I’m Pregnant… What I Wish I Knew About Taking SSRI Antidepressants

April 9, 2014

Selective Serotonin Re-uptake Inhibitors or SSRI’s are used for treatment of depression and anxiety. Common SSRI’s preparations are Zoloft, Celexa, Lexapro, Luvox, Paxil, and Prozac among others. Serotonin is a substance that plays a role in moods, and is produced by the brain. This substance is then re-absorbed by the body in a way that maintains a certain level of serotonin in the brain. SSRI’s increase the serotonin level in the body by blocking the re-absorption of the substance.

While SSRI’s seem to be more effective at elevating the mood in severe cases of depression than in mild cases, they also have other side effects which in some cases outweigh the benefits of taking the drug. In particular, women who are pregnant should know that there is an increased chance of birth defects in their unborn child when taking one of these medications during pregnancy.

In 2006 the FDA began official black box warnings on these types of pharmaceuticals. A black box warning is the highest type of alert the FDA can require short of removing a product from the market.

I wish I knew the side effects on my unborn baby

To women who are pregnant (significant possible effects on the unborn baby):

Heart Defects – such as atrial or ventricular septal defects (ASD or VSD) which are holes in the heart
Persistent Pulmonary Hypertension – Damages heart and lungs. Usually not detected until birth
Anencephaly – Fatal defect where baby is born without a large part of the brain and skull
Cleft Lip and Palate – Deformity of upper mouth and palate.
Respiratory Distress – Breathing difficulties due to underdeveloped lungs

Beyond these possible effects on the unborn baby, SSRI’s also have possible side effects of nausea, diarrhea, fatigue, dry mouth, rash, drowsiness, headaches, agitation, and sexual side effects, such as inability to reach orgasm, or for men, erectile dysfunction.

I wish I knew that scientists can’t even explain how this drug works.

While we understand the mechanics of increasing the serotonin level in the brain, we can’t really explain why increasing the serotonin level affects moods in a positive way. There is even some body of work which says that brain chemistry has little to no effect on depression. We don’t know what causes depression exactly; we only know that depressed people seem to have lower serotonin levels in the brain. Increasing the serotonin levels seems to aid feelings of calm and well-being. But there’s a lot about brain chemistry that we still don’t know, and while this medication helps in most cases, there is no definitive explanation of how or why it works.

I wish I knew that the pharmaceutical company would hide these side effect from me

The possible side effects on unborn children, when SSRI’s are taken during pregnancy are well known and well established. Research as long ago as 1980 established that use of SSRI’s in pregnant women increases the probability of birth defects in the unborn child by a statistically significant amount. However, the drug companies attempted to bury the information, in order to maintain sales volumes of the medications.

In 2009, a jury awarded a $2.5 million verdict against GlaxoSmithKline, manufacturer of Paxil, because they “negligently failed to warn” an expectant mother and her doctor about the risks of Paxil side effects, in spite of long standing studies which linked Paxil to birth defects. The mom in this case took Paxil throughout her pregnancy. The child was born in 2006, with holes in his heart which required open heart surgery. After reviewing the evidence, the jury awarded more than twice what the family was asking based on the evidence of negligently failing to warn the patient of possible side effects on the unborn baby.