Antidepressant use while pregnant risky for baby;

[Guest guest]

If you open a drug data base or drug data book, you will find 90% of

drugs are not to be taken while pregnant or nursing. Antidepressants

are however treated as different, since mother can harm baby in the

womb, should she do something undesirable. Hence most think that such

drugs should be continued. The effect of these drugs on teenagers has

been a subject of several lawsuits in USA and most of us know. The

effect of these drugs on babies in womb is now being researched.

 

Use of the selective serotonin-reuptake inhibitor (SSRI) type of

antidepressants, such as Prozac or Zoloft, during late pregnancy

seems to raise the risk of a serious problem called pulmonary

hypertension of the newborn (PPHN), investigators report.

PPHN occurs when blood pressures within the lung get too high,

causing poorly oxygenated blood to be pumped to the rest of the body,

Dr. Christina D. Chambers and her associates explain. Up to 20

percent of infants affected by the disorder do not survive.

 

Previous work by Chambers' group suggested that use of fluoxetine

(Prozac) in late pregnancy may be a risk factor for transient newborn

complications, including PPHN.

 

Their current study, reported in The New England Journal of Medicine,

included 377 infants with possible PPHN and 836 comparison infants

born in one of four metropolitan areas. The mothers were interviewed

within 6 months of delivery regarding their use of antidepressants.

 

Use of SSRIs overall or during the first half of pregnancy was not

associated with the risk of PPHN. By contrast, taking such drugs

after 20 weeks into pregnancy did seem to raise the risk of PPHN.

 

Chambers' group suggests that the SSRIs may raise the risk of PPHN by

increasing levels of serotonin in the lungs. This chemical could then

work to tighten the blood vessels, resulting in elevated pressures.

 

Nonetheless, " about 99 percent of women exposed to one of these

medications late in pregnancy will deliver an infant unaffected by

PPHN, " the researchers stress.

 

" Pending further studies to confirm these findings, " they

conclude, " clinicians and their patients must consider both the

benefits of SSRIs in the treatment of depression and the potential

risk of PPHN relative to the risks and benefits of alternative

treatments or nontreatment. "

 

Echoing these recommendations in a related editorial, Dr. James L.

Mills, from the National Institute of Child Health and Human

Development in Bethesda, Maryland, observes that the study is based

on a small number of cases, and that a mother's untreated depression

can also adversely affect the fetus.

 

" There is a pressing need, " he writes, " for experts to compare SSRIs

with other forms of treatment to determine which are the safest, the

most effective, and the best tolerated by pregnant women. "

 

SOURCE: The New England Journal of Medicine, February 9, 2006.

 

[The journal article is available for reading online, for those who

wish to read the original article]

 

Dr Bhate