant women, by regulating what is ingested. First and foremost, the FDA recommends that women who have become pregnant or are trying to become pregnant speak with their physician about medications they are taking — because some drugs are or might be harmful to babies, like SSRIs. Also, because of the bodily changes that pregnant women experience, doctors might alter the medication dosage in order for that medication to remain effective and safe for the mothers.
The FDA also suggests that pregnant women read the label of any over-the-counter drugs that they might take. By law, the labels of all over-the-counter medications must list the dangers or potential dangers that the drugs pose to pregnant women.
The FDA divides prescription drugs into different categories based on research and known dangers to pregnant women and their babies. The categories are as follows:
- A — Studies involving humans show that drugs assigned to this category (like folic acid and some thyroid hormone medications) pose no or very little risk to pregnant women and their babies
- B — Either no good human studies are available and studies in animals showed no harm to animal mothers and babies who are exposed to drugs in this category, or studies involving animals indicate a minor risk to animal mothers and babies and use of the medications by human mothers showed no or little risk of problems (including amoxicillin, Zofran and some insulin).
- C — Either there are no good studies involving humans or animals or there are studies that show a risk to babies, yet the medications (like some SSRIs and Diflucan) still provided more benefit to mothers and babies than harm.
- D — Studies involving humans show that drugs assigned to this category (including some SSRIs like Paxil, Lithium and some chemotherapy drugs) show a risk of birth defects, yet in some cases the drugs may still benefit mothers and babies.
- X — Studies involving both humans and animals show that medications (like Accutane and Thalomid) pose a risk of birth defects and mothers should not take these drugs.
Even if you have talked to your doctor or read labels to understand the risk of these drugs, you should be aware that some "safe" drugs may still lead to birth defects. Always consult your doctor prior to taking medications while pregnant, but if a medication is okayed by your doctor and later causes issues, speak with an experienced birth defect attorney.
