SSRIs may increase birth defect risk

pregnancy Pregnant women taking the most widely prescribed class of antidepressants may be linked to increased risk for babies of congenital heart defects.

According to specialist Professor Stephen Pilling, new NICE guidance on SSRIs will warn that taking them during pregnancy doubles the risk of a child being born with a potentially lethal defect.

One of the drugs cited by a BBC Panorama programme on this issue is Citalopram – but its manufacturer, Lundbeck, said there was no evidence of a link between the drug and major foetal malformations.

Current prescription guidelines warn only against taking Seroxat (paroxetine) in early pregnancy.

However, Prof. Pilling, an expert adviser to NICE, claimed the guidance will be updated to warn against all SSRIs in early pregnancy – which, inevitably, would reduce their uptake among younger women in general.

“We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we’re perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar – if not greater – risks,” commented Prof. Pilling.

The risk of any baby being born with a heart defect is 2%, he said – but the mother taking an SSRI in early pregnancy increases the risk to 4%. “For women who are mildly to moderately depressed, I don’t think that those risks, in most cases, are really worth taking.”

Lundbeck commented that according to a recent review, Citalopram “does not appear to be associated with an increased risk of major foetal malformations” – and denying a depressed patient medication “may generate greater risks to the woman and her foetus than the risks of exposure to the medication.”