MISLEADING REPORTS AND NEWS HEADLINES ABOUT ANTIDEPRESSANT USE DURING PREGNANCY PUT UNBORN AT RISK
SHORT VERSION:
Headlines following a 2007 CDC study examining the effects of antidepressants on the developing fetus were grossly misleading.
One in the June LA Times read: “Small Link Found Between Antidepressants, Birth Defects.“ The Times sums up as follows: ” ‘The take-home message is that we are talking about very small risks’….” But ask Dr. Peter Breggin what he thinks, and he doesn’t mince words, as evidenced by the title of his July, 2007 report in the Huffington Post:
“Pregnant Mothers Should Not Take SSRI Antidepressants”
Breggin, a psychiatrist who previously taught at Harvard and worked for the National Institute of Mental Health (NAMI), now conducts a private practice in Ithaca, NY. Breggin says the CDC study in question showed “…several severe birth defects were doubled or nearly tripled in frequency when SSRIs were taken in the first trimester. This, combined with the other known toxic effects of SSRIs, including brain damage and dysfunction,” he adds, “make these drugs contraindicated in pregnancy.”
Breggin discusses specifics of the CDC study (Alwan et al., 2007), along with another, associated with Boston University (Louik et al., 2007).
CDC results summary:
“‘Anencephaly–birth without a forebrain–showed a 2.4 times greater occurrence in women who had taken SSRIs in the first trimester.'”
“Omphalocele–babies born with organs outside the body–was found to be present 2.8 times as often in the SSRI-treated mothers compared to the control group.”
“Craniosynostosis–the premature closing of one or more sutures or fibrous joints knitting the bones of the infant’s skull–showed 2.5 times more prevalence in infants exposed in utero to SSRIs.”
Boston University results summary:
Found an “…association between sertraline (Zoloft) and both omphalocele and septal defects in the heart, and between paroxetine (Paxil) and right ventricular outflow tract obstruction defects of the heart.”
Breggin says Louik, whose study was funded in part by Paxil’s maker GlaxoSmithCline, made repeated statements to the press “…reassuring people, in effect, not to worry. And it was Louik’s comments, adds Breggin, that were responsible for the downplaying of risks in headlines that followed.
A survey of website commentary on this issue confirms Breggin’s complaint that expectant mothers are being misled. They are being advised to continue antidepressants while pregnant on the basis that depression has hazards of its own. However, I found none of these sources advising mothers of alternative treatments for depression (and other psychiatric or behavioral symptoms) like those found at the Brain Bio Centre, online, for one. I found no mention of screening those suffering with depression for the nutritional deficiencies or other physical causes of depression. Furthermore, Breggin notes, the hazards of depression “…pale in comparison to the upheaval that will befall new mothers, fathers and the extended families of the children who are born with profound birth defects.”
Of additional concern is new research (Robert Whitaker’s for one) showing that use of antidepressants, particularly long-terms use, is known to exacerbate depression and even cause suicide – the main concern of those advocating continuing SSRI use during pregnancy.
http://www.huffingtonpost.com/dr-peter-breggin/pregnant-mothers-should-n_b_57270.html
LONG VERSION:
Headlines following a 2007 study examining the effects of antidepressants on the developing fetus were grossly misleading. One for the 28 June LA Times read: “Small Link Found Between Antidepressants, Birth Defects,” with further misleading statements to follow within the text. While admitting the “higher risk of developmental problems…” and the life-threatening status of those effects, it adds that “…the defects are rare and normally occur in no more than one in 2,500 births,” failing to point out that the study is not dealing with normal, non-drug, conditions. [emphasis added] The Times sums up its downplaying of the risks as follows: ” ‘The take-home message is that we are talking about very small risks,’ said UC San Diego epidemiologist Christina Chambers, who has studied the effects of antidepressants but wasn’t involved in the new research.”
But ask Dr. Peter Breggin what he thinks about these opinions, and he doesn’t mince words, as evidenced by the title of his July, 2007 report in the Huffington Post:
“Pregnant Mothers Should Not Take SSRI Antidepressants”
Breggin, a psychiatrist who has taught at Harvard and worked for the National Institute of Mental Health (NAMI), now conducts a private practice in Ithaca, NY. Breggin says the CDC study in question showed “…several severe birth defects were doubled or nearly tripled in frequency when SSRIs were taken in the first trimester. This, combined with the other known toxic effects of SSRIs, including brain damage and dysfunction,” he adds, “make these drugs contraindicated in pregnancy.”
Breggin’s article goes on to discuss the specifics of the CDC study, (Alwan et al., 2007) along with another, associated with Boston University (Louik et al., 2007).
CDC results summary, according to Breggin:
“‘Anencephaly–birth without a forebrain–showed a 2.4 times greater occurrence in women who had taken SSRIs in the first trimester.'”
“Omphalocele–babies born with organs outside the body–was found to be present 2.8 times as often in the SSRI-treated mothers compared to the control group.”
“Craniosynostosis–the premature closing of one or more sutures or fibrous joints knitting the bones of the infant’s skull–showed 2.5 times more prevalence in infants exposed in utero to SSRIs.”
Boston University results summary, according to Breggin:
Found an “…association between sertraline (Zoloft) and both omphalocele and septal defects in the heart, and between paroxetine (Paxil) and right ventricular outflow tract obstruction defects of the heart.”
Breggin says Louik, whose study was funded in part by Paxil’s maker GlaxoSmithCline, made repeated statements to the press “…reassuring people, in effect, not to worry. She made no mention of other birth defects and neonatal problems associated with SSRI antidepressants.” And it was Louik’s comments, adds Breggin, that were responsible for the downplaying of risks in headlines that followed.
Another deceptive side of this misleading response to the 2007 studies is the overshadowing of serious SSRI risks to neonates found and reported two years earlier. The American College of Obstetricians and Gynecologists in 2006 warned pregnant women to avoid taking Paxil and also expressed concern over any antidepressant usage during pregnancy, after an FDA public advisory reported that congenital malformations, particularly of the heart, were increased by use of Paxil during the first trimester.
Breggin lists a number of other adverse effects on the fetus, shown to be associated with the mother’s use of antidepressants. These include delayed bone development (ossification), as many as 30% of newborns experiencing withdrawal symptoms, and an increased risk of newborns developing persistent pulmonary hypertension (PPHN), the latter estimated to occur “…six times more frequently in children exposed to SSRIs after the twentieth week of pregnancy.” Because PPHN makes it difficult for children to get enough oxygen into their lungs, it results in “’significant morbidity and mortality‘(Food and Drug Administration, 2006).”
“Withdrawal reactions,” explains Breggin, “confirm that the brain of the fetus has been bathed in SSRIs and that is has suffered significant functional changes.” He adds that “Serotonin is intimately involved in the development of the brain in utero and SSRIs inhibit normal brain cell development (Norrholm and Ouimet, 2000).”
Adding to all these serious concerns over damaging effects of antidepressants on the developing embryo, is an alarming report of increased use of SSRIs during pregnancy, jumping from “5.7% in1999 to 13.4% in 2003 (Seward, 2007).”
Breggin says the headlines and reports following these studies were “carefully calculated to mislead and obfuscate.” They further, he adds, “…flew in the face of evidence linking SSRI exposure during pregnancy to increased birth defects and the additional evidence of SSRI toxicity in the developing brain.” The CDC’s press release, Breggin says used intentionally misleading language in saying the study “’found no significant increase in the risks for the majority of defects assessed…’” [emphasis added]. However, Breggin clarifies, he’s never heard of any drug that affects the “majority” of defects.
A survey of website commentary on this issue confirms Breggin’s complaint that expectant mothers are being misled. They are being advised to continue antidepressants while pregnant on the basis that depression has hazards of its own. However, I found none of these sources advising mothers of alternative treatments for depression (and other psychiatric or behavioral symptoms) like those found at the Brain Bio Centre, online, for one. I found no mention of screening those suffering with depression for the nutritional deficiencies or other physical causes of depression. Furthermore, Breggin notes, the hazards of depression “…pale in comparison to the upheaval that will befall new mothers, fathers and the extended families of the children who are born with profound birth defects.”
Of additional concern is new research showing that use of antidepressants, particularly long-terms use, is known to exacerbate depression and even cause suicide – the main concern of those advocating continuing SSRI use during pregnancy.
In fact,“ adds Breggin, “the new FDA labels for antidepressants specifically warn about SSRI-induced suicidality in youth and in young adults, the very group most likely to become pregnant (Food and Drug Administration, 2007). Now we know that the SSRIs not only threaten to cause the death of the mother through suicide but the death of the child as well through lethal birth defects.”
Though CDC and others advise expectant mothers to speak with their doctors about SSRI use during pregnancy, the misinformation CDC has perpetuated will no doubt affect the way doctors, in turn, advise their patients.
In conclusion Breggin suggest a number of alternatives to drugs for dealing with depression, including exercise, therapy (including family therapy), and support groups.
Though Breggin does not mention the orthomolecular and other nutritional approaches, many have found these and other physical therapies helpful, if not completely curative.
Breggin says no one should blame the parents if their children suffer birth defects. However, if a mother has taken an antidepressant, which, he says, increase “…her risk by 240%, we must hold responsible the doctor who prescribed it, the drug company who manufactured and falsely promoted it, and the medical establishment that covers up and minimizes the drastic hazards associated with these toxic chemicals, including risks to adults, children and the unborn.”
To see Dr. Breggin’s complete article, go to:
http://www.huffingtonpost.com/dr-peter-breggin/pregnant-mothers-should-n_b_57270.html
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