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

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

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

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

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

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

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

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