Can the Use of SSRI’s (Anti-Depressants) Cause a Child’s Birth Defect?

What are SSRIs?

Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that ease the symptoms of moderate to severe depression. These antidepressants are the most commonly prescribed because they are relatively safe compared to their counterparts and create fewer side effects.

How do SSRIs Relieve Depression?

SSRIs increase the levels of serotonin (a neurotransmitter) in the brain, which allows for more signals to travel between brain cells. The SSRIs selectively slow down the reabsorption of serotonin, leaving more of the neurotransmitter available for higher stimulation. SSRIs also treat anxiety disorders, obsessive-compulsive disorders, and other conditions.

What are Some Examples of SSRIs?

Some of the Food and Drug Administration-approved SSRIs are citalopram, fluoxetine, paroxetine, and vilazodone. Fluvoxamine, an SSRI used to treat obsessive-compulsive disorder, also relieves depression.

What are Some Side Effects and Risks of SSRIs?

Selective serotonin reuptake inhibitors function in the same manner as most antidepressants and have similar side effects. However, some people can react to different SSRIs in varying degrees depending on their brain chemistry. Common side effects for SSRIs include drowsiness, nausea, insomnia, nervousness, sexual issues, and headaches.

SSRIs are generally safe, but they can become dangerous when used with other medications or drugs. Serotonin syndrome happens when two or more medications that raise the levels of serotonin combine, leading to excess. Side effects include anxiety, confusion, lack of coordination, and accelerated heart rate.

Why Would Pregnant Women Take SSRIs?

Between 10% and 15% of pregnant women suffer from depression and take medications to treat the symptoms. The use of antidepressants by women during pregnancy has increased over time, and doctors often prescribe SSRIs to these patients due to their relative safety.

Does the use of SSRIs Cause Birth Defects?

Drug and medication use generally causes environmentally influenced birth defects due to absorption of these substances through the umbilical cord. However, the FDA and studies conducted by the New England Journal of Medicine (NEJM), and the Center for Disease Control and Prevention (CDC) differ on the relationship between SSRI use and congenital disorders.

What Does the FDA Believe?

The FDA declared a link between SSRIs and the specific birth defect of persistent pulmonary hypertension of the newborn (PPHN) via a Public Health Advisory based on a single study from July 2006. The FDA requested SSRI sponsors change their labeling to mention risk of PPHN. As of December 2011, the FDA revised that link to be inconclusive due to conflicting findings in recent studies.

What Does the NEJM Study say?

The NEJM study of antidepressant use and cardiac defects in 2014 found that there was no substantial risk of defects from use of SSRIs during the first trimester. Researchers linked the few cases of heart conditions in the infants to the effects of the depression itself, factors related to those conditions, and other illnesses present in the mother, rather than the use of antidepressants.

What Does the CDC Study say?

The CDC’s study from July 2015 made a link between certain SSRIs and birth defects. Some conditions were two or three times more frequent with mothers who took fluoxetine and paroxetine. Fluoxetine was related to heart and skull abnormalities, while paroxetine was related to heart, skull, brain, and abdominal wall defects.

However, the most commonly prescribed SSRI, sertraline, has no connections to any birth defects found during the study. CDC researchers found that, despite these links to birth defects, the risk of SSRI consumption leading to birth defects was significantly low.