Depression drug's effect on baby

Provided by: Canadian Press
Written by: HELEN BRANSWEL
TORONTO (CP) - Weaning women off antidepressants known as selective seratonin reuptake inhibitors in the final trimester of pregnancy to protect their babies can be an unwarranted and dangerous practice, experts suggest in a commentary published in a medical journal Tuesday.
The authors, led by the director of The Hospital for Sick Children's Motherisk program, said withdrawal of the medication can put the mental health of mothers at serious risk - potentially jeopardizing their babies in the process.
They suggest the transient and treatable symptoms some babies experience after prenatal exposure to the drugs represent "a lesser evil" in comparison to the risk to the mother's mental health.
"No one will convince me that being a baby of a psychotic mum who was taken inappropriately off of a drug served the baby's needs. There's no way. We see terrible stuff," said Dr. Gideon Koren, director of Motherisk and lead author of the article, published in the Canadian Medical Association Journal.
"Like everything in medicine, you have to strike a risk/benefit balance. And what we know about the baby now is that the risk is very small. We know that many of the women may have a huge risk."
Untreated depression in pregnancy can lead to suicidal thoughts, substance abuse, hypertension, spontaneous abortion, low-weight babies and post-partum depression, the authors note.
The U.S. Food and Drug Administration and Health Canada last summer instructed makers of these antidepressants - more commonly called SSRIs - to issue warnings about post-birth complications noted in some babies born to women taking the drugs. Medications in this class include Paxil, Prozac and Zoloft.
Up to 30 per cent of newborns exposed to the drugs before birth experience some of a constellation of symptoms that have been given the name "poor neonatal adaptation." Affected newborns display jitteriness, poor muscle tone, weak cries, respiratory problems that may require use of a ventilator and occasionally seizures.
Doctors were advised to consider gradually decreasing the mother's SSRI dosage in her final trimester to ensure the fetus received no drug for at least seven to 10 days before delivery.