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    Antidepressants Linked to Birth Defect

    Study Shows Small Risk of Heart Defect From SSRIs Taken During Pregnancy

    Larger Studies Needed

    Pedersen says much larger studies are needed to determine whether any one SSRI is safer or less safe than any other during pregnancy.

    In an editorial published with the study Friday in BMJ Online First, birth defects researcher Christina Chambers, PhD, agrees that larger studies are needed.

    Chambers is an epidemiologist and associate professor at the University of California, San Diego School of Medicine.

    "If an increased risk for major congenital malformations does exist, this study and others suggest that the absolute risk for the individual pregnant woman is very low," she writes. "Furthermore, each of the more commonly used drugs in this class has been implicated in at least one study, so it is difficult to conclude that one SSRI is 'safer' than another."

    Last month, two leading medical groups in the U.S. teamed up to issue guidelines for treating depression during pregnancy.

    The joint statement from the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) recommended that:

    • Women who experience psychotic episodes, have bipolar disorder, or those who are suicidal or have a history of suicide attempts should not be taken off antidepressants.
    • Women with mild depression and those who have had few symptoms for six months or longer can consider gradually reducing their drug doses or stopping drugs altogether under the close supervision of their prescribing doctor.
    • Psychotherapy and other treatments may be an appropriate alternative to drugs during pregnancy for some, but not all, women with depression.

    Chambers tells WebMD that the joint ACOG/APA guidelines should help women and their doctors understand their options.

    "Every pregnant woman has about a 3% risk of having a baby with a birth defect," she says. "If there is a risk associated with SSRI use it is very small over and above this baseline risk."

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