The survey, conducted by the Substance Abuse and Mental Health Services Administration, involved in-person interviews with 67,500 people aged 12 and older. Not only did the survey show that women were more likely to be depressed, the rate of mental illness among people aged 18 to 25 was twice that of those aged 50 and older.

The information goes hand-in-hand with other studies that show antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, are now one of the most prescribed medications in the United States. While many people find relief from their symptoms of depression and anxiety from these antidepressants, caution should be used by women, especially those of childbearing age and those who are pregnant or thinking of becoming pregnant. Studies have linked SSRI use during pregnancy to serious birth defects.

SSRIs include the brand names Paxil, Zoloft, Lexapro, Celexa and Prozac. All were considered relatively safe to use during pregnancy because there were no studies to prove that the drugs caused birth defects or other pregnancy complications. That is, until researchers began gathering data that showed a link between Paxil and persistent pulmonary hypertension (PPHN).

A stronger warning was placed on Paxil, but researchers are concerned that other drugs in the same class of antidepressants may carry the same risk for PPHN or other birth defects including heart defects, neural tube defects, and defects of the intestines or abdominal organs. Malformation defects have also been reported.

Source: Fox News

SOURCE: Paxil and Pregnancy › Women more likely than men to suffer from mental disorders

SSRIs are used to treat depression and some forms of anxiety. They are known by the brand names Zoloft, Paxil, Lexapro, Celexa and Prozac, and are among the most prescribed drugs in the country.

The FDA’s announcement is based on a large retrospective database study in 2009 that found no link between SSRI use and PPHN, and a case-control study of nearly 12,000 births that showed a link between PPHN and cesarean delivery, but not SSRI use in the second half of pregnancy. This conflicting data left the FDA panel members scratching their heads and siding with the drug companies, who profit heartily from antidepressant sales.

The FDA warns that untreated maternal depression can be risky and lead to low birth weight, preterm delivery, lower Apgar scores, poor prenatal care, failure to recognize or report impending labor, and increased risks of fetal abuse, neonaticide, or maternal suicide.

Yet, that risk should be weighed by the possible dangers SSRIs can cause babies. Despite the studies which indicate there might be a risk for PPHN if used during pregnancy, other studies show that the drugs could cause other serious defects such as malformations, heart defects and neural tube defects. Newer studies have suggested SSRI exposure in utero may also put babies at risk for autism.

At the very least, physicians and their patients should carefully weigh the risks and benefits of SSRIs before becoming pregnant.

Source: Clinical Psychiatry News

SOURCE: Paxil and Pregnancy › FDA gives go-ahead to prescribing SSRIs to pregnant women despite risks

It was four years ago, and studies were beginning to show just how dangerous Paxil is to developing fetuses. The drug was linked to serious birth defects of the heart and lungs as well as neural tube defects. Those studies recently resulted in the reclassification of Paxil from a Category C to a Category D drug – a rating given by the Food and Drug Administration (FDA) to inform doctors and patients of birth defects associated with certain drugs.

Paxil is in a class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. They are among the most prescribed drugs in the country. Paxil is the only SSRI classified as a Category D drug. All other SSRIs, such as Zoloft, Celexa, Lexapro, and Prozac, are classified as Category C drugs. The difference between the two categories is that studies prove that Category D drugs cause birth defects in humans, whereas with Category C drugs, there is not enough evidence to rule out the risk.

Taylor tried to wean off Paxil before becoming pregnant, but she fell into a deep depression. Last year, after she and her husband decided they were ready to start a family, Taylor returned to her doctor, this time asking for an alternative to Paxil. She just couldn’t risk being without an antidepressant. Her doctor recommended Zoloft.

Taylor’s visit to her doctor came just months before new studies suggested Zoloft – and other SSRIs – may be just as dangerous to developing fetuses as Paxil. Taylor says she had no choice but to take the risk. Taylor’s baby was born with pneumonia, a condition doctors didn’t associate with any cause, “but antidepressants never enter(ed) the conversation,” she said. Still, her infant daughter must stay in the NICU until she recovers.

“We’ll leave the hospital days before she will. We’ll drive home with an empty car seat and stare at an empty bassinet,” she writes. “My Zoloft, even if I don’t like it as much as Paxil, will come in handy.”

Source: Babble

SOURCE: Paxil and Pregnancy › Mother weighs risks of Zoloft during pregnancy

Today, as many as one in six pregnant women in the United States are diagnosed with major depressive disorder, and most are given SSRIs to treat their symptoms. This class of drugs includes brand-name drugs such as Prozac, Zoloft and Paxil. Recent studies have reported problems with newborns whose mothers have used SSRIs, including increased pain sensitivity, heart and lung defects, and developmental malformations, which could be linked to the drug use.

For the Danish study, researchers identified about 400 women who took antidepressants during pregnancy as well as nearly 500 women who were depressed but not treated with medication. The researchers then documented and compared when children in each group hit developmental milestones, such as sitting without support, looking toward sounds, and venting irritation.

At six months of age, babies who were exposed to SSRIs in the second or third trimester were 26 percent more likely to sit on their own compared to 30 percent of babies who were not exposed to SSRIs. The babies exposed to antidepressants also took an average of 16 days longer to sit on their own and 29 days longer to walk than babies who were not exposed. By 19 months of age, the movement differences had vanished, although the children who were exposed to antidepressants had a slightly more difficult time occupying themselves without calling out for attention.

The study shows that not only might SSRIs affect the development of the fetus, “these drugs have an effect on the fetus’ brain,” said Dr. Lars Henning Pedersen, who worked on the study. Dr. Pedersen said he would like to see more studies exploring how babies exposed to antidepressants as fetuses fare later in life. He plans to do a study on the same group of babies once they reach their teens.

Source:
Reuters

SOURCE: Paxil and Pregnancy › Babies exposed to SSRIs may reach developmental milestones late

Paxil is in a class of drugs known as selective serotonin reuptake inhibitors, or SSRIs. Other drugs in this class include Zoloft, Celexa, Lexapro and Prozac. When Paxil was approved by the Food and Drug Administration (FDA) in 1992 for the treatment of depression and anxiety disorders, it was listed as a Category C pregnancy drug, meaning that there have been no studies to show whether the drug could harm fetuses. However, reports of birth defects including those affecting the heart, lungs and other organs, from women who took the drug while pregnant were enough for the FDA to require the drug be reclassified as a Category D drug, meaning studies have proven that use during pregnancy can cause birth defects.

Since the drug was approved, more than 600 cases alleging birth defects linked to Paxil have been filed. The first trial resulted in a verdict for the plaintiffs and an award of $2.5 million in compensatory damages for the family of Lyam Kilker, who was born with three cardiac birth defects after his mother took Paxil while pregnant.

While Paxil is the only SSRI classified as a Category D drug, newer studies are beginning to question the safety of other SSRIs on fetuses, particularly Zoloft. Two studies published in the New England Journal of Medicine found a statistically significant increased risk of various birth defects possibly linked to Zoloft. Canadian and Swedish studies backed up that claim, singling out persistent pulmonary hypertension as a potentially fatal condition from SSRI exposure.

Animal experiments have also shown that not only do SSRIs pass through the placental barrier, they have direct effects on the developing neural crest and brachial arch cells that migrate in a very early developing embryo to form all of the major organ systems in babies. When neural crest cells don’t migrate properly or they’re interfered with by an agent such as Paxil or Zoloft, many problems can arise.

More and more lawsuits filed against makers of SSRIs are holding these drug companies accountable for their actions in response to these studies, and their responsibility to adequately warn users of the potential dangers of their drugs.

Source:
Dissident Voice/Bloomberg

SOURCE: Paxil and Pregnancy › Paxil lawsuits have cost drug maker $1 billion

Fetuses

The study conducted by researchers from the University Medical Centre, Utrecht, the Netherlands, focused on fetuses that were exposed to standard and high doses of selective serotonin reuptake inhibitors (SSRI), a class of medications used to treat depression and anxiety. Researchers noted that fetuses exposed to SSRIs exhibited disrupted emergence of quite, non-rapid eye movement (non-REM) sleep during the third trimester, which was “characterized by continual bodily activity and, thus, poor inhibitory motor control during this sleep state near term.”

While the clinical significance of this observation is not yet defined, researchers say it could predict sleep problems in children as they grow and develop.

It also raises more questions about the safety of the use of SSRIs during pregnancy. It has been shown in studies that some SSRI medications used during pregnancy may put babies at greater risk for autism. Studies have shown that babies exposed to SSRIs in utero are at an increased risk for congenital malformations and developmental disorders.

SSRI medications include the brands Paxil, Zoloft, Celexa and Lexapro. All SSRI medications are classified as Category C drugs except Paxil, which recently was reclassified as a Category D drug. Category C drugs are ones in which animal tests have shown potential birth defects but there have been no tests on humans, or no clinical tests are available. Category D drugs are drugs that have been proven in studies to increase the risk for birth defects if used during pregnancy.

Source: Nature.com

SOURCE: Paxil and Pregnancy › SSRI use during pregnancy may cause sleep problems in children

It was the question posed recently on BabyCenter.com, a website resource for expectant mothers, new mothers, and women hoping to become pregnant in the near future. The question sparked numerous responses from women who were faced with making that decision. Some women commented that they needed the medication because they struggled with severe depression and anxiety. But they still worry about the effects the drug may have on their unborn babies.

The concerns are valid. Two recent studies reported that selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressants, increase the risk for congenital malformations and developmental disorders among children whose mothers took SSRIs while pregnant.

The first study, published in the journal Obstetrics and Gynecology, found a two- to four-fold increased risk of cardiac and neural tube defects with some SSRIs, and fetal alcohol spectrum disorders were also 10 times more likely in children exposed to an SSRI while in the womb.

The second study, published in the Archives of General Psychiatry, found a two- to three-fold increase in autism spectrum disorders among children exposed to SSRIs during pregnancy. The risk was greater when the SSRI was used during the first trimester of pregnancy.

Most SSRIs are classified as Category C drugs, meaning that either studies in animals have shown adverse affects on the fetus but there are no controlled studies in women, or studies in women and animals are not available. These drugs are only given if the potential benefit justifies the potential risk to the fetus.

Paxil is the only SSRI classified as a Category D drug, meaning that there is positive evidence of fetal risk in humans when used during pregnancy. The classification was only recently downgraded. While dangerous to fetuses, the FDA says these drugs may be acceptable if they are needed in a life-threatening situation or for a serious disease where safer drugs cannot be used or are ineffective.

Source: www.BabyCenter.com

SOURCE: Paxil and Pregnancy › Women question safety of antidepressants while pregnant

Paxil is in a class of medications known as selective serotonin reuptake inhibitors, or SSRIs. The drugs are used to treat depression, anxiety, and various personality disorders. Paxil was recently reclassified as a Category D medication, meaning that there is positive evidence of birth defects when used during pregnancy, but may be acceptable if the drug is needed in a life-threatening situation or for a serious disease where safer drugs cannot be used or are ineffective.

All other SSRI medications are classified as Category C medications, meaning that either studies in animals have revealed birth defects and there are no controlled studies in women, or studies in women and animals are not available. These drugs are only given if the potential benefit justifies the potential risk to the fetus.

Paxil’s new safety label now warns men of possible problems with their role in conception. A known side effect of SSRI use in men is includes erectile dysfunction and premature ejaculation. But, according to a study published in the journal Fertility & Sterility, Paxil may also increase the level of “sperm fragmentation.” And this, the study suggests, may even cause major genetic damage to the sperm.

The study looked at 35 healthy men who took Paxil for five weeks. The men were tested both at the beginning of the five weeks and at the end. At the beginning of the study, only 10 percent showed DNA fragmentation. When the trial ended, half of the men tested positive for signs of abnormal DNA fragmentation. Fragmented DNA occurs when sperm DNA is missing pieces of genetic code. The men were retested after discontinuing Paxil, and their sperm appeared to return to normal.

Researchers did not speculate whether this sperm fragmentation might lead to birth defects, but suggested it may impair fertility.

Sources: FDA

SOURCE: Paxil and Pregnancy › Paxil may damage sperm, impair fertility in men

Researchers have found that when the test is used on newborns it can identify 75 percent of the most serious cardiac abnormalities. When used with traditional methods, 92 percent of the cases were detected.

Congenital heart defects are the No. 1 birth defect, with more than 25,000 cases reported in the United States each year. Some are so mild that there are no outward symptoms, like murmurs which resolve on their own. But in some cases, the defect is so serious that newborns become ill soon after birth. In still other cases, signs and symptoms occur only later in childhood. Severe heart defects often require multiple surgeries, a lifetime of medications and preventative measures to maintain a working heart and healthy body. For some, the only hope is a heart transplant.

Congenital heart defects are typically detected by ultrasound during pregnancy or by listening to the baby’s heart after birth. However, with this type of screening, many heart problems go undetected, which can put the baby’s life at risk.

Scientists don’t always know what causes hearts to develop abnormally. Genetics and the environment play a strong role, as can medications taken by the mother during pregnancy. Medications that have been linked to heart defects in infants include Accutane (for acne), lithium (for some forms of mental illness,) and some anti-seizure drugs. Recently, researchers have raised concerns about certain SSRI medications used to treat depression and anxiety. Studies have linked certain heart defects to SSRI such as Prozac and Paxil. And new reports show that Zoloft may be just as dangerous.

Source: BBC

SOURCE: Paxil and Pregnancy › New screening for newborns could detect heart defects faster

The study, which was published in the Health Affairs journal, was co-authored by Mark Olfson, a professor of clinical psychiatry at Columbia University. The results were reported by the Wall Street Journal.

Antidepressants were the second-most widely prescribed class of drugs in 2010, second only to cholesterol-lowering statins. Zoloft or a generic version of the drug known as sertraline was the most prescribed antidepressant with 36 million prescriptions written in 2010.

Zoloft is in a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), and are approved by the Food and Drug Administration (FDA) to treat depression, anxiety disorders and some personality disorders. Other drugs in the class include Paxil, Celexa, Lexapro, and Prozac.

A 2010 meta-analysis of SSRIs found that the drugs worked best for patients with severe depression. Patients with mild or moderate symptoms may receive little or no benefit from the medication. Yet, taking SSRIs put users at risk for side effects that include nausea and vomiting, headache, strange dreams, changes in appetite and weight, changes in sexual behavior, increased feelings of depression and anxiety which may provoke panic attacks, and suicidal ideation.

The drugs also put expectant mothers at risk for delivering a baby with serious birth defects. SSRIs cross the placenta and have been associated with congenital malformations, in particular septal defects. Some evidence suggests that SSRIs are linked to neonatal abstinence syndrome and persistent pulmonary hypertension.

All SSRIs except Paxil are listed as Pregnancy Category C drugs, meaning that risk cannot be ruled out because adequate, well-controlled human studies are lacking and animal studies may or may not have shown a risk to the fetus. Paxil was recent downgraded from a Category C to a Category D drug, indicating that there is positive evidence of risk to fetuses.

Source: Wall Street Journal

SOURCE: Paxil and Pregnancy › Widely used SSRIs raise concerns of birth defects

GlaxoSmithKline

Paxil is a type of medication known as selective serotonin reuptake inhibitors (SSRIs), and is prescribed for the treatment of depression and anxiety disorder. Other brands of SSRIs include Zoloft, Lexapro, Prosac and Celexa. Paxil is considered more toxic to unborn babies than any other SSRI, and is listed as a Category D drug. All other SSRI drugs are Category C drugs, meaning they are safer for use during pregnancy.

Since 2005, studies have linked Paxil to birth defects including cardiac (heart) defects, pulmonary (lung) defects, neural tube defects (brain and spinal cord), craniosynostosis (abnormally shaped skull), infant omphalocele (abdominal wall defects), club foot (one or both feet turn downward and inward), and anal atresia (complete or partial closure of the anus).

Newer studies also have linked the antidepressant to an increased risk of Neonatal Persistent Pulmonary Hypertension (PPHN).

More recent studies have also linked serious birth defects with other types of SSRIs, which has led some people to question whether all SSRIs should be labeled as Category D drugs and avoided during pregnancy.

Anyone who has taken an SSRI during pregnancy and delivered a child with a birth defect may have a case against the drug’s maker.

SOURCE: Paxil and Pregnancy › Millions awarded to women in Paxil, birth defects lawsuits

The study showed that women taking fluoxetine, known by the brand name Prozac, in early pregnancy is associated with a two-fold increased risk for isolated ventricular septal defects, while paroxetine, also known as Paxil, was associated with a four-fold increased risk for right ventricular outflow tract defects. Both are defects with the heart.

The study involved 635,583 babies, of whom 6,976 had first-trimester exposure to SSRIs. SSRIs are a class of antidepressants prescribed to treat depression, anxiety disorder, and some personality disorders. They are the most prescribed antidepressants in the country.

Heli Malm, MD, PhD, from the Teratology Information Service at Helsinki University Central Hospital in Finland, where the study was conducted, said prescribing SSRIs to pregnant women should be banned because of the serious risks it poses to fetuses.

The FDA recommends that women talk to their doctor before stopping use of any medication.

Source: TopNews New Zealand

SOURCE: Paxil and Pregnancy › Paxil use during pregnancy increases risk for serious heart defects

Pregnant women

Autism is a developmental disorder that appears in the first three years of life, and affects the brain’s normal development of social and communication skills. The incidence of autism has increased dramatically over the past 30 years, from 4 in 10,000 children to 40 in 10,000.

SSRIs are used to treat depression, anxiety disorder, and some personality disorders. They work by increasing the level of serotonin in the brain. SSRIs are the most widely prescribed antidepressants in the United States.

In the new study, researchers from Kaiser Permanente Northern California reviewed the medical records of more than 1,600 children, 298 of whom had autism spectrum disorders (ASDs). They found that the risk of having a child with autism spectrum disorder was about twice as great among women who took SSRIs during the year before she gave birth. The risk was four times higher in women who took SSRIs during their first trimester.

Women who are pregnant or are planning to become pregnant and are taking SSRIs should discuss with their doctors the pros and cons of using any medication.

Source: Medical News Today

SOURCE: Paxil and Pregnancy › Study: SSRI use during pregnancy increases risk of autism

What concerns doctors is that many of these medications have never been studied in pregnant women to determine if use during pregnancy increases birth defect risk. This gray area puts the decision of whether to use medications in the hands of women and their doctors. Often, drug companies rely on information from animal trials when data from human trials is not available. But that can be misleading.

Such is the case with Paxil. Once labeled as a Category C drug, the drug was not associated with birth defect risks and thus was thought somewhat safe to use at least during the later months of pregnancy. However, this was proven to be false after the Food and Drug Administration (FDA) began receiving reports from women who took the antidepressant and had babies born with defects, in particular heart defects. Lawsuits soon followed.

Paxil has since been classified as a Category D drug, one that is not deemed safe to use during pregnancy. But all other antidepressants in the same class, known as selective serotonin reuptake inhibitors (SSRIs), still are classified as a Category C drug, and are still prescribed to pregnant women suffering from depression and anxiety disorder. Studies show that these drugs, which include the brand Zoloft, are just as dangerous to developing fetuses.

Women who are pregnant or are considering becoming pregnant should discuss with their doctors whether the risks and benefits of the drugs they take in order to determine whether they are safe for their unborn babies.

Source: Fox News

SOURCE: Paxil and Pregnancy › Most pregnant women taking medication despite possible risks

“To say the least, I was absolutely distraught with this news. I thought this was something that I did … because I stayed on the Paxil for selfish reasons,” Beverly said. Despite the heartbreaking loss, Beverly and her husband were ready to try again to get pregnant. Her e-mail to GSK continued, “I don’t want to stop taking my miracle pill. But, then again, if there is a chance that this might hurt or affect the baby, I want to know upfront. And I will somehow stop taking it for the time being.

“Please contact me as soon as possible. Please don’t forget about me.”

GSK never responded. Three weeks later, Beverly sent another e-mail, this time asking specifically, “I was asking to see if you have any or are in the process of any clinical trials for women who are currently on Paxil and pregnant. I wanted to find out information to see how many women were on Paxil during pregnancy and if they were able to successfully have healthy babies.”

Five days later, Beverly got a response. GSK attached a copy of its current product information for Paxil, and then suggested she contact her physician or pharmacist with any questions.

Eight years later, the first Paxil birth defect trial resulted in a $2.5 million verdict against GSK. Since then, hundreds of lawsuits have been filed against GSK, and the FDA downgraded Paxil’s status from a Category C to a Category D drug, indicating clinical trials showed the drug caused birth defects in developing fetuses.

Paxil, an antidepressant in a class of drugs known as selective serotonin reuptake inhibitors, or SSRIs, is the only SSRI listed as a Category D drug. But new studies suggest that Zoloft, another SSRI, and others in the class, may be just as dangerous to fetuses when used by mothers during pregnancy.

Beasley Allen Law Firm is currently investigating cases where SSRIs may have caused birth defects.

*Name changed
Source: Unite for Life

SOURCE: Paxil and Pregnancy › GSK avoided questions about safety of Paxil during pregnancy

Lyam’s parents filed suit against GlaxoSmithKline (GSK) claiming the drug company failed to adequately warn users of the risks associated with using Paxil while pregnant. The trial resulted in a landmark $2.5 million verdict against the pharmaceutical company.

Hundreds of more lawsuits were filed against GSK, and for the second quarter of 2010, GSK announced legal charges of about $2.4 billion. Soon, lawsuits against other antidepressants began to surface suggesting other antidepressants in the class were just as likely to cause birth defects.

Paxil has since been downgraded from a Category C drug to a Category D. Category D means that studies in pregnant women have demonstrated risk to the fetus. Paxil is in a class of antidepressants known as SSRIs, or selective serotonin reuptake inhibitors.

All other SSRIs are currently listed as Category C drugs, meaning the drugs have been shown to harm fetuses in animal studies but have not been adequately studied in humans. With Category C medications, doctors and patients must decide if the benefits are greater than the risks. However, new studies suggest that other types of SSRIs may be more dangerous to developing fetuses than previously thought.

Pregnant women or women considering pregnancy should discuss with their doctors any concerns they have about SSRIs and birth defects, and whether the benefits of taking the drug outweigh the possible risks to the fetus.

Source: Unite for Life

SOURCE: Paxil and Pregnancy › Other SSRIs may be just as dangerous as Paxil to fetuses

These studies showed an increased risk for all congenital malformations with SSRIs and particularly with paroxetine, known by the brand name Paxil. A few studies after 2005 have also found an association between prenatal exposure to SSRIs (especially paroxetin) and congenital malformations.

Exposure to SSRIs in late pregnancy has been associated with a three-fold increased risk of neonatal behavioral syndrome, including signs of withdrawal or serotonin impregnation. Restlessness, poor tone, respiratory distress, and hypoglycemia were the most frequent signs. These symptoms occur during the first days of life and are usually brief and not serious.

Recent studies have also documented an increased risk of persistent pulmonary hypertension and cases of cerebral hemorrhage, which can be life threatening.

“In practice, the potential risk implies that the decision to treat a pregnant woman with SSRIs (notably paroxetin) should be taken carefully; this means double-checking the diagnosis, the potential benefits, adverse effects and possible alternatives. Neonatal toxicity seems to be relatively frequent when SSRIs are prescribed during late pregnancy,” the researchers wrote. “For all depressed pregnant women, the severity of the depression must be taken into consideration before introducing a pharmacological treatment.”

Source: PubMed

SOURCE: Paxil and Pregnancy › SSRIs, especially Paxil, dangerous to unborn babies

Paxil, manufactured by GlaxoSmithKline (GSK), is an antidepressant in a class of medications called selective serotonin reuptake inhibitors (SSRIs), which work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. It is used to treat depression, panic disorder, and social anxiety disorder. The medication is also used to treat chronic headaches, tingling in the hands and feet caused by diabetes, and certain male sexual problems. It is also used in combination with other medications to treat bipolar disorder. It may also be prescribed for other uses.

The drug’s safety label now warns patients that, “epidemiological studies have shown that infants born to women who had first trimester paroxetine exposure had an increased risk of cardiovascular malformations, primarily ventricular and atrial septal defects (VSDs and ASDs). In general, septal defects range from those that are symptomatic and may require surgery to those that are asymptomatic and may resolve spontaneously. If a patient becomes pregnant while taking paroxetine, she should be advised of the potential harm to the fetus. … For women who intend to become pregnant or are in their first trimester of pregnancy, paroxetine should only be initiated after consideration of the other available treatment options.”

In 2005, when the FDA first warned of the dangers with Paxil in women of childbearing age, GSK was ordered to change the pregnancy category of the drug from C to the stronger warning of D. Category D means that studies in pregnant women (controlled or observed) have demonstrated a risk to the fetus.

In 2010, a new study using the Swedish Medical Birth Register from July 1, 1995 to 2007 identified women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care. Data showed a specific association between Paxil use and infant cardiovascular defects. There was also a strong association between Paxil and hypospadias, a birth defect of the urethra in male infants. The drug has also been associated with an increased risk for spontaneous miscarriage.

Beasley Allen Law Firm is currently investigating cases of birth defects caused by Paxil, or generic versions of the drug, known as paroxetine.

Source: FDA

SOURCE: Paxil and Pregnancy › New study shows Paxil during pregnancy causes heart defects

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

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

Numerous studies have not found an increased risk of major birth defects associated with the use of SSRIs during pregnancy. However, exposure to SSRIs late in pregnancy has been associated with short-term complications in newborns including jitteriness, mild respiratory distress, excessively rapid respiration, weak cry, poor muscle tone, and admission to the neonatal intensive care unit. Unpublished data regarding the use of Paxil® during the first trimester of pregnancy have raised concerns about an increased risk of congenital heart malformations. Thus, the US Food and Drug Administration issued a public health advisory regarding the use of Paxil® during pregnancy and the manufacturer changed its pregnancy category from C to D. A Category C classification is for drugs that have been shown to harm fetuses in animal studies but have not been adequately studied in humans. A Category D classification means a drug has been found to be harmful to human fetuses.

The potential risk of SSRIs during pregnancy must be weighed against the risk of depression relapse if the medication is discontinued. Untreated depression has its own risks, including low weight gain, alcohol and substance abuse, and sexually transmitted diseases, all of which have negative maternal and fetal health implications. Fetal echocardiography should be considered for women who were exposed to Paxil® in early pregnancy.

ACOG’s Committee on Obstetric Practice emphasizes that decisions about depression treatment should involve the obstetrician and the mental health clinician, along with the patient, ideally prior to pregnancy. However, because approximately 50% of pregnancies are unplanned, preconception planning for women with depression will not always be feasible, and treatment decisions about SSRIs will undoubtedly occur during pregnancy.

Committee Opinion #354, “Treatment with Selective Serotonin Reuptake Inhibitors During Pregnancy,” is published in the December 2006 issue of Obstetrics & Gynecology.

Source: The American College of Obstetricians and Gynecologists

SOURCE: Paxil and Pregnancy › ACOG Issues Opinion on SSRI Antidepressant Use During Pregnancy

ACOG’s Committee on Obstetric Practice “recommends that treatment with all SSRIs [selective serotonin reuptake inhibitors] or selective norepinephrine reuptake inhibitors or both during pregnancy be individualized and paroxetine [Paxil] use among pregnant women or women planning to become pregnant be avoided, if possible,” read the statement, which is in the December issue of Obstetrics & Gynecology.

The guidelines come a full year after the U.S. Food and Drug Administration(FDA) issued a warning about possible birth defects associated with Paxil when the drug is taken during the first trimester of pregnancy.

This warning was based on two studies. The first found about a 2 percent risk of heart defects in babies born to mothers who took Paxil early in their pregnancy, compared with a 1 percent risk in the general population.

The second study found that the risk of heart defects was 1.5 percent in babies whose mothers took Paxil in the first three months of pregnancy, compared with 1 percent in babies whose mothers took other antidepressants in the first trimester. The most common defects were cardiovascular.

“Since the FDA warnings a year ago, most ob/gyns have been trying to avoid Paxil during pregnancy,” noted Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. “This is just a formal statement by ACOG.”

The initial FDA warning came in September of 2005. In December of the same year, the FDA instructed Paxil’s maker, GlaxoSmithKline, to reclassify the drug from a Category C to D (a stronger warning) for pregnant women. Category D means studies in pregnant women have demonstrated a risk to the fetus.

Other reports had indicated that SSRIs, the category of antidepressants which includes Paxil as well as Celexa, Prozac and Zoloft, may cause newborns to have withdrawal symptoms.

ACOG acknowledged that these potential problems must be weighed against yet another study which found that pregnant women who discontinue their antidepressant medication are five times more likely to relapse into depression than women who continue with the medication.

“Untreated depression has its own risks, including low weight gain, alcohol and substance abuse, and sexually transmitted diseases, all of which have negative maternal and fetal health implications,” the statement said.

Women of reproductive age have the highest prevalence of major depressive disorders, with ACOG experts estimating that about 1 in 10 will experience a bout of major or minor depression sometime during pregnancy or the postpartum period.

Ideally, these issues should be considered before a woman becomes pregnant, the ACOG panel said. But, given that about half of all pregnancies are not planned, many decisions regarding treatment will inevitably happen after the woman has conceived. Fetal echocardiography, which looks for heart trouble, should be considered for women who were exposed to Paxil in early pregnancy, the statement recommended.

“Women who have certain health problem such as depression really should try to plan their pregnancies with their ob/gyn and psychiatrist,” Wu confirmed. “The major danger will be to women who have an unplanned pregnancy and don’t realize it until they’re two months along. There’s a lot of organ development during that time, and exposure to certain SSRIs may pose some dangers.”

SOURCE: Health Day News

SOURCE: Paxil and Pregnancy › Ob/Gyn Group Urges Pregnant Women to Shun Paxil

A second study suggests there may be additional, though rare, risks of SSRI medications during pregnancy. This study focused on newborn babies with persistent pulmonary hypertension (PPHN), which is a serious and life-threatening lung condition that occurs soon after birth of the newborn. Babies with PPHN have high pressure in their lung blood vessels and are not able to get enough oxygen into their bloodstream. About 1 to 2 babies per 1000 babies born in the U.S. develop PPHN shortly after birth, and often they need intensive medical care. In this study PPHN was six times more common in babies whose mothers took an SSRI antidepressant after the 20th week of the pregnancy compared to babies whose mothers did not take an antidepressant. The study was too small to compare the risk in one drug compared to another, and this risk has not so far been investigated by other researchers. The study, by Christina Chambers and others, was published on February 9, 2006 in The New England Journal of Medicine.

The finding of PPHN in babies of mothers who used a SSRI antidepressant in the second half of pregnancy adds to concerns coming from previous reports that infants of mothers taking SSRIs late in pregnancy may experience difficulties such as irritability, difficulty feeding and in very rare cases, difficulty breathing. In addition, the labeling for paroxetine (Paxil) was recently changed to add information about findings in an epidemiology study suggesting that exposure to the drug in the first trimester of pregnancy may be associated with an increased risk of cardiac birth defects (see FDA Public Health Advisory for Paxil dated December 8, 2005).

The uncommon potential risk to the newborn of PPHN has not been confirmed by additional studies. Uncertainty about these rare events and their potential impact on the newborn, along with the potential risk to the mother of recurring depression if she stops her antidepressant medicines during pregnancy, makes decisions about the treatment of depression in pregnant women especially challenging for health care professionals and patients.

Women who are pregnant or thinking about becoming pregnant should not stop any antidepressant without first consulting their physician. The decision to continue medication or not should be made only after there has been careful consideration of the potential benefits and risks of the medication for each individual pregnant patient. If the decision is made to stop treatment with SSRIs before or during pregnancy, this should be done with a healthcare professional, according to the prescribing information for the drug, and patients should be observed closely in case their depression comes back.

The FDA is seeking additional information about the possible risk of PPHN in newborn babies of mothers who took SSRI antidepressants in pregnancy. In the meantime, the FDA has asked the sponsors of all SSRIs to change prescribing information to describe the potential risk for PPHN. Prescribing information will be updated with information from additional studies when this information becomes available.

SSRIs and a Combination Drug Containing an SSRI

• Celexa (citalopram)
• Fluvoxamine
• Lexapro (escitalopram)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Symbyax (olanzapine/fluoxetine)
• Zoloft (sertraline)

Source: FDA Public Health Advisory

SOURCE: Paxil and Pregnancy › Treatment Challenges of Depression in Pregnancy and the Possibility of Persistent Pulmonary Hypertension in Newborns

Results of two early studies reviewed by the FDA showed that women who took Paxil during the first three months of pregnancy were about one and a half to two times as likely to have a baby with a heart defect compared with women who took other antidepressants or women in the general population. Most of the heart defects reported in these studies were of the type known as atrial and ventricular septal defects (holes in the walls of the chambers of the heart). These types of heart defects can range in severity from relatively minor that resolve without treatment to those that cause serious symptoms and need to be repaired surgically. The risk for this type of heart defect is approximately one per cent of births in the general population. In one of the studies with Paxil, women taking the drug had an approximately two per cent risk of having a baby with heart defects, and in the second study, women taking Paxil in the first trimester had an approximate 1.5% risk of having a baby with heart defects.

According to the FDA announcement:

FDA is advising health care professionals to discuss the potential risk of birth defects with patients taking Paxil who plan to become pregnant or are in their first three months of pregnancy. Health care professionals should consider discontinuing Paxil (and switching to another antidepressant if indicated) in these patients. In some patients, the benefits of continuing Paxil may be greater than the potential risk to the fetus. FDA is advising health care professionals not to prescribe Paxil in women who are in the first three months of pregnancy or are planning pregnancy, unless other treatment options are not appropriate.

The manufacturer of Paxil, Glaxo Smith Kline, has changed the product labeling from pregnancy class C to class D, meaning that that studies in pregnant women (controlled or observational) have demonstrated a risk to the fetus. However, the benefits of therapy with Paxil may outweigh the potential risks to the fetus.

It’s important to note that these conclusions are preliminary and are based on early results of two studies. The FDA is collecting additional data and waiting for the final results of these and other studies in order to better characterize and understand the risk for birth defects associated with Paxil. If you’re currently taking Paxil, talk to your doctor if you are pregnant or planning to become pregnant. He or she can advise you on the best course of action for your situation and medical condition

Source: MedicineNet

SOURCE: Paxil and Pregnancy › Updated Product Labeling Warns of Birth Defect

FDA is advising patients that this drug should usually not be taken during pregnancy, but for some women who have already been taking Paxil, the benefits of continuing may be greater than the potential risk to the fetus.  Women taking Paxil who are pregnant or plan to become pregnant should talk to their physicians about the potential risks of taking the drug during pregnancy.  Women taking Paxil should not stop taking it without first talking with their physician.

The early results of two studies showed that women who took Paxil during the first three months of pregnancy were about one and a half to two times as likely to have a baby with a heart defect as women who received other antidepressants or women in the general population. Most of the heart defects reported in these studies were atrial and ventricular septal defects (holes in the walls of the chambers of the heart). In general, these types of defects range in severity from those that are minor and may resolve without treatment to those that cause serious symptoms and may need to be repaired surgically.

In one of the studies, the risk of heart defects in babies whose mothers had taken Paxil early in pregnancy was about 2 percent, compared to a 1 percent risk in the whole population. In the other study, the risk of heart defects in babies whose mothers had taken Paxil in the first three months of pregnancy was 1.5 percent, compared to 1 percent in babies whose mothers had taken other antidepressants in the first three months of pregnancy.

FDA has asked the manufacturer, Glaxo Smith Kline (GSK), to change the pregnancy category from C to D, a stronger warning. Category D means that studies in pregnant women (controlled or observational) have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risks to the fetus.

Based on results of the preliminary data, GSK updated the drug’s labeling in September 2005 to add data from one study. As additional data have become available, the label has now been changed to reflect the latest data from the two studies and to change the pregnancy category.

Source: FDA

SOURCE: Paxil and Pregnancy › FDA Advising of Risk of Birth Defects with Paxil