For the past several years, the public health community has suspected the potentially adverse effects of selective serotonin reuptake inhibitors (SSRIs) on an unborn child. Although not all studies provided a conclusive answer, previous research findings alerted medical authorities to the possibility of an increased chance of birth defects such as cardiac malformation and respiratory distress. Now, recent studies provide additional evidence, supporting the notion that prenatal exposure to SSRIs increases the risk of birth complications such as autism and respiratory problems.
SSRIs are a class of anti-depressants that work by blocking the serotonin receptors during nerve transmission, thus increasing one’s serotonin levels. Serotonin is a type of neurotransmitter; they are chemical messengers that affect many aspects on one’s physical and psychological health. Because they affect one’s mood, it is widely believed that depression is strongly linked to serotonin deficiency. Several SSRIs have been approved by the U.S. Food and Drug Administration (FDA), including brands such as Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram) and Lexapro (escitalopram).
Only a few short years after SSRIs hit the market, questions arose over whether the anti-depressants cause violent tendencies. Attorneys Jerrold S. Parker and Leonard Finz filed the very first case under such claims. The suit involved Rhonda Hala, a secretary from Long Island, who had mutilated herself 150 times and attempted suicide on six occasions while taking Prozac. Hala had no previous history of violence. In later years, regulators in both the US and Europe released officials warnings about the association between suicidal tendencies and SSRI use.
In 2005, the FDA released a warning that cited the increased risk of heart defects in newborns exposed to Paxil in the womb during the first trimester.
In 2006, a major study conducted at the University of California, San Diego found a connection between SSRI use during pregnancy and persistent pulmonary hypertension in the newborn (PPHN). PPHN is usually a very rare but dangerous respiratory disorder. Despite treatment, it is fatal in 10 to 20 percent of infants. The study, led by Christina Chambers, studied 377 women and found that newborns were six times as likely to have PPHN if the mother took an SSRI after her 20th week of gestation. Still, the results were somewhat dampened by another study indicating that a woman can relapse into depression if she stops taking anti-depressants during pregnancy.
More recently, findings published in the journal Archives of General Psychiatry link prenatal SSRI exposure to autism and related disorders. Lead author and director of autism research at Kaiser Permanente Northern California Lisa Croen, PhD, discovered that SSRI use during pregnancy increased the overall chances of developing autism spectrum disorders (ASD) by 2.2-fold. If the anti-depressant was used during the first trimester, these odds increased to 3.8-fold. According to Coen, approximately 2 percent of children born with autism during the late 1990s can be linked to SSRI use. This proposed statistic however, may have increased due to the more widespread use of SSRIs today.
Now, a study published in the British Medical Journal (BMJ) last month further supports a relationship between prenatal SSRI exposure and the increased risk of PPHN. The findings contradict the recent actions of the FDA, who publicly questioned the link between PPHN and SSRIs only weeks before. This study was much larger, more wide-reaching and thus more condemning, than the previous studies that the FDA has somewhat overlooked. The study analyzed birth records of more than 1.6 million women across five different countries including Sweden, Norway, Finland, Iceland and Denmark. Researchers looked at Prozac, Paxil, Celexa and Zoloft. They found that, although chances were low, use of these SSRIs during the course of pregnancy more than doubles a newborn’s chances of developing PPHN.