Antidepressants no risk to pregnancies
Reported May 24, 2008
Montreal researchers say pregnant women can continue taking antidepressants because the drugs do not pose a risk to their babies.
Published in the highly regarded British Journal of Psychiatry, the Montreal study found anti- depressants have little impact on the fetus and do not increase a woman’s risk of delivering babies with birth defects.
Anick Bérard of the Université de Montréal and Ste. Justine Hospital analyzed data from 2,329 pregnant women in Quebec between 1998 to 2002.The women had been diagnosed with at least one psychiatric disorder and treated with antidepressants for at least 30 days before pregnancy.
Bérard, a senior researcher, said it’s the first study to investigate the impact of antidepressant use during the first trimester of pregnancy in mothers with psychiatric disorders.
The study found little to link birth defects or malformations to antidepressants.
The finding is significant because of the widespread use of antidepressants. Since one in two pregnancies is unplanned, women who are already on antidepressants often think they must discontinue the medication for the good of their babies, Bérard said.
“We’re fearful of having another thalidomide on our hands,” she said, referring to the sedative and anti-morning sickness pill widely prescribed to pregnant women in 1950s and 1960s that caused severe birth defects in thousands of children in North America.
According to Statistics Canada, the proportion of expectant mothers using antidepressants rose to 14 per cent in 2007 from 12 per cent five years ago.
The issue remains controversial because of conflicting results in previous studies.
“Some say it’s good, others say it’s real nasty,” said Bérard, director of the research unit examining medication and pregnancy at Ste. Justine Hospital.
Antidepressants have been linked to premature births, smaller babies, heart defects and death from hypertension.
In 2005, Health Canada and the U.S. Food and Drug Administration issued warnings about higher risks of heart defects in babies whose mothers took the antidepressant Paxil while pregnant.
Last year, Bérard’s team found Paxil was linked to an increase in heart defects, but only when taken in high doses prescribed to severely depressed women.
An estimated one per cent of all babies are born with heart defects. Paxil raised the risk to three per cent, Bérard noted.
No drug is without risk, Bérard said. But left untreated, depression can also increase the chance of preterm birth and postpartum depression, other studies show.
Bérard’s findings are supported in independent research from the Motherisk Program at the Hospital for Sick Children and the University of Toronto.
“Women are terrified. Health Canada and the FDA warnings were premature,” said Adrienne Einarson.
Einarson’s findings, published in the American Journal of Psychiatry last month, show that Paxil does not increase the risk of cardiovascular birth defects.
“There is no increased risks for birth defects; that’s one thing we are sure about,” she said.