Antidepressants Linked to Birth Defects

Antidepressants including Celexa, Effexor, Lexapro, Paxil and Zoloft have been linked to an increased risk of birth defects.  

Antidepressants (SSRIs [selective serotonin reuptake inhibitors]), such as Celexa (citalopram), Effexor (venlaxafine), Lexapro (escitalopram), Paxil (paroxetine) and Zoloft (sertraline), since September of 2005 have been suspected to cause birth defects including:

• Heart (cardiac)
• Lung (pulmonary)
• Brain and spinal cord (neural-tube defects)
• Abnormally shaped skull (craniosynostosis)
• Abdominal wall defects (infant omphalocele)
• Club foot (one or both feet turn downward and inward)
• Complete or partial closure of the anus (anal atresia)

In July 2006 the FDA issued a warning about the increased risk of Neonatal Persistent Pulmonary Hypertension (PPHN) to babies whose mothers had taken SSRI antidepressants such as Celexa, Lexapro, Paxil and Zoloft.  The study (published in 2006 in the New England Journal of Medicine by Christina Chambers of the University of California, San Diego) this warning was based on suggested that PPHN was six times more common in babies whose mothers had taken an SSRI after the 20thweek of pregnancy compared to babies whose mothers did not.  PPHN occurs in babies soon after birth and causes high blood pressure in the lungs and they are not able to get enough oxygen into their bloodstream.  PPHN is a life-threatening disorder in which 10 to 20 percent of infants end up dying even if they receive treatment.

In addition, researchers from Denmark's Aarhus University published a study on September 25, 2009 in Online First of BMJ that tied the use of SSRI's with a heart defect involving a piece of tissue that separates parts of the heart.  Zoloft more than tripled the risk of this defect.  Taking more than one SSRI pushed the risk of having a baby with this heart defect to nearly five times more likely.

Women who took Paxil during the first trimester of pregnancy were twice as likely to give birth to children with atrial septal defects (ASD) and ventral septal defects (VSD).  These are holes in the walls of the chambers of the heart.  Other defects that may be linked to Paxil include cardiomyopathy, hypoplastic left heart syndrome (HLHS), hypoplastic right heart syndrome (HRHS), bicuspid aortic valve, tricuspid stenosis, limb reductions, spina bifida, anencephaly, cleft mitral valve as well as those defects listed above.  These findings prompted the FDA to ask GlaxoSmithKline, the manufacturer of Paxil, to strengthen the drug's pregnancy category from C to D (those that cause danger to the fetus).

A May 31, 2010 study published online in the Canadian Medical Association Journal by scientists at the University of Montreal stated that women who take antidepressants during the first trimester of their pregnancy were more likely to miscarry than women who did not.  The risk was found to be 68 percent higher.  The researches found that Effexor was among the antidepressants that carried the highest risk.  A study in the March 2010 issue of Pediatrics found associations between exposure to antidepressants in late pregnancy and prolonged motor developmental milestones at 6 and 19 months of age.  Effexor was one listed.

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