Women and Doctors Deal With Conflicting Information Regarding SSRI Side Effects


. By Heidi Turner

When there is no consensus about the potential for Lexapro side effects, it can be difficult for patients to know if the benefits are worth the risks. After all, the risk of Lexapro birth defects has to be weighed against the benefits of taking the antidepressant. This is especially true for pregnant women, who must consider the risks to their fetus. The problem is when researchers and experts do not actually agree on the risks, leaving women and their physicians to make decisions based on incomplete information.

As a selective serotonin reuptake inhibitor (SSRI), Lexapro is often included in discussion of SSRI antidepressant birth defects. Such side effects reportedly include an increased risk of persistent pulmonary hypertension of the newborn and other congenital birth defects. But study findings often contradict each other, with some finding an increased risk of birth defects in infants exposed to Lexapro prior to birth and others finding no such risk. Still others find no increased risk of specific congenital birth defects, but do find an increased risk of other birth defects.

One such study, published in The New England Journal of Medicine (6/28/07), titled "Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects" examined data from the National Birth Defects Prevention Study to determine whether there was an increased risk of selected birth defects in infants exposed to SSRI antidepressants.

Researchers found no significant associations between the use of SSRIs during early pregnancy—the first trimester—and an increased risk of birth defects, including congenital birth defects. "However, we observed associations between SSRI use and the occurrence of anencephaly, craniosynostosis and omphalocele, defects that had not been previously associated with maternal SSRI use in pregnancy," researchers wrote. In other words, they could not confirm findings of previous studies but did find other birth defects that could potentially be linked to the use of SSRIs during pregnancy.

Meanwhile a more recent study, published in the Archives of General Psychiatry suggested that the use of SSRIs during pregnancy was linked to an increased risk of having a child with autism. Researchers found that children exposed to SSRIs during the first trimester were almost four times more likely to develop an autism spectrum disorder, compared with children not exposed to an SSRI.

The flip side, however, is that untreated depression during pregnancy poses a risk to the mother and the child as well, which is why women and their doctors must discuss whether an SSRI antidepressant such as Lexapro is a suitable medication or if another option is preferable.


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