Anti-depressants during pregnancy can increase birth defects risk



Anti-depressants during pregnancy can increase birth defects risk
   
 
The use of the antidepressant paroxetine during the first 12 weeks of pregnancy can increase the risk of birth defects, researchers have said. A review of studies published between 1966 and November 2015 showed a 23% increase of major congenital malformations and a 28% increased risk of major cardiac malformations among newborns.


Antenatal depression is common – while statistics vary as to how many women suffer, it is thought around one in 10 will experience depression at some point during their pregnancy. The NHS notes that antidepressants are not normally recommended for pregnant women, but exceptions can be made if the risk posed by depression outweigh risks of treatment – if they are recommended, it is normally a type of antidepressant called selective serotonin reuptake inhibitor (SSRI).

In the latest study, which has been accepted for publication in the British Journal of Clinical Pharmacology, researchers note until 2005, paroxetine – an SSRI – was considered safe for use during pregnancy. While a small unpublished study by the drug manufacturer showed the potential for increased risk of cardiac malformations, subsequent research produced conflicting results.

To assess the risk of paroxetine, the University of Montreal team looked at 23 studies into the drug over 50 years. Their findings showed that compared to no use of paroxetine during the first trimester, risk of both cardiac and congenital malformations was increased. Normally the risk for cardiac malformations is 1%, with major malformations being 3%.

Concluding, the researchers said paroxetine "bears more risks than benefits" for pregnant women. Study leader Anick Bérard added: "Given that the benefits of antidepressants overall, and selective serotonin reuptake inhibitors including paroxetine specifically, during pregnancy is questionable at best, any increase in risk – small or large – is too high.


"Indeed, the risk/benefit ratio suggests non-use in women with mild to moderately depressive symptoms, which is 85% of pregnant women with depressive symptoms. Therefore, planning of pregnancy is essential, and valid treatment options such as psychotherapy or exercise regimens are warranted in this special population."

Using a medication prescribed to treat conditions including depression, obsessive-compulsive disorder, anxiety and post-traumatic stress disorder during the first trimester of pregnancy may increase newborns' risk of heart defects, says a study.Up to one-fifth of women of childbearing age experience depressive symptoms that often lead to mild to moderate depression, and prescriptions for anti-depressants during pregnancy have increased in recent years.The most common drugs for treating depression in pregnant women are selective serotonin reuptake inhibitors, and up until 2005, one drug in that class - paroxetine - was considered to be safe for use during pregnancy.To provide a comprehensive assessment of the effects of paroxetine on newborns, the researchers conducted a literature review and analysis of all relevant studies published from 1966 to 2015. 


The investigators uncovered 23 eligible studies.Compared with no use of paroxetine, first trimester use of paroxetine was associated with a 23 percent increased risk of any major congenital malformations and a 28 percent increased risk of major cardiac malformations in newborns, the study said."Indeed, the risk/benefit ratio suggests non-use in women with mild to moderately depressive symptoms, which is 85 percent of pregnant women with depressive symptoms,” said lead researcher Anick Berard from University of Montreal in Canada.“Therefore, planning of pregnancy is essential, and valid treatment options such as psychotherapy or exercise regimens are warranted in this special population," Berard said.The study was published in the British Journal of Clinical Pharmacology.

Anti-depressants during pregnancy can increase birth defects risk Anti-depressants during pregnancy can increase birth defects risk Reviewed by Ajit Kumar on 8:32 PM Rating: 5

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