No Word on Birth Defects in New SSRI Research


. By Gordon Gibb

The debate over Selective Serotonin Reuptake Inhibitor (SSRI) birth defects and various other side effects will undoubtedly see more play in the wake of a new study that showed that SSRI antidepressants help depressed individuals become more optimistic, self-confident and outgoing. Such a response could be a boon for female patients who are neither pregnant nor planning to become pregnant.

A recent study published in the Archives of General Psychiatry and funded by the National Institute of Mental Health could have major implications for depression treatment.

Researchers studied 240 adults who participated in the second phase of a trial designed to compare the benefits of medication and cognitive therapy. Of these, 120 were assigned to take the SSRI paroxetine (Paxil) for 16 weeks. Another 60 received cognitive therapy for 16 weeks, and a further 60 were given a placebo for eight weeks followed by eight weeks of paroxetine if their mental state failed to improve. All subjects who reported improvements in their depression in response to psychotherapy or medication were followed for a year.

Personality changes were less dramatic among the group receiving cognitive therapy—and so was their depression improvement. Several researchers not involved in the study cautioned that the findings might prompt greater use of medications.

Brent Roberts, a psychologist at the University of Illinois at Urbana-Champaign, noted that not all depressed patients—including some of the subjects in the study—respond to SSRIs so favorably.

The findings are striking because psychologists have long thought that personality traits like neuroticism and extroversion are moorings of an adult's personality that shift very little in response to time and changing circumstances.

Will the findings translate into more SSRI prescriptions for pregnant women? Doctors have long had to weigh the risks to both mother and fetus when prescribing SSRIs to pregnant women suffering from depression. Some studies have shown that there are risks to the neurological, emotional and psychological development of a child carried in the womb of an untreated depression patient. An expectant mother successfully treated with SSRI antidepressants achieves a lessened risk for dramatic harm to both.

Time will tell if these new findings will influence the debate over the reported link between SSRIs and birth defects in children.


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