CDC: Some antidepressants, but not others, linked with birth defects

Popular antidepressants Paxil and Prozac are linked to higher rates of birth defects, but several similar drugs used to treat depression in pregnant women carry no such risks, a new study found.

The study, from the federal Centers for Disease Control and Prevention (CDC), analyzed conflicting results from previous studies along with new data on nearly 28,000 births. It found no links between birth defects and other antidepression drugs such as Zoloft, Celexa and Lexapro.

"It should be terribly reassuring," to women because it means they have many safe choices for treating depression during pregnancy, Edward McCabe, medical director of the March of Dimes, said.

For the study, published in the medical journal BMJ, formerly the British Medical Journal, researchers asked women what medications they took in the month before and first three months of pregnancy. Then, they analyzed whether women who took certain medications were more likely to have children with birth defects than women who did not take those medications.

The study does not prove Paxil and Prozac cause birth defects, CDC researcher Jennita Reefhuis said. But it provides strong support for some links suggested by previous studies on drugs collectively known as selective serotonin reuptake inhibitors (SSRIs), she says. Specifically:

• Both Paxil (paroxetine) and Prozac (fluoxetine) were linked with a defect that obstructs blood flow from the heart to the lungs.
• Paxil also was linked with holes in the heart wall and with anencephaly, a condition in which babies are born without parts of the brain and skull.

The study also found evidence linking Prozac with irregularly shaped skulls and linking Paxil with abdominal wall defects, but that evidence is not as strong, Reefhuis said.

While risks for some conditions doubled or tripled among women taking Paxil or Prozac, the overall risks remained low, Reefhuis said.

For women taking Paxil, the risk of giving birth to a child with anencephaly rose from 2 in 10,000 to 7 in 10,000; the risk of giving birth to a child with a heart blood flow problem rose from 10 in 10,000 to 24 in 10,000, the study found.

Just as important, Reefhuis said, is what the study did not find: any link between birth defects and several similar, but chemically distinct drugs, including the most-widely used drug, Zoloft (sertraline), as well as Celexa (citalopram) and Lexapro (escitalopram).

"Women definitely should not stop taking the antidepressants they are on without talking to their doctors," she said. "But this analysis can help guide doctors and patients."

Treating depression during pregnancy is important, said the March of Dime's McCabe, who was not involved in the study.

"Women should not be afraid to have their depression treated," he said. "Depression is a severe, debilitating disease," and not treating it can harm mothers and babies.

About 1 in 5 women have depression at some point in their lives and 1 in 7 are treated for it in the months before, during or after pregnancy, according to the March of Dimes. Treatment can include counseling, as well as medication.
Source : usatoday


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