What the Media Doesn’t Say about Antidepressants & Pregnancy

In reality, you cannot separate the need for the baby to be healthy and to survive from the mother’s mental state. How many mothers honestly do not worry that something could go wrong with their babies or do not feel responsible for protecting their children? How many women who lost children can go on day by day not feeling anything about that loss? Which antidepressant are you supposed to take to help with depression if you’re dealing with loss after your baby dies from an antidepressant?

Unlike Vogue Magazine or TIME, for some reason ABC has decided to promote more misinformation that will no doubt prove deadly for far too many babies, and possibly mothers too. Read on to find out more…

You may have read a couple of posts I recently wrote (see: here – AMA Review: Antidepressants Pose Significant Risk of Serious Harm to Babies and here – ABC Story on ACOG Release Refers Readers to momsandmeds.com and CHAADA) after I was contacted for a possible story on TV by an ABC producer regarding the ACOG / APA guidelines on antidepressants and pregnancy.

As I wrote in those articles, I had sent numerous emails to the producer with various studies and analyses including not only the conflicts of interest (the conflicts document was so extensive that it took up about 20 pages or so in Word and I didn’t even look up all the names) among the researchers either writing or cited in the report, but also a comparison of the difference between the ABC article they published, and the actual report issued by the ACOG and APA.

I don’t expect that I’ll be hearing much back from them, but the reason I am writing this is not because I really wanted to be on TV (far from it) but because it just makes me horrified that the media can take something that says there is evidence of harm to babies (to quote the ACOG release, “[T]he use of antidepressant medications during pregnancy have been associated with negative consequences for the newborn…some studies have linked fetal malformations, cardiac defects, pulmonary hypertension, and reduced birth weight to antidepressant use during pregnancy.”) and twist it around by quoting “experts” with fancy titles who are willing to say that “the jury is still out” on whether antidepressants can hurt babies. The proposition is that it’s the depression that causes the birth defects, not the drugs.

The ACOG report clearly says that there is evidence of harm – but unfortunately when you watch the videos put out or read the articles on the ABCnews.com website you won’t know that unless you look further.

Just think about cases in which mothers who lose babies to antidepressants or have babies with severe birth defects linked to antidepressants go on to have more children off of antidepressants, without further problems in the babies. Julie Edgington is one example (out of 5 children, only one baby had problems and it was the one exposed to Paxil, Manie, her 4th), Kelly S., who lost her baby to a Paxil heart defect, is another. I was myself told that I shouldn’t have more kids because I would risk severe PPD. I had nothing of the sort. Toby is one of the healthiest kids I’ve seen. I know I am not the best example because I wasn’t actually depressed during pregnancy (was never depressed except for when I was taking Zoloft while nursing), but it just goes to show that there is no conscience regarding the harm coming to babies from these drugs. I was told to stay on Zoloft if I ever did want to have another baby. I am so thankful that Toby is drug-free and healthy.

I honestly do not know how these people can live with themselves.

A great example of what the public sees if they are not up on the latest information, but just passively receiving news bytes, is the ABC piece that just came out which covers Heather Armstrong’s story and states that there is no convincing proof that antidepressants cause harm to the baby. In it Heather tells ABC that she went off her meds during her last pregnancy but experienced panic attacks, and then later, suicidal thoughts after her baby was born, so she decided to stay on it during this recent pregnancy.

1) Of course when you go off antidepressants you can experience panic attacks or even suicidal thoughts – it’s called withdrawal. Been there, done that. For me the withdrawal was way worse than being on the drug at a stable dose, but once I got off of the drug and had time for it to clear out of my system I felt so much better.

Even if you were suicidally depressed before ever taking antidepressants, that does not mean that antidepressants will cure the suicidal thoughts, nor does it mean that you cannot find safe and effective alternatives (link to postpartum nutrition / orthomolecular medicine article). (See also: Preventing & Treating Emotional Problems and a post about counseling and self help.)

Perhaps Prozac really helped Heather feel better mentally but that does not justify what could have happened to the baby. During her last pregnancy she says that she had panic attacks. I think I’ll take panic attacks over my baby dying. It wasn’t even until after her baby was born that she says she had suicidal thoughts. So, were those a result of a drug withdrawal, or did she have a hormonal imbalance after birth of estrogen or thyroid that so many women have? I can’t claim to know what caused Heather Armstrong’s depression after her birth of her first child, but I can guarantee that it was not a Prozac deficiency and that there are safe treatments available. However it still makes no sense to me why having PPD would lead someone to consciously decide to take drugs during a subsequent pregnancy. If you had PPD before, then by all means if you are going to take drugs for PPD, do so after the baby is born and don’t do it while nursing. The time it takes you to get your placebo effect should be well worth it considering the peace of mind and increased safety for the baby.

In my opinion the reason women do this sort of thing stems from the misinformation fed to them by their doctors or other people in the public doing the off label marketing spin. Off-label marketing, or promoting psychiatric drugs to pregnant women (no psychiatric drug is FDA approved for pregnancy), by the way, is currently illegal, but the drug companies usually find ways to get others to do it for them. That’s more than I can say for Pfizer’s criminal behavior with the illegal marketing of Geodon and Lyrica.

2) Just because Heather Armstrong’s baby was born without complications (and she had an unmedicated birth if I am not mistaken) does not mean that the drugs are safe. Nor does it mean that whatever drug she is feeding her daughter in her breast milk is safe for the baby. I am so thankful that her daughter is ok so far, because no baby deserves to suffer from these drugs and I truly hope that she continues to be ok.

But this does not excuse pushing drugs on the entire country with misleading information from conflicted “researchers.”

Here is what you will probably not see on ABC any time soon:

(I hope ABC will prove me wrong, but so far no such luck)

Craniosynostosis caused by Antidepressant Exposure
Craniosynostosis before / after surgery (caused by antidepressant exposure)
Omphalocele caused by antidepressant exposure
Omphalocele caused by antidepressant exposure
Anencephaly (lack of forebrain) caused by antidepressant exposure - 100% fatal
Anencephaly (lack of forebrain) caused by antidepressant exposure - 100% fatal

Look at these devastating photos and ask yourself if it is really worth it to expose your baby to something that can cause a birth defect like this, when there is no taking back the exposure. I lived through suicidal and homicidal thoughts for four months because of Zoloft and I would not want to live through that again, but I would rather go through it (drug-induced or not) a hundred more times rather than have to live through losing a baby or having a baby born with a severe birth defect.

Everyone is bound to go through sad times, depression, grief and despair at some point in their lives but that does not mean that the entire human population suffers from serotonin deficiencies (when in reality serotonin excess is what leads to problems in the first place) or “chemical imbalances.”

I enjoy occasionally drinking wine or mixed drinks, but that doesn’t mean that because I feel relaxed while drinking alcohol, that I should drink when pregnant or that I suffer from an alcohol imbalance.

Women deserve to know the truth about what can happen with these drugs. They deserve to get the truth about what is causing their emotional problems (not some sales tactic like attributing it to an unproven, unprovable chemical imbalance) and how to safely deal with them with “alternative” medicine, orthomolecular medicine, proven hormone therapy, counseling, etc. They deserve support and understanding and compassion. They do not deserve to be fed deadly lies. But mostly, their babies deserve for the mothers to know.

ABC quotes doctors who say you cannot separate the health of the child from the health of the pregnant mother. This is an illogical catch phrase that they use in order to try and make us feel guilty for insisting on drug free options because some women obviously already take antidepressants and find it impossible to stop (again, this is caused by horrific withdrawal and the drug companies seem fine with that). Try and think about what this really means. They are saying that the mother’s mental health cannot be ignored during pregnancy because doing so hurts the baby. They are saying depression is more dangerous than drugs to the baby. Aside from the fact that this is clearly untrue, and that antidepressants do not reduce birth defects, but rather, increase them, think about whether you have ever been sad during pregnancy. Does feeling sad during pregnancy or being depressed cause PPHN, cardiac defects, the lack of a forebrain, and stillbirth? Or do toxic drugs with mystery chemicals that dangerously elevate serotonin and affect the organ development of babies cause these problems?

Something most people don’t know is that Fen-phen which was taken off the market for heart and lung-related deaths is actually a serotonergic drug which was a chemical mirror image of an SSRI. As I have said repeatedly and will say again, when you have drugs leading to heart problems and PPH in adults, how could they possibly not hurt babies the same way or worse?

Even after considering the fact that antidepressants actually cause depression and suicide, and work about as well as a placebo, this catch phrase makes about as much sense to me as saying that a mom who is addicted to crack, or drinks 5 coffees a day, or smokes, or is an alcoholic, should be told to keep doing those things if it eases her anxiety or fatigue while pregnant. Or about as much sense as telling women to go take Thalidomide because we’re not really sure that Thalidomide causes problems and it was probably actually the morning sickness causing the birth defects and not the Thalidomide. The jury is still out on whether swallowing RAID or drinking bleach while pregnant is bad for your baby. Perhaps working in a nuclear plant or handling plutonium should be considered safe for pregnant women too.

In reality, you cannot separate the need for the baby to be healthy and to survive from the mother’s mental state. How many mothers honestly do not worry that something could go wrong with their babies or do not feel responsible for protecting their children? How many women who lost children can go on day by day not feeling anything about that loss? Which antidepressant are you supposed to take to help with depression if you’re dealing with loss after your baby dies from an antidepressant?

Stop lying to women about what are confirmed, known risks.

If the jury were still out, the FDA would not be issuing warnings like:

“Infants born to mothers who took SSRIs after the 20th week of pregnancy were 6 times more likely to have persistent pulmonary hypertension (PPHN) than infants born to mothers who did not take antidepressants during pregnancy.”

See: PPHN Paxil baby Sarah Hart here. Sarah survived, but Matthew did not.
Face to Face:
http://www.flickr.com/groups/madnapfacetoface/

See more FDA MedWatch Data here: http://www.cchrint.org/psychdrugdangers/MothersAct.html

I can only hope that every person responsible for off-label marketing will be held accountable in some way. I am no expert in FDA  or criminal law, but when you essentially have money laundering taking place – drug companies giving donations to organizations, who then promote drugs through their own organizations via blogs, press releases, and speeches, it would seem that either the drug companies, or the individuals doing the marketing should be held to account for the off label promotions.


Warnings/Studies Showing Risks Associated with Antidepressants and Pregnant Women or New Mothers:

There is ample evidence to support the risks associated with placing pregnant women or new mothers on antidepressant drugs:

  • September 7, 2005: The Australian Therapeutic Goods Administration issued an information sheet to health professionals warning that SSRI antidepressant use—especially Paxil—in early pregnancy could cause congenital [defect at birth] heart abnormalities in newborns.[i]
  • September 27, 2005: The FDA and GlaxoSmithKline issued a warning that pregnant women taking Paxil or other antidepressants during their first trimester of pregnancy, placed their newborns at increased risk of major congenital and cardiovascular [heart] malformations at birth.[ii]
  • February 9, 2006: The New England Journal of Medicine found that mothers who took SSRI antidepressants in the second half of their pregnancies were 6 times more likely to give birth to infants with a lung disorder called persistent pulmonary hypertension (PPHN). The condition occurs when a newborn’s circulation system does not adapt to breathing outside the womb and causes high pressure in the blood vessels of the lungs making them unable to get enough oxygen into their bloodstream and can be fatal. Between 10% and 20% of infants with PPHN would die even if they receive treatment.[iii]
  • March 10, 2006: Based on the New England Journal of Medicine study, Health Canada issued a warning that SSRI antidepressants and other newer antidepressants when taken by pregnant women placed newborns at risk of developing the rare lung condition; persistent pulmonary hypertension or PPHN.[iv]
  • April 7, 2006: A Canadian study from the University of Ottawa published by the American Journal of Obstetrics and Gynecology, found pregnant women who used SSRI antidepressants were more likely to have premature and low birth weight babies.[v]
  • June 2006: An Archives of General Psychiatry study found women who take antidepressants during pregnancy at risk of giving birth to children with respiratory problems.[vi]
  • July 19, 2006: The FDA warned of the risk of a fatal lung condition in newborns whose mothers took SSRIs during pregnancy. The agency added it was seeking more information about persistent pulmonary hypertension in newborns from the drugs. It asked drug makers to list the potential risk on their drug labels.[vii]
  • November 2006: The journal Epidemiology published a study entitled “Maternal Use of Selective Serotonin Reuptake Inhibitors and Risk of Congenital Malformations.” Researchers did the study from Aarhus University. It found that pregnant women who take SSRI antidepressants are more likely to have babies with birth defects than mothers who don’t take these drugs.[viii]
  • August 2007: The American Journal of Psychiatry published a study that determined that antidepressant use during pregnancy was associated with premature births.[ix]
  • September 18, 2007: A study published in the Annals of Internal Medicine of nearly 500,000 women by researchers at the University of Pittsburgh Medical Center found that nearly 50% of women taking a prescription drug that could cause birth defects did not receive warnings to avoid pregnancy.
  • Moreover, experts say the seriousness of a life-threatening lung disorder found six times more often in infants born to mothers who take antidepressants during pregnancy is not being adequately conveyed to women while they are considering whether to use the drugs.[x]
  • The Physicians’ Desk Reference (PDR) states: “Like many other drugs, paroxetine [chemical name for the antidepressant Paxil] is secreted in human milk, and caution should be exercised when Paxil…is administered to a nursing woman.”

Selected SSRI Antidepressant Studies/Warnings on Suicide Since 2001:

  • March 22, 2004: The FDA warned that SSRIs could cause “anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia [severe restlessness], hypomania [abnormal excitement] and mania [psychosis characterized by exalted feelings, delusions of grandeur].”
  • February 18, 2005: A study conducted at the Ottawa Health Research Institute and published in the British Medical Journal determined that adults taking SSRI antidepressants were more than twice as likely to attempt suicide as patients given placebo.[xi]
  • June 30, 2005: The FDA issued a Public Health Advisory entitled “Suicidality in Adults Being Treated with Antidepressant Medications,” that there could be an increased risk of suicidal behavior in adults taking antidepressants. It recommended that physicians monitor adults who took antidepressants for suicidal tendencies.[xii]
  • August 4, 2005: The Australian Therapeutic Goods Administration published an Adverse Drug Reactions Bulletin reporting evidence supporting an association between SSRI use and “new onset of suicidality” in adults.[xiii]

[i] “Information for health professionals concerning the use of SSRI antidepressants in pregnant women,” Australian Therapeutic Goods Administration,” 7 Sept. 2005.[ii] “Important Prescribing Information,” Letter to healthcare professionals by GlaxoSmithKline, Sept. 2005; Miranda Hitti, “New Study Links Paxil to Twice as Many Birth Defects as Other Antidepressants,” WebMD Medical News, 27 Sept. 2005.[iii] Christina D. Chambers, Ph.D., M.P.H., Sonia Hernandez-Diaz, M.D., Dr.P.H., Linda J. Van Marter, M.D., M.P.H., Martha M. Werler, Sc.D., Carol Louik, Sc.D., Kenneth Lyons Jones, M.D., and Allen A. Mitchell, M.D., “Selective Serotonin-Reuptake Inhibitors and Risk of Persistent Pulmonary Hypertension of the Newborn,” New England Journal of Medicine, Vol. 354, 2006, pp. 579-587.

 

[iv] Health Canada Advisory, “Newer antidepressants linked to serious lung disorder in newborns,” 10 Mar. 2006.

[v] Andre Pickard, “Prozac-type drugs increase birth risks, study finds,” Globe and Mail, 4 June 2006.

[vi] Tim F. Oberlander, M.D., FRCPC; William Warburton, Ph.D.; Shaila Misri, M.D., FRCPC; Jaafar Aghajanian, B.Sc.; Clyde Hertzman, M.Sc., M.D., FRCPC, “Neonatal Outcomes After Prenatal Exposure to Selective Serotonin Reuptake Inhibitor Antidepressants and Maternal Depression Using Population-Based Linked Health Data, Archives of General Psychiatry, Vol. 63, 2006, pp. 898-906.

[vii] “Antidepressants should list new risks: FDA,” Reuters, 19 July 2006.

[viii] Wogelius, Pia, Nørgaard, Mette, Gislum, Mette, Pedersen, Lars, Munk, Estrid, et.al. “Maternal Use of Selective Serotonin Reuptake Inhibitors and Risk of Congenital Malformations,” Epidemiology, Vol. 17, No. 6, Nov. 2006.

[ix] Rita Suri, M.D., Lori Altshuler, M.D., Gerhard Hellemann, Ph.D., Vivien K. Burt, M.D., Ph.D., Ana Aquino, B.S., Jim Mintz, Ph.D., “Effects of Antenatal Depression and Antidepressant Treatment on Gestational Age at Birth and Risk of Preterm Birth,” American Journal of Psychiatry, Vol. 164, Aug. 2007, pp. 1206-1213.

[x] Evelyn Pringle, “Women not warned about SSRI-related lung birth defect,” Countercurrents.org, 2 October 2007.

[xi] “Drugs Raise Risk of Suicide; Analysis of Data Adds to Concerns on Antidepressants,” The Washington Post, 18 Feb. 2005.

[xii] “Suicidality in Adults Being Treated with Antidepressant Medications,” FDA Public Health Advisory, 30 June 2004.

[xiii] “Suicidality with SSRIs: adults and children,” The Australian Therapeutic Goods Administration (TGA) Adverse Drug Reactions Bulletin, Vol 24, No. 4, Aug. 2005, p. 14.

18 thoughts on “What the Media Doesn’t Say about Antidepressants & Pregnancy

    1. Thanks Jenny. I tried hard to get all those links & warnings in there and not just blather on and on. How someone can be ok with poisoning developing babies in the womb at a time when their organs are forming and anything could happen, is beyond me. I hope more moms will see this and not give into the lies.

  1. I have to say that in reading your article I agree with most of what you have written. I do not however agree that omphaloceles are caused by antidepressant exposure and think that you may have been missinformed. I have never taken an antidepressant in my life and fret over taking something as simple as tylenol. Despite my caution my son was born with a large omphalocele. Omphaloceles are believed to be genetic and even then they are not sure what really causes them. They do however develope in the fourth week of pregnanacy. So women who do start taking antidepresants after this time period could not have caused the omphalocele. I am not saying I do not agree with your statements in your article and I am very impressed with all you research. I just don’t like how this makes me look as a mother of an omphalocele baby who has never taken an antidepresant in my life. Please understand my frustration and thank you for pressing so hard to get the story out there to others.
    Omphalocele baby’s mother

    1. The studies show an increase in omphalocele. That does not mean that you can not have a birth defect in the absence of a specific toxin that causes the birth defect. There is more than one cause to many problems.

  2. I feel so sad for what happened to so many innocent babies. This is ONE REASON why no one should be on anti-depressants. If you feel down, do these few things:
    1. Eat carrots (beta-carotene is natural anti-depresssant)
    2. Jog or do yoga! Exercise is a great way to stop feeling depressed!
    3. Boost intake of vitamin B!
    4. Have some exposure to sunlight (natural vitamin D)

    Why give your money to medicine that don’t work or are harmful?

    It’s not just the babies. It’s a fallacy to think that what’s harmful to fetus is not harmful to adults. Check out my tweets with hashtag #drugfail Am on a mission to inform public the dangers of prescription drugs. NONE OF THEM ARE SAFE, and definitely not safe enough to take long-term!

  3. I do not disagree with any of you comments except one, Anencephaly (lack of forebrain). I’m afraid to say it’s a little off-topic but research does need up-to-date evidence:
    http://belovedvitoria.blogspot.com/
    This condition, though I agree is almost always fatal is not 100% fatal as you can see here.

  4. My fourth child was born with a large omphalocele. Seeing that baby, I thought it was mine! It makes me so sad that I was lied to. I was on Celexa for two years before getting pregnant. We were trying to get pregnant. We asked the Dr’s if it was safe. They told us it was. When I was 19 weeks along, we found out she had a birth defect. Devastating! If someone had told me it wasn’t safe I never would have been on it even if it meant struggling! I live everyday knowing that I did this to her. The surgeries and pain she has gone through. A woman should never take something if it puts her baby at risk. Mothers put their children first even if that means we get hurt. Seeing you baby go through hell is worse than your issue! I have never gone back on a anti depressant. I exercise and eat right and that helped more than the meds ever did. I wish you well as you get the truth out. The pharmaceutical company s want you to start taking one pill. One pill leads to two pills and then three. They do not care about your health or your life. Just the money they are raking in.

  5. I respect your opinion, however I do not on your opinion on depression. As a mother and soon to be grandmother of a daughter who has suffered from depression anxiety and OCD since the age of 5 these issues are very real and very debilitating if not medicated. People that truly suffer from these issues connot just stop their medication and suffer through it. My daughter tried not taking her meds and wound up in the hospital and she does have a hard time dealing with the facts that there are some risks but if she didnt take her medication she would have never made it this far in her pregnancy. Her dr has not lied to her about medication but yes the stress and physical problems are a greater risk for her than the medicine. I do understand your feelings on this but there are a lot of women out there that truly suffer from these diseases that want children as much as ones who don’t and I don’t feel you should criticize them for doing their best. They do have to live with their decision but that is hard enough without having people make light of their illness or their decisions.
    Respectfully
    Susan Pettis

  6. Very informative & beautiful memorandums of little Matthew & Indiana. My heart was breaking watching the videos, I can’t fathom the loss the families feel. Sweet angels. So so very sad.

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