SSRI use during pregnancy increases risk of neonatal problems

New study reveals both benefits and risks of antidepressants during pregnancy

image of Happy-tablets
SSRI use in pregnancy is associated with an increased risk of all neonatal problems, including breathing issues, that led to longer hospital stays and neonatal care.. Happy tablets by Spookygonk.

2015 Study Abstract

Objective:
Using national register data, the authors examined the relationship between prenatal selective serotonin reuptake inhibitor (SSRI) treatment and pregnancy complications, accounting for psychiatric diagnoses related to SSRI use.

Method:
This was a population-based prospective birth cohort study using national register data. The sampling frame included 845,345 offspring, representing all singleton live births in Finland between 1996 and 2010. Pregnancies were classified as exposed to SSRIs (N=15,729), unexposed to SSRIs but with psychiatric diagnoses (N=9,652), and unexposed to medications and psychiatric diagnoses (N=31,394). Pregnancy outcomes in SSRI users were compared with those in the unexposed groups.

Results:

  1. Offspring of mothers who received SSRI prescriptions during pregnancy had a lower risk for late preterm birth (odds ratio=0.84, 95% CI=0.74–0.96), for very preterm birth (odds ratio=0.52, 95% CI=0.37–0.74), and for cesarean section (odds ratio=0.70, 95% CI=0.66−0.75) compared with offspring of mothers unexposed to medications but with psychiatric disorders.
  2. In contrast, in SSRI-treated mothers, the risk was higher for offspring neonatal complications, including low Apgar score (odds ratio=1.68, 95% CI=1.34–2.12) and monitoring in a neonatal care unit (odds ratio=1.24, 95% CI=1.14–1.35). Compared with offspring of unexposed mothers, offspring of SSRI-treated mothers and mothers unexposed to medications but with psychiatric disorders were both at increased risk of many adverse pregnancy outcomes, including cesarean section and need for monitoring in a neonatal care unit.

Conclusions:
In a large national birth cohort, treatment of maternal psychiatric disorders with SSRIs during pregnancy was related to a lower risk of preterm birth and cesarean section but a higher risk of neonatal maladaptation. The findings provide novel evidence for a protective role of SSRIs on some deleterious reproductive outcomes, possibly by reducing maternal depressive symptoms. The divergent findings suggest that clinical decisions on SSRI use during pregnancy should be individualized, taking into account the mother’s psychiatric and reproductive history.

Sources and more information

Labeling Kids with Bogus ‘Mental Disorders’

Childhood is Not a Mental Disorder

Video published on 20 Dec 2010 by CCHRInt.

More information
  • 20 Million Kids & Adolescents are labeled with “mental disorders” that are based solely on a checklist of behaviors. There are no brain scans, x-rays, genetic or blood tests that can prove they are “mentally ill“, yet these children are stigmatized for life with psychiatric disorders, and prescribed dangerous,life-threatening psychiatric drugs. The statistics on children being drugged in the United States, by IMS health are 8.4 million including 1 million children between the ages of 0-5.
  • More about ADHD & Child Mental Disorders and about the Number of Children & Adolescents Taking Psychiatric Drugs in the U.S.
  • Watch more pharma videos on @DES_Journal YouTube channel.

Heightened fracture risk for some antidepressant drug used to reduce symptoms of the menopause

Menopausal women using SSRIs “at risk for fractures”

image of crutches
SSRIs – a class of antidepressant drug used to reduce symptoms of the menopause – may increase the risk of bone fractures, according to new research. Image of Crutches by mnd.ctrl.

2015 Study Abstract

Background
Selective serotonin reuptake inhibitors (SSRIs) were recently approved by the FDA to treat vasomotor symptoms associated with menopause. No prior study has directly examined whether fracture risk is increased among perimenopausal women who initiate SSRIs or among a population of women without mental disorders more generally.

Methods
Female patients without mental illness, aged 40–64 years, who initiated SSRIs were compared with a cohort who initiated H2 antagonists (H2As) or proton-pump inhibitors (PPIs) in 1998–2010, using data from a claims database. Standardised mortality ratio weighting was applied using the propensity score odds of treatment to adapt the distribution of characteristics among patients starting H2A/PPIs to the distribution among SSRI initiators. Poisson regression estimated risk differences and Cox proportional hazards regression the RR of fractures among new users of SSRIs versus H2A/PPIs. Primary analyses allowed for a 6-month lag period (ie, exposure begins 6 months after initiation) to account for a hypothesised delay in the onset of any clinically meaningful effect of SSRIs on bone mineral density.

Results
Fracture rates were higher among the 137 031 SSRI initiators compared with the 236 294 H2A/PPI initiators, with HRs (SSRI vs H2A/PPI) over 1, 2 and 5 years of 1.76 (95% CI 1.33 to 2.32), 1.73 (95% CI 1.33 to 2.24) and 1.67 (95% CI 1.30 to 2.14), respectively.

Conclusions
SSRIs appear to increase fracture risk among middle-aged women without psychiatric disorders, an effect sustained over time, suggesting that shorter duration of treatment may decrease fracture risk. Future efforts should examine whether this association pertains at lower doses.

Sources and more information

Medicating normalness: saying “know” to drugs

Are we over-medicating ourselves and our children?
Video with Alan Cassels 5/6

Are we over-medicating ourselves and our children? Drug policy researcher Alan Cassels discusses the drug industry; the methods and practices on how they operate and he questions whether or not we need to take as many prescription drugs as we are lead to believe for that ‘quick fix’ in our lives.

More information

Medicating normalness: saying “know” to drugs

Are we over-medicating ourselves and our children?
Video with Alan Cassels 3/6

Are we over-medicating ourselves and our children? Drug policy researcher Alan Cassels discusses the drug industry; the methods and practices on how they operate and he questions whether or not we need to take as many prescription drugs as we are lead to believe for that ‘quick fix’ in our lives.

More information

Medicating normalness: saying “know” to drugs

Are we over-medicating ourselves and our children?
Video with Alan Cassels 2/6

Are we over-medicating ourselves and our children? Drug policy researcher Alan Cassels discusses the drug industry; the methods and practices on how they operate and he questions whether or not we need to take as many prescription drugs as we are lead to believe for that ‘quick fix’ in our lives.

More information

Antidepressant drugs use during pregnancy : Not safe

Who says antidepressants in pregnancy are safe?

pregnancy-depression-drugs image
Prenatal exposure to antidepressant drugs was linked to ADHD In children in a 2014 study.

Four countries have done nine studies on the effects of antidepressants during pregnancy or breast feeding. They found that newer and older antidepressants can cause premature births, and increase the risk of cardiovascular interventions such as heart surgery in early childhood. In addition, newer antidepressants could also cause withdrawal symptoms, respiratory problems, and neurological problems.

Six counties have issued a total of 15 drug regulatory warnings on antidepressants causing severe problems for newborns. They warn of:

  • Newer antidepressants causing seizures,
  • Wellbutrin, Cipralex, Luvox, Remeron, Effexor and Zyban increasing the risk of a life-threatening lung condition in newborns,
  • Zoloft and Celexa causing withdrawal symptoms and increasing the risk of a life-threatening lung condition in newborns,
  • Paxil and Prozac causing withdrawal symptoms and increasing the risk of cardiovascular birth defects and a life-threatening lung condition in newborns

Read Antidepressant Drugs Are Not Safe During Pregnancy—No Matter What the Pharma Shills Say, by CCHR International, November 4, 2010.

In 2014, a study found that antidepressant use in pregnancy was associated with higher risk for ADHD in children, another found a link to ASD and developmental delays in boys  another found that pregnant mothers may be unknowingly predisposing their infants to type 2 diabetes and obesity later in life,.

Watch the video The Truth about Pills and Pregnancy.

Do anti-depressant medications work the way they are supposed to?

The science behind commonly used anti-depressants appears to be backwards

Mc Master University campus image
The science behind commonly used anti-depressants appears to be backwards says Mc Master University researchers

The science behind many anti-depressant medications appears to be backwards, say the authors of a paper that challenges the prevailing ideas about the nature of depression and some of the world’s most commonly prescribed medications.

We are taking people who are suffering from the most common forms of depression, and instead of helping them, it appears we are putting an obstacle in their path to recovery” said lead author Paul Andrews, assistant professor of Psychology, Neuroscience and Behaviour at McMaster University.

Sources and more information

  • The science behind commonly used anti-depressants appears to be backwards, McMaster University, February 17, 2015.
  • Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response, ScienceDirect, doi:10.1016/j.neubiorev.2015.01.018, 24 January 2015.

Your doctor or therapist has confirmed it: you have depression. Now what?

To Treat Depression : Drugs or Therapy?

Your doctor or therapist has confirmed it: you have depression. Now what?

…” Until recently, many experts thought that your clinician could literally pick any antidepressant or type of psychotherapy at random because, with a few clinical exceptions, there was little evidence to favor one treatment over another for a given patient.

In fact, I used to delight in tormenting the drug company representatives when they asked me how I picked an antidepressant. I would take a quarter out of my pocket, flip the coin and say I’d let chance decide because their drug was no better or worse than their competitors’. “…

  • continue reading To Treat Depression, Drugs or Therapy? nytimes, JANUARY 8, 2015.
  • more info via Toward a Neuroimaging Treatment Selection Biomarker for Major Depressive Disorder, JAMA Psychiatry, August 2013.

Who says SSRIs are Safe?

Antidepressants simply cannot be considered to be “safe” in pregnancy

Adam Urato, MD, image
Antidepressants simply cannot be considered to be “safe” in pregnancy. Adam Urato, MD, explains why this is the case and address the counterarguments.

The issue of the safety of antidepressants in pregnancy has never been more important as more and more women of childbearing age take these medications and exposure rates during pregnancy increase worldwide. The topic really is not that complicated. It’s just common sense that serotonin plays a crucial role in fetal development. The antidepressants cross the placenta, into the developing fetus, and chemically alter that serotonin system. So it shouldn’t surprise us that animal and human research is showing harm… ”

Read Antidepressants and Pregnancy: Who Says They Are Safe?
Dr Adam Urato‘s post reviews the evidence in this area and address the counterarguments, mad in america, December 8, 2014.

By the same author: More Bad News On Antidepressants And Pregnancy, commonhealth.wbur, June 12, 2012.