The FDA has been reexamining some widely accepted treatments — including the use of antidepressants during pregnancy. Our National Mental Health Correspondent Dr. Nicole Clark has more.
Antidepressants are a widely accepted treatment for pregnant women experiencing mental health disorders. But last week, several members of an FDA panel expressed their concern surrounding the use of selective serotonin reuptake inhibitors or SSRI’s — like Lexapro or Zoloft — during pregnancy.
“Never before in human history have we chemically altered developing babies like this, especially the developing fetal brain,” said Dr. Adam Urato, during the July 21 meeting. “And this is happening without any real public warning. That must end.”
Urato, the chief of maternal fetal medicine at MetroWest Medical Center in Massachusetts, was one of several panelists who expressed concern over how SSRIs may affect development, both in utero and after birth.
But other panel experts point out that for many potential side effects, the increase in risk associated with the drugs is less than one percent.
They argue that the benefits of using SSRIs outweigh the risks.
“When mental health conditions go untreated, these women are less likely to attend their prenatal care appointments and they’re more likely to use substances during their pregnancy,” said Dr. Kay Roussos-Ross, the director of University of Florida College of Medicine’s perinatal mood disorders program. “They are also more likely to face additional risks such as preeclampsia and cesarean delivery. Worst of all, these women are at risk of suicide.”
One in five new and expecting mothers experience perinatal mood disorders, according to the National Institute of Health — and only half of those diagnosed receive adequate treatment.
“In this country, that maternal mortality is at its peak. We have the highest maternal death rates of any developed country in the world. And the leading cause of maternal mortality and maternal death in this country is mental illness.” said perinatal mental health specialist, Paige Bellenbaum.
Suicide and overdoses account for nearly a quarter of maternal deaths in the United States, according to the CDC. Bellenbaum says these medications are key to the treatment of mental health disorders during pregnancy.
“SSRIs are one of the safest treatment options that we have available in our toolbox of interventions to treat depression and anxiety and other psychiatric illnesses for pregnant and post-partum people and birthing parents,” says Bellenbaum.
“SSRIs are very commonly prescribed. We know that they are safe. We know they’re effective. And most importantly, we know that they save lives.”
Bellenbaum and other experts worry that pregnant people may be less likely to seek treatment after this latest FDA panel.
“When things like this week’s FDA panel communicate misinformation the fear that we have is that we will be taking a giant step backwards all the work that we’ve put into minimizing the shame and stigma around these conditions and minimizing the fears around taking medication,” says Bellenbaum.
The panel urged further long-term studies and stronger warning labels. If you or someone you know is experiencing symptoms of depression, speak to your doctor about treatment options.
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