The study, conducted by researchers at Karolinska Institute in Stockholm, Sweden, found that infants born to women who took SSRIs late in their pregnancy had a two-fold increase of having PPHN compared to infants born to women who did not take the drugs.

The absolute risk was three infants per 1,000 exposed to SSRIs during late gestation. And the risk with different SSRIs was similar. Those involved in the study included sertraline, known by the brand Zoloft; citalopram, known by the brands Celexa and Ciprami; paroxetine, known by the brand Paxil, and fluoxetine, known by the brand Prozac.

Currently, only Paxil is listed as a Category D drug, meaning that it is discouraged during pregnancy because studies have linked use in pregnant women to birth defects. All other SSRIs are listed as Category C drugs, and are still considered relatively safe to use during pregnancy.

However, this latest study suggests that women and their doctors should use more caution when weighing risks and benefits of SSRIs during pregnancy, especially since most SSRIs are still considered safe to use during pregnancy despite the latest study suggesting otherwise.

SSRIs are among the most prescribed drugs in the United States. In the past two decades, use of antidepressants in the U.S. has increased 400 percent. Eleven percent of Americans over the age of 12 take an antidepressant, and about 14 percent of them have been using the medication for more than a decade.

Source: EMaxHealth

SOURCE: Paxil and Pregnancy › Another study shows PPHN risk with SSRI exposure

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

Newer studies suggest that there is no increased risk of suicide, and others show that the risk of suicide attempts in adults who start taking SSRIs is actually reduced, particularly in men and especially with sertraline, known by the brand name Zoloft. These findings are published in a recent issue of the journal Lancet.

This is good news to the millions of people who suffer from depression. But researchers are quick to warn that there are serious safety risks with the drugs, especially when they are used by women during pregnancy.

Paroxetine, known by the brand name Paxil, has been proven to increase the risk of major fetal malformations, especially cardiac defects. SSRI use during late pregnancy has also been linked to persistent pulmonary hypertension in newborns. And, continuous exposure to SSRIs throughout pregnancy can increase the risk of preterm birth compared with babies who had little or no SSRI exposure in utero.

SSRIs include the brand-name drugs Zoloft, Paxil, Lexapro, Celexa and Prozac.

Researchers conclude that SSRIs serve a purpose in treating depression but should be used with caution during pregnancy and advise that Paxil be avoided all together.

Source: Medscape

SOURCE: Paxil and Pregnancy › SSRIs still considered risky during pregnancy

The registries cover only about 28 percent of the overall population, and data from other areas beyond England and Wales is missing, so the accuracy of the results is still in question. What it does raise is questions about why the birth defect rate would increase.

Many factors can affect birth outcomes, several of which are considered preventable including lifestyle changes during pregnancy (such as smoking, and drug and alcohol abuse) and getting regular prenatal care. What some women don’t realize is that the prescription medication they are taking while pregnant could have detrimental affects on developing fetuses.

For example, one of the most prescribed drugs in both the United States and the United Kingdom is a type of antidepressant known as selective serotonin reuptake inhibitors, or SSRIs. Drugs in this class include Paxil, Zoloft, Celexa, Lexapro and Prozac.

Most of these drugs are labeled as safe to take during pregnancy; however, newer studies are providing more evidence that using them during pregnancy could increase the risk for heart defects, neural tube defects (including spina bifida) and other defects, including gastroschisis.

Source: The Independent

SOURCE: Paxil and Pregnancy › Could SSRIs be contributing to an increase in birth defects?

The FDA has been conducting an investigation into studies that suggest using selective serotonin reuptake inhibitors (SSRIs) during pregnancy increases the risk of persistent pulmonary hypertension (PPHN) in newborns. The agency said that when grouped with other studies, the results were conflicting and thus it is premature for the FDA to make any formal conclusions about the risk.

SSRIs are one of the most commonly prescribed medications in the United States. They are prescribed to treat depression and other psychiatric disorders. SSRIs are marketed under various brand and generic drug names Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); and Viibryd (vilazodone).

The FDA already has notified health care professionals and the public on the use of SSRIs by women during pregnancy and the potential risk of the rare heart and lung condition. The initial Public Health Advisory issued in July 2006 on this potential risk was based on a single published study. Since then, the FDA says there have been conflicting findings from newer studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.

PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with the condition may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage and even death.

The FDA is advising doctors not to alter their current clinical practice of treating depression during pregnancy. However, any serious side effects with SSRIs should be reported to the FDA at www.FDA.gov/MedWatch/Report.htm.

Source: FDA

SOURCE: Paxil and Pregnancy › FDA won’t issue stronger warnings on SSRI use during pregnancy

Australia’s current system was introduced in 1979 following the thalidomide tragedy in which pregnant women in Australia and Europe were prescribed thalidomide to treat morning sickness. The drug, however, was found to cause serious birth defects and malformations. Since then, drugs in many countries have been given classifications to help doctors and patients better understand the risks associated with the drugs if taken during pregnancy.

Australia uses a letter-based system that ranks the safety of medications with categories A, B1, B2, B3, C, D and X, with “A” being considered safest and “X” being the most dangerous. Critics of the Australian system say the categories are viewed more as a “bible” for physicians rather than a guide. Thus, many women opt to forgo medications while pregnant just to be safe.

These same critics point to the system used in the United States, which is also an alphabetical system that categorizes drugs into A, B, C, D and X. But the system used in the United States is hardly flawless.

For example, a class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, are among the most prescribed drugs in the United States. These drugs include brand names such as Paxil, Zoloft, Lexapro, Celexa and Prozac.

All but Paxil are classified as Category C drugs, meaning that there are not sufficient studies that show whether use of the drug during pregnancy will cause birth defects. Paxil was recently reclassified from a C to a D pregnancy drug after studies proved the drug caused birth defects if taken during pregnancy.

The unfortunate news is that when Paxil was classified as a Category C drug, doctors and patients were under the assumption that using the drug during pregnancy was relatively safe. Many women found out too late that Paxil was dangerous to developing fetuses.

Now, more studies suggest that other SSRIs may be just as dangerous as Paxil, yet they are still classified as Category C drugs.

Source: Sky News

SOURCE: Paxil and Pregnancy › Drug classifications can be confusing for pregnant women

SSRIs are among the most prescribed medications in the United States and are the most poplar antidepressants prescribed in recent years. Little data was available to determine the risks on fetuses, thus many women were under the assumption that the drugs were safe. However, studies began to question that safety record.

Most of the concern focused on paroxetine, known by the brand name Paxil. Earlier studies resulted in Paxil being downgraded to a Category D pregnancy drug, meaning studies have shown the drug can cause birth defects if used during pregnancy.

The latest study suggests other SSRIs, including Zoloft, Celexa, Lexapro and Prozac, may be just as dangerous to developing fetuses. Researchers reviewed data from nationwide birth registries covering 11 years. The cohort included 635,583 babies, of whom 6,976 were exposed to SSRIs during the first trimester. The data showed that babies exposed to SSRIs were at greater risk for major cardiovascular anomalies than babies who were not exposed to SSRIs during gestation.

Specific defects linked to SSRI exposure include ventricular septal defects and right ventricular outflow tract defects. There was also a risk for neural tube defects.

The study also found that fetal alcohol syndrome disorders were nearly 10 times mere common in SSRI-exposed babies than in unexposed children. Therefore, the researchers advised, special attention should be given to alcohol use in pregnant women who use SSRIs.

Source: MedScape

SOURCE: Paxil and Pregnancy › Study raises more concerns about SSRIs and birth defects

This month, 13 Americans are suing Grunethal GmbH and companies now merged into GlaxoSmithKline and Sanofi, claiming the drug companies conspired to withhold the results of studies that showed their drug Thalidomide, used to treat morning sickness in pregnant women, caused birth defects, including missing and malformed limbs.

The plaintiffs were all born with birth defects between 1957 and 1962. The drug companies claim that the birth defects associated with Thalidomide were known in Europe, and that they could not have happened in the United States because the drug was only used in a limited clinical trial. The drug companies allege that the link between birth defects and Thalidomide was not known until 1961, however the lawsuits claim the companies were aware of the risks as early as 1955.

It’s taken 50 years for the victims of Thalidomide to seek justice, but lawsuits are already mounting against manufacturers of another class of drugs that studies show may cause serious birth defects – selective serotonin reuptake inhibitors, or SSRIs. These antidepressants are among the most prescribed medications in America, and many women are under the belief that these drugs are safe to use during pregnancy.

The truth is drug companies do receive complaints about their medication but are often slow to share the news. For example, women who used the SSRI Paxil during pregnancy and delivered babies with serious brain, heart and lung defects found out too late that their babies could have been spared injury if only they had been made aware of the possible risks associated with the drug.

It took several complaints for the Food and Drug Administration (FDA) to order stronger warnings on Paxil use during pregnancy. Many of those mothers are waiting for their day in court.

Source: Business Week

SOURCE: Paxil and Pregnancy › Drug companies should not hide risk for birth defects

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

But when drug companies cover up studies that suggest that their drug may actually put fetuses at risk for serious birth defects, it can have devastating consequences.

Such claims are being made about of the makers of some drugs in a popular class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. The drugs, known by the brand names Zoloft, Celexa, Lexapro and Prozac, are classified as Category C pregnancy drugs, meaning there are no studies that show how the drugs affect developing fetuses.

Paxil is the only SSRI that is classified as a Category D pregnancy drug, meaning studies have proven the drug can cause birth defects of the brain, spinal cord, heart, and lungs.

With little information to go by, and fear that their symptoms of depression may return, many women trust the packaging on their antidepressant bottle to reassure them that their baby will be OK. But the truth can be difficult to decipher.

Recent studies have suggested that all SSRIs may be as dangerous as Paxil, and a recent report in the Archives of General Psychiatry suggested that pregnant women who use SSRIs may be more likely to have a baby with an autism spectrum disorder.

So whom can a woman trust?

“In pregnancy in general, we tend to be afraid of all medications,” says Dr. Lori Wroble, the chief obstetrician for Harvard Vanguard Medical Associate at Newton-Wellesley Hospital. “And I think it’s actually scarier when you don’t have enough studies, because it’s an open-ended question that you’ll always wonder about.”

Source: The Pregnancy Blog

SOURCE: Paxil and Pregnancy › Women should use caution with SSRI use during pregnancy

SSRIs are among the most commonly prescribed drugs in the United States and include brand names such as Zoloft, Paxil, Effexor, Celexa and Prozac. The popularity of these drugs has eclipsed the sale of older, generally less expensive tricyclic antidepressants.

Both types of antidepressants are considered equally effective and were considered equally as safe as well. However, a study published in a recent issue of the British Medical Journal suggests otherwise.

The study used data from a large collection of anonymous health records called Q Research to pit the two types of antidepressants together. They found that among the 60,000 people in the study who were older than 65 and suffered from depression, the patients taking the older tricyclic antidepressants had a lower death risk than patients who took the more modern SSRIs.

The study also found serotonin-triggering antidepressants were associated with a higher risk of attempted suicide. SSRIs currently have a black box warning that use, especially in children and adolescents, may cause suicidal ideation and patients using the drugs should be monitored for signs of bizarre or depressive behavior.

The new study casts a darker shadow on the safety of SSRIs. Elderly patients who use SSRIs are encouraged to discuss any concerns with their doctors. Any side effects with these or any drugs should be reported to the FDA MedWatch Adverse Event Reporting Program at www.FDA.gov/MedWatch/Report.htm.

Source: Third Age

SOURCE: Paxil and Pregnancy › Study: SSRIs may be dangerous to elderly

Researchers at Yale School of Medicine followed a group of 778 pregnant women with a history of depression who decided independently whether or not to continue antidepressant medication throughout their term. The study was based on a larger cohort of 3,000 women, all over 18, with a history of depression.

The cohort tracked the women through pregnancy and the post-partum period. At least all women had experienced at least one depressive episode prior to becoming pregnant. The study found 21 percent of the 3,000 women followed were taking antidepressants at the start of their pregnancy. Only 14 remained on their medications by their second trimester.

Many of the women said the decision to discontinue taking antidepressants once they became pregnant was a difficult one. The most commonly prescribed antidepressants are known as selective serotonin reuptake inhibitors (SSRI), and are sold under brand names such as Zoloft, Paxil, Celexa and Prozac. New studies have shown that using SSRIs during pregnancy can cause serious birth defects of the brain, spinal cord, heart and lungs.

Source: Yale Daily News

SOURCE: Paxil and Pregnancy › Women should not fear discontinuing antidepressants while pregnant

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

SSRIs include brand names such as Celexa, Lexapro, Prozac, Paxil, Zoloft and Symbayax. They work by blocking the reabsorption of the neurotransmitter serotonin in the brain. Adjusting the serotonin helps the brain cells send and receive chemical messages, which helps alleviate depressive emotions.

Recent studies have shown a link between SSRI use during pregnancy and birth defects, in particular heart and lung defects. Data from these studies led to the reclassification of Paxil from a Category C drug to a Category D drug, meaning it is not advised for use during pregnancy because of a proven risk for birth defects. Newer studies suggest other SSRIs should be reclassified as well.

The FDA’s latest safety communication warned doctors and patients that Celexa should no longer be used at doses greater than 40 mg per day because it can cause abnormal changes in the electrical activity of the heart. These changes, known as prolongation of the QT interval on the electrocardiogram, or CECG, can lead to an abnormal heart rhythm (including Torsade de Pointes), which can be fatal.

Patients at particular risk for developing prolongation of the QT interval include those with underlying heart conditions and those who are predisposed to low levels of potassium and magnesium in the blood.

Any side effects with Celexa or any other SSRI should be reported to the FDA MedWatch Adverse Event Reporting Program at www.FDA.gov/MedWatch/Report.htm.

Source: FDA

SOURCE: Paxil and Pregnancy › FDA issues warning about SSRI Celexa in higher doses

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

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

All selective serotonin reuptake inhibitors, or SSRIs, except for paroxetine, or Paxil, are categorized as Class C. These drugs include citalopram, sold as Celexa; fluoxetine, sold under the brand Prozac; fluvoxamine, known as Luvox; sertaline, or Zoloft; and escitalopram, sold as Lexapro. Paxil was recently switched from a Category C to a Category D drug.

Class C drugs show harm to fetuses in animal studies, but there are no adequate controlled human studies to confirm or deny this harm to fetuses to human. These medications are considered OK to be prescribed to pregnant women if they need the medications.

Category D drugs, like Paxil, are more toxic. With these drugs, there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

But studies on all SSRIs suggest that other antidepressants in the class, such as Zoloft, may be just as dangerous to unborn children as Paxil. In June 2007, studies found an association between use of SSRIs in early pregnancy and a risk of abnormal skull development, gastrointestinal abnormality, and brain defects. In September 2009, a study published in the British Medical Journal found that SSRI antidepressants increase the risk of heart defects when taken during the first trimester.

Since antidepressants serve an important purpose for women who suffer from depression, the FDA advises women who are pregnant or thinking about becoming pregnant not to stop taking their antidepressant without first consulting their physician. The decision to continue medication or not should be made after both risks and benefits of the medication are weighed.

Sources:
Safe Fetus
Consumer Affairs

SOURCE: Paxil and Pregnancy › Women should consider SSRI risks to fetuses

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

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

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

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

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

Paxil Linked to Twice as Many Birth Defects

GlaxoSmithKline recently conducted a study of major birth defects in infants born to women who took antidepressants (including Paxil) during the first trimester of pregnancy.

In a study of more than 3,500 pregnant women, Paxil was linked to twice as many major birth defects as other antidepressants, according to the FDA.

Birth defects are very rare in the U.S., and it’s not certain what role, if any, Paxil played in the birth defects seen in the study, notes GlaxoSmithKline.

Changes have been made to the labeling information on pregnancy precautions that accompanies Paxil, says the FDA.

GlaxoSmithKline is a WebMD sponsor.

Most of the birth defects seen in the study were heart related; the most common heart malformations were ventricular septal defects, which are holes between the heart’s two main pumping chambers. These are common birth defects overall as well.

The study was a retrospective epidemiological study. That means it looked at large groups of people in hindsight. There was no data on birth defects in babies born to women who didn’t take antidepressants during early pregnancy.

From the Company to Doctors

It is “difficult” to determine whether Paxil caused those birth defects, says GlaxoSmithKline in a letter sent to doctors.

In the letter, the company notes that these findings differ from previous studies looking at birth defects and antidepressants.

Data from the large Swedish Medical Birth Registry hasn’t shown evidence of increased risk of major birth defects with antidepressants, including Paxil, notes GlaxoSmithKline.

GlaxoSmithKline spokespeople were not immediately available for comment.

Paxil’s Warning

Paxil’s official web site puts it this way:

“Tell your doctor if you are pregnant or plan to become pregnant as there is a potential risk to the fetus with [Paxil]. Some studies of [Paxil] in pregnant women have suggested a possible increased risk of malformations, while others have not shown such a risk.”

Antidepressants, including Paxil and others, such as Prozac and Zoloft, have been linked to withdrawal symptoms in babies born to mothers taking these medications. These antidepressants are known as selective serotonin reuptake inhibitors (SSRIs).

The Paxil web site also says: “Babies born to mothers who have taken antidepressants, including SSRIs such as Paxil, in the third trimester of pregnancy have reported complications, including difficulties with breathing, turning blue, seizures, changing body temperature, feeding problems, vomiting, low blood sugar, floppiness, stiffness, tremor, shakiness, irritability or constant crying. Tube feeding, help with breathing and longer hospitalization may be needed. There have also been reports of premature births in pregnant women exposed to SSRIs, including Paxil.

“Like many antidepressants, Paxil can be present in breast milk so tell your doctor if you are nursing.”

Source: WebMD Health News

SOURCE: Paxil and Pregnancy › New Study Links Paxil to Twice as Many Birth Defects as Other Antidepressants