In 2010, up to almost 7,000 babies conceived by in vitro fertilization (IVF) may have been exposed to an antidepressant, the study authors said.
In their research, Urato and his team looked at the existing literature on women who had fertility problems and were also taking SSRIs. They say they found a number of concerns.
First of all, some studies suggest that SSRIs may actually undermine women's efforts to get pregnant, the researchers said. And for those who do get pregnant, the drugs may increase the risk for miscarriage as well as congenital problems in their children. The most striking association was for use of Paxil (paroxetine) during pregnancy and the risk for congenital heart defects, they said.
The study authors noted that, in 2005, the U.S. Food and Drug Administration requested that Paxil's maker, GlaxoSmithKline, change Paxil's pregnancy category from a "C" to a "D" rating, indicating that it poses a risk to the fetus.
The authors also pointed to a 2011 study from Kaiser Permanente Medical Care Program of Northern California that found a "twofold increased risk of autism spectrum disorders associated with maternal treatment with SSRI antidepressants during the pregnancy, with the strongest effect associated with treatment during the first trimester."
On the other hand, isn't untreated depression in a mother-to-be a hazard for both mother and fetus? According to Currier, sometimes SSRIs remain the best option for women facing this situation.
"Generally speaking, for women with very mild depression, the first course of treatment is that of cognitive behavioral therapy or other non-pharmacological [forms] of treatment," she said. "But in many cases, patients with moderate and severe depression will, in fact, require antidepressant therapy in order to treat their comorbid psychiatric illness
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