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Physician concerned over findings on antidepressants

In a guest blog entry for Boston NPR station WBUR, Dr. Adam C. Urato, MD, maternal-fetal medicine physician at Tufts Medical Center, writes of his alarm at the growing body of literature indicating that it’s risky for pregnant women to take antidepressants.

Urato makes reference to two recent articles showing that antidepressant use by pregnant women is associated with preterm birth, one of which also showed increased rates of neonatal seizures in newborns who were exposed to antidepressants in utero.

“Current research suggests that antidepressant use (typically the SSRIs) by pregnant women is associated with increased risks of miscarriage, birth defects, preterm birth, preterm premature rupture of membranes, preeclampsia, and decreased fetal growth,” Urato writes.

SSRI, or selective serotonin reuptake inhibitor, antidepressants include Prozac and Zoloft.

Urato compares the situation to a virus affecting about 5 percent of all pregnant women, which would amount to about 200,000 U.S. pregnancies per year.

More than 10 percent of those women infected with the virus would miscarry; up to 20 percent or more would have preterm birth, and 30 percent of newborns would show effects of the exposure in the days after birth. Some of those effects would be severe, such as seizures and trouble breathing.

“If this were to occur it would be considered a public health emergency and a tremendous effort would be put forth to address it,” Urato writes. “Yet this epidemic is happening and, in many ways, it is going unrecognized. Pregnant women and the public are unaware. It is the epidemic of antidepressant drug exposure during pregnancy.”

Newborns who were exposed to antidepressants in utero have increased rates of what is called the newborn behavioral syndrome, which can consist of a variety of symptoms including tremors, agitation, excessive crying, respiratory difficulties, and seizures, Urato writes.

Exposed newborns also have been shown to have dangerous heart conditions, and a potentially fatal condition called persistent pulmonary hypertension characterized by constriction in arteries leading to the baby’s lungs.

Patients should consult their doctors before making any changes in their medication. A consultation with an SSRI lawyer is also important if there are significant injuries.

See the blog entry here:

http://commonhealth.wbur.org/2012/06/antidepressants-pregnancy#more-21811