birth defects and antidepressants

Lately, there have been ads on television run by www.rxbirthdefects.com that have been asking them to contact them if anyone took particular antidepressants during pregnancy (I guess they’re recruiting people to join a class-action lawsuit). According to them, some of them cause severe birth defects. Maybe I just hadn’t been paying much attention to the news for the last few years, but until seeing that commercial, I didn’t even know this was a huge issue. Well, apparently it is. For instance, FDA issued a warning that Paxil may put newborns at risk for birth defects. For many of us who take antidepressants, it’s not easy to make changes as a non-pregnant person. If I were pregnant, I can’t imagine even being hinted by the idea that something I’m taking could be causing harm to the fetus. The last thing a pregnant person wants to do is to cause harm to the baby, but at the same time, she probably would like to be mentally sound during the pregnancy.

Mayo Clinic has a page “Antidepressants: safe during pregnancy?” that addresses some questions concerning this dilemma.

They had this overview on the page, arranged alphabetically by type of antidepressant (the list goes on beyond what is copied here):

Selective serotonin reuptake inhibitors (SSRIs)

Citalopram (Celexa)

Risks: Has been associated with a rare but serious newborn lung problem (persistent pulmonary hypertension of the newborn, or PPHN) when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with a birth defect that affects the brain and skull (anencephaly), a birth defect that affect sutures on the head (craniosynostosis) and a birth defect that affects the abdominal organs (omphalocele) Recommendation: Consider as an option during pregnancy

Fluoxetine (Prozac, Sarafem)

Risks: Has been associated with PPHN when taken during the last half of pregnancy Recommendation: Consider as an option during pregnancy

Paroxetine (Paxil)

Risks: Has been associated with fetal heart defects when taken during the first three months of pregnancy; has been associated with PPHN when taken during the last half of pregnancy; has been associated with anencephaly, craniosynostosis and omphalocele Recommendation: Avoid during pregnancy

Sertraline (Zoloft)

Risks: Has been associated with PPHN when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with omphalocele Recommendation: Consider as an option during pregnancy

Note: Persistent pulmonary hypertension of the newborn, anencephaly, craniosynostosis and omphalocele are rare conditions. Even if you take an SSRI during pregnancy, the overall risks remain extremely low.

Tricyclic antidepressants (TCAs)

Amitriptyline

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies Recommendation: Consider as an option during pregnancy

Nortriptyline (Pamelor)

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies Recommendation: Consider as an option during pregnancy

Monoamine oxidase inhibitors (MAOIs)

Phenelzine (Nardil)

Risks: May cause a severe increase in blood pressure that triggers a stroke Recommendation: Avoid during pregnancy

Tranylcypromine (Parnate)

Risks: May cause a severe increase in blood pressure that triggers a stroke Recommendation: Avoid during pregnancy

Other antidepressants

Bupropion (Wellbutrin)

Risks: No established risks during pregnancy Recommendations: Consider as an option during pregnancy