An estimated 16 percent of woman will experience symptoms of depression, known as postpartum depression (PPD), during the first year after giving birth. If left untreated, PPD can have serious consequences for both the mother and her newborn child. The newborn may experience lower APGAR scores, failure to thrive, and poor physical, emotional and behavioral development for the baby.

But more and more attention is being paid to antenatal depression, or depression during pregnancy. Nearly one-fourth of women experience antenatal depression. Maternal depression can lead to poor maternal self-care, increased risk-taking behavior and poor pregnancy outcomes.

Treatment often comes in the form of a pill, or antidepressant. But the APA/ACOG review report indicates that symptoms of depression and antidepressant use during pregnancy may lead to serious problems for the baby, including preterm delivery, low birth weight and birth defects. Weighing the best treatment should be approached individually with each patient.

For example, a recent scientific study indicated that antidepressants taken during the first trimester increased the risk of birth defects. Some drugs, such as Paxil (paroxetine), had even a greater risk of birth defects, in particular defects of the heart, when taken during the first three months of pregnancy.

The report recommends that given the potential for serious consequences from antidepressant use during pregnancy, some women who are pregnant or considering pregnancy should taper or discontinue therapy to reduce their risk. Women who have mild or no depressive symptoms for six months should consider discontinuing treatment with antidepressants before becoming pregnant. For these women, psychotherapy may be a safer treatment plan.

Women with suicidal or acute psychotic symptoms should optimize their therapy and consult with a therapist about adjusting their antidepressant therapy before becoming pregnant. For these women, the risks associated with untreated depression may outweigh the potential harm to the unborn baby. If at all possible, antiepileptic agents, which are often used with patients with severe symptoms of depression and psychosis, should be avoided for the first three months of pregnancy.

The report further encourages women who suffer from depression who are pregnant or thinking about becoming pregnant to discuss treatment options with their physician or trained clinician to ensure a safe and healthy pregnancy.

SOURCE: Paxil and Pregnancy › Treatment guidelines for women before, during pregnancy

“GSK knew it was not safe to take Paxil (during pregnancy) but said nothing,” his parents say in a video on YouTube. Now Manie has a broken heart, and a scar that runs down the center of his chest. He holds a sign against his scarred chest. It reads, “Why?”

“How many more babies will suffer,” they ask. “Answer this, GSK, please.”

In September 2005, a study on infants born to women taking antidepressants, including Paxil, during the first trimester of pregnancy, revealed a greater risk for overall birth defects and an increased risks for heart defects specifically. Following the study, GSK updated the PRECAUTIONS subsection of its label for Paxil to include the risk of birth defects, including heart defects.

“Do the benefits outweigh the risks?” Manie’s parents ask.  “No. Never.”

What’s to become of Manie’s broken heart?

Read more of Manie’s story at bigpharmavictim.blogspot.com

Source: YouTube, jiedgi

SOURCE: Paxil and Pregnancy › Parents ask GSK: ‘How many more babies will suffer?’

Sometimes drugs are essential for the health of the pregnant mother. In those cases, it is imperative for women to discuss their condition with their doctor and weigh the benefits and risks of medication. Drugs taken by a woman who is pregnant most often reach the fetus by crossing the placenta, just as nutrients and oxygen do. When a pregnant woman takes medication, it can cause premature birth by forcefully contracting muscles in the uterus, starve the fetus of nutrients and oxygen thus resulting in an underweight or underdeveloped baby, or cause abnormal development (or birth defects) and even death.

The Food and Drug Administration (FDA) classifies drugs according to the degree of risk they may cause the fetus during pregnancy, as it did with Paxil in 2005 after reports that women taking Paxil during the first trimester of pregnancy had a greater risk of delivery a baby with a birth defect, especially a heart defect. Some drugs are highly toxic and should be avoided during pregnancy. In some cases, doctors may prescribe an alternative medicine that is safer for the unborn baby.

Source: Merck

SOURCE: Paxil and Pregnancy › Pregnant women beware: Some medications can be lethal to fetus

Researchers looked at data collected between 1990 and 1996 from a larger study investigating heart disease risk, and pulled data from 555 women who were 24 years old on average when they gave birth. Researchers studied that data for links between race, preterm birth and pre-pregnancy depressive mood. The data showed that 18.1 percent of the 249 black women gave birth prematurely – at less than 37 weeks gestation – compared to 8.5 percent among the 306 white participants.

The prevalence of pre-pregnancy depression was also higher among black women compared with white women – 9.4 percent compared to 7.2 percent, respectively. Researchers say the findings suggest that a woman’s overall health must be viewed when considering reproductive outcomes.

But it also points to a need for health care professionals to address a woman’s emotional presence especially if she is pregnant or considering pregnancy. Depression during pregnancy can be dangerous for both the mother and her unborn child, leading to poor nutrition; dependence on alcohol, drugs or cigarettes; and suicidal behavior, all of which can contribute to premature birth. Psychotherapy and antidepressants are a viable option but doctors and patients must both be advised of the potential risks that antidepressants carry. Some SSRIs commonly used to treat depression, such as Paxil, can increase the risk of birth defects, especially heart defects, which have led manufacturers like GlaxoSmithKline to include warnings of potential birth defects on the medication’s label.

Source: Reuters

SOURCE: Paxil and Pregnancy › Depressed, black women at higher risk of delivering prematurely

Pregnant women

The study, published earlier this year in the Journal of the American Medical Association, examined more than 11,000 low-income mothers in New Jersey. The data indicated that 9.6 percent of women with diabetes who had no indication of depression during pregnancy, developed depression during the year following delivery.

Researchers say that the findings do not establish that diabetes causes postpartum depression, only that the two are related and that health care professionals should consider the mental health of patients when dealing with low-income individuals with diabetes both during pregnancy and the postpartum period.

About 10-20 percent of women will struggle with some symptoms of depression during pregnancy, and a quarter to half of those will suffer major depression, according to the American Pregnancy Association. Untreated depression can have potential dangerous risks to both the mother and baby, leading to poor nutrition; dependence on alcohol, drugs or cigarettes, and suicidal behavior that can cause premature birth, low birth weight and developmental problems. Add maternal diabetes to the mix, and mothers can feel even more consumed by emotions.

While antidepressants can serve as a viable treatment for depression, women should discuss their options with their healthcare provider. Some SSRI medications, such as Paxil, have been shown to increase the risk of overall birth defects and in particular heart defects, when taken during pregnancy. As of September 2005, Paxil manufacturer GlaxoSmithKline has updated its precautions section on the Paxil labels to warn of the potential risk to babies when taken by mothers during the first trimester.

SOURCE: Paxil and Pregnancy › Women with diabetes more likely to suffer postpartum depression

Dr. Zachary Stowe, director of the Women’s Mental Health Program at Emory, is listed as the primary investigator on at least three National Institutes of Health grants that involve antidepressant use in pregnant women and the effects on children delivered by those women.

According to records, Dr. Stowe received payments totaling more than $250,000 between 2007 and 2008 from drugmaker GlaxoSmithKline PLC, during which time Dr. Stowe delivered at least 95 promotional talks on behalf of the drug company. Dr. Stowe contends his work with GlaxoSmithKline was not a conflict of interest and that such relationships are not uncommon in research.

Dr. Stowe is the second Emory researcher who has been reprimanded for not properly disclosing his financial arrangements with drug companies. Last fall, Dr. Charles Nemeroff resigned as chairman of Emory’s Department of Psychiatry for similar conflict of issues concerns.

Of heightened concern is GlaxoSmithKline’s antidepressant Paxil, which recent studies have shown have a greater risk of causing serious birth defects in the children of women who took the antidepressant during the first three months of pregnancy. As a result, GlaxoSmithKline updated the cautions section of Paxil to indicate the risk of overall birth defects, in particular heart defects.

Sources:
Atlanta Journal Constitution
Wall Street Journal

SOURCE: Paxil and Pregnancy › Psychiatrist reprimanded for taking money from drug maker

The findings are based on a study published in the online journal Fertility & Sterility. It is touted as one of the first studies to investigate the effects of antidepressants on sperm quality. While fertility wasn’t a direct focus of the study, “we can infer that as many as half of men taking SSRIs have a reduced ability to conceive,” says Dr. Peter Schlegel the study’s senior author.

More than a third of participants in the study also reported significant changes in erectile function and ejaculatory difficulties. Both sexual function and compromised sperm DNA returned to normal one month after discontinuation of the antidepressant.

Antidepressants also can have a more serious effect on fertility. Women who take antidepressants during the first trimester of pregnancy are at greater risk of having a baby with serious birth defects. Studies show that while a number of birth defects have resulted from use of antidepressants, paroxetine (Paxil, Seroxat) poses the greatest risk to an unborn child. Those defects include cardiac defects such as ventricular septal defects, pulmonary hypertension, omphalocele, and craniosynostosis.

Those who are pregnant or are considering pregnancy should consult with their doctors about any medications, including antidepressants, they are taking. In some cases, doctors may recommend an alternative that is safer for the unborn child and won’t interfere with conception.

SOURCE: Paxil and Pregnancy › Paxil, Seroxat may interfere with man’s ability to conceive

Pregnant woman and women who are trying to get pregnant are routinely prescribed prenatal vitamins containing at least 1,000 milligrams of folic acid as a way to improve the health of the unborn child. In the mid-1990s, the Food and Drug Administration (FDA) took the effort one step further, requiring that folic acid be added to breads, cereals, flours, corn meals, pastas, rice and other grain products. Researchers say that move likely contributed to the 26 percent drop in neural tube defects, according to the U.S. Centers for Disease Control and Prevention. Now they say folic acid also may be tied into the six percent drop in heart defects each year after folic acid was added to grain supplies, researchers say.

While congenital heart defects are rare, such news is encouraging. “If you can reduce such a significant abnormality by doing something as simple as a public health intervention by increasing folic acid in the grain supply and encouraging individuals to take folic acid supplementation, it’s a win-win situation,” said Dr. Diane M. Ashton, deputy medical director of the March of Dimes.

Besides consuming a folic acid supplement or consuming foods high in folic acid, another step a woman can take to improve her chances of having a healthy baby is to discuss with her doctors any medications she is taking. Some drugs, such as SSRI antidepressants like Paxil, have been linked to a an increased risk of overall birth defects, and specifically heart defects.

SOURCE: Paxil and Pregnancy › Folic acid may help reduce risk of heart defects in newborns

The organization recently sponsored a British study of 1,400 women and found mothers of multiples (twins and triplets) are almost twice at risk of experiencing symptoms of depressions as mothers of single babies. This, researches say, may be linked to the emotional battles these mothers of multiples face trying to conceive, dealing with IVF treatments or handling the increased risk of miscarriage.

The study also found that one in eight mothers of multiples had to be separated from their newborns shortly after birth because the babies required medical treatment. This separation stirred traumatic emotions in mothers. Tending to a newborn can be exhaustive, and that pressure is doubled – and even tripled – with multiple newborns to care for.

Other factors that can contribute to postpartum depression include socio-economic stress, lack of a stable and supportive family relationships, and the self-imposed pressure many women put themselves under by trying to be the “perfect mom.” Partners of expectant and new mothers are also at increased risk for depression, according to the study.

By screening expectant mothers, BeyondBlue hopes to identify women at higher risk for depression so they can seek treatment sooner. “Long-term untreated PND (postnatal depression) can cause delayed cognitive and emotional development in the baby. The benefits of picking up PND early are immense,” says Dr. Nicole Highet, deputy chief executive for BeyondBlue.

SOURCE: Paxil and Pregnancy › Australian group to screen expectant mothers for postpartum depression

SSRIs (selective serotonin reuptake inhibitors) are antidepressants that affect serotonin levels in the brain. It’s not fully understood how they work but it is thought they provide higher levels of serotonin at the brain receptor site. SSRI discontinuation syndrome can occur during or following interruption or the lowering of dosage or the discontinuation of an SSRI or SNRI (serotonin-norepinephrine reuptake inhibitor) antidepressant.

Side effects can occur between 24 hours to one week after reduction or stoppage of dosage and they can be overwhelming. Side effects may include dizziness, electric shock-like sensations or “zaps,” sweating, nausea, insomnia, tremor, confusion, and vertigo.

If you are considering coming off your antidepressant, Summer Beretsky on PsychCentral.com offers some tips on how to make the process in a blog that details her challenges when she came off Paxil. Her weaning process was a months long ordeal that involved tapering down her dosage by splitting or shaving pills over the course of seven months. During that time of weaning off she says she suffered from side effects headaches, lethargy, depression, dizziness, the “zaps,” and nausea, to name a few. Read her personal story and tips on gradually weaning off SSRIs on the site’s blog.

SOURCE: Paxil and Pregnancy › Coming off antidepressants can take months of effort

One of the most important is to see your health care provider before getting pregnant so that she can evaluate your health and identify any health or lifestyle risks that may affect your pregnancy.

Your doctor will discuss various subjects with you. Here is what the March of Dimes says you can expect during your pre-pregnancy checkup:

1. Family History. A family history includes medical information about you, your partner and your families. If any of you have had birth defects or disorders, you may need to see a genetic counselor to asses any potential risks.

2. Medical Conditions. Some medical conditions, such as epilepsy, diabetes or high blood pressure may require you have special care during pregnancy.

3. Medications. If you take medications to treat any existing conditions, your provider may ask you to change to a drug that’s safer during pregnancy. Some medications taken during pregnancy, such as antidepressants, have been found to cause birth defects in babies.

4. Vaccinations. Chickenpox or rubella (German measles) during pregnancy can harm your baby. Your doctor will encourage you to be up-to-date on your immunizations. If you do not know if you are immune to a disease, your doctor can schedule a blood test to find out. If you need a shot, wait at lest one month after the shot before trying to conceive.

SOURCE: Paxil and Pregnancy › Pre-pregnancy checklist for women considering pregnancy

For the study, researchers observed a group of 300 pregnant women, most of whom did not suffer from depression but some either had a history of depression or reported becoming depressed during pregnancy. Of those observed, some took medication to treat their depression either for part of their pregnancy or for the entire pregnancy; some did not take medication and remained depressed; and some did not take medication and reported being depressed for only part of their pregnancy.

The research found that the women who took medication for the duration of their pregnancy and the women who did not take medication but still suffered with depression had a much higher rate of premature birth (20 percent) than the women who took no medication and recovered from their depression during their pregnancy (4 to 9 percent).

Antidepressants can also carry others risks to unborn babies. A 2005 scientific study showed a link between birth defects in babies born to women who took antidepressants during pregnancy. The recurrence was rare enough that some antidepressants are still considered viable options for pregnant women.

However, one antidepressant showed a greater risk to unborn children in the first trimester over other antidepressants, Paxil. As a result of the study, drug manufacturer GlaxoSmithKline updated the PRECAUTIONS subsection on the labeling for its popular antidepressant Paxil, citing a greater risk for overall birth defects, in particular heart defects.

Women who are pregnant or are considering becoming pregnant should consult with their doctors to determine what depression treatment is best for them.

SOURCE: Paxil and Pregnancy › Study: antidepressants, depression linked to preterm birth

Seeking help from a health care provider is vital not only to the mother, but to her unborn child. Depressed mothers-to-be may not have the energy to take care of themselves or seek optimal prenatal care. She may even rely on smoking cigarettes or drinking alcohol to cope, which can have detrimental effects on an unborn child. Health care providers can discuss healthier options, such as group or one-on-one therapy. In some cases, antidepressants may be recommended.

According to the Mayo Clinic, few medications have been proven safe beyond a doubt for use during pregnancy, which is why many doctors advise their patients who are pregnant or are considering pregnancy to wean off most drugs. However, some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), should only be taken during pregnancy after a woman weighs the risks with her doctor because of the possibility of serious birth defects.

Common SSRIs that have previously been prescribed for depression during pregnancy include Celexa, Prozac, Zoloft and Paxil. However, with all those medications there is a possible risk of persistent pulmonary hypertension, or PPHN, in the newborn. The risk is so rare that Celexa, Prozac and Zoloft are still considered options for use during pregnancy.

However, in 2005, a scientific study indicated that women who took Paxil during the first three months of pregnancy had a greater risk of their unborn child developing birth defects – in particular heart defects – than any other antidepressant. As a result of that study, GlaxoSmithKline, makers of Paxil, updated the PRECAUTIONS section of its medication label discouraging use of Paxil during pregnancy.

The Mayo Clinic urges women to consult with their doctors and learn the risks and benefits of antidepressants during pregnancy before making a decision.

SOURCE: Paxil and Pregnancy › Mothers-to-be should weigh risks of antidepressants during pregnancy

According to Women’s Health, changing hormones throughout a woman’s life can trigger depression, including times such as puberty, during and after pregnancy, and during perimenopause. Some women also experience depressive symptoms right before their period. Women with a personal or family history of depression are more prone to suffer from postpartum depression.

It is identified by symptoms such as trouble sleeping, lack of interest, feelings of guilt, loss of energy, difficulty concentrating, changes in appetite, restlessness or slowed movement, and thoughts or ideas about suicide. It also can begin at any time within the first three months after delivery. And it can seriously threaten both the woman and her baby, which is why women who think they are experiencing postpartum depression, or individuals who are concerned about a loved one, should seek medical attention immediately.

Postpartum depression can be treated through support groups, counseling sessions with a mental health professionals and even antidepressants from a group of selective serotonin reuptake inhibitors (SSRIs). The most common ones are Zoloft, Paxil, Celexa and Prozac. A woman should discuss with her doctor if she plans to breastfeed while taking medication as many antidepressants can get into her breast milk and may cause problems for the baby.

She will want to discuss going off the medication before getting pregnant again, as some antidepressants, such as Paxil, have been linked to serious birth defects in babies whose mothers took the medication during pregnancy.

SOURCE: Paxil and Pregnancy › Postpartum depression puts mother, baby at risk

Christine K had been prescribed a combination of Paxil, Risperdal and Depakote five years prior to becoming pregnant. While pregnant she read that Paxil could be harmful to her unborn baby. She asked her doctor take her off the meds, but he insisted she stay on them.

Christine K did more research on the medications and learned that a scientific study on infants born to women taking antidepressants during the first trimester of pregnancy showed that women who took Paxil had a greater risk of birth defects compared to other antidepressants.

As a result of the study, in 2005, GlaxoSmithKline informed health care professionals that it was updating the precautions section of the label for its antidepressant Paxil to include the risk of birth defects and, in particular, heart defects.

In 2006, the Food and Drug Administration (FDA) released another Public Health Advisory based on another study that indicated additional risks associated with taking antidepressants during pregnancy including persistent pulmonary hypertention (PPHN), a serious and life-threatening lung condition that occurs soon after birth, omphalocele and craniosynostosis.

Six months into her pregnancy, against her doctor’s orders, Christine K heeded the warning signs she had read about online and weaned herself off Paxil and the other antidepressants. But the damage had already been done. While her son doesn’t have any of the above mentioned severe birth defects, he does experience sleep problems, aversions to eating, and overall poor health.

“In the first three years of his life, this child has needed more medical care and doctor’s appointments than my other three children combined,” she told the Dissident Voice. “All I can do is watch and wait and hope (his medical problems) resolve on their own.”

SOURCE: Paxil and Pregnancy › Child is helpless victim of mother’s use of Paxil during pregnancy

What Gibson soon realized was that a warning about heart defects in infants born to women who took Paxil during pregnancy was issued the very month her daughter was born.

“I never would have taken the (Paxil) had I been told,” Gibson told a reporter for The Province.

The long, red scar down the middle of her daughter’s chest is a painful reminder of the condition she was unnecessarily born with. She says her daughter’s heart defect has made the little girl prone to infections and stunted her growth.

In 2005, the FDA issued a warning to pregnant women and their doctors to stay away from Paxil because of the increased risk of heart defects in newborns. The agency fell short of banning the medication for pregnant women but stated that it “is advising patients that this drug should usually not be taken during pregnancy.”

The risk of heart defects among newborns is about 1 percent overall. For infants born to women taking Paxil, that number jumps to 1.5 to 2 percent, according to studies cited by the FDA.

SOURCE: Paxil and Pregnancy › Babies born to women taking Paxil at higher risk for heart defects