Posted on 02/03/2005 5:11:11 PM PST by neverdem
In the wake of a yearlong debate over the risks of antidepressants to minors, a new analysis of World Health Organization medical records has found that infants whose mothers take the drugs while pregnant may suffer withdrawal symptoms shortly after they are born. The study challenges the assurances that many doctors have long given pregnant women with depression that taking the drugs would not affect their babies.
But experts said that the study, appearing today in the journal Lancet, was not definitive, and must be weighed against the benefits of drug treatment. Untreated maternal depression can also harm a developing fetus, the experts said, and may lead to lasting childhood problems, whereas all of the infants in the study recovered completely within 24 hours.
"This study is important in that it gives us a red flag that babies exposed to antidepressants during pregnancy should be closely observed, and may go through unusual behaviors at first," said Dr. Timothy Oberlander, a developmental pediatrician at the University of British Columbia who was not involved in the research. He does no research or consulting for pharmaceutical companies.
Some 10 percent to 15 percent of women suffer bouts of despair during the hormonal chaos of pregnancy, and about a quarter of them get antidepressant treatment, doctors estimate, usually with drugs like Prozac, from Eli Lilly; Paxil, from GlaxoSmithKline; and Zoloft, by Pfizer. If not treated, these women may also be at increased risk of post-partum depression, a devastating disorder that not only clouds the relationship between mother and child but can interfere with the child's social development, according to Dr. Janet DiPietro, a professor at the Johns Hopkins School of Public Health.
In the new study, researchers in Spain and Sweden searched through a large electronic database of adverse drug reactions stored in Uppsala, Sweden, maintained by the W.H.O. since 1968. They looked for reports of newborns who were exposed in utero to antidepressants, and who had symptoms after birth that included heightened agitation, fever and quickened breathing. Psychiatrists have long observed these kinds of reactions in adults who abruptly stop taking certain antidepressants, and a few recent smaller studies have also noted similar symptoms in infants born to mothers who have been taking antidepressants. The European researchers found more than 100 such cases, and narrowed those to 93 that could be linked strongly to any antidepressant medication, based on a reading of the treating doctors' original reports. After conducting a statistical analysis based in part on W.H.O. estimates of drug usage, the authors concluded that the withdrawal reports were more common than would be expected by chance - and should be published, to alert doctors and patients.
In 13 of the 93 cases, the study found, infants suffered convulsions, a reaction that has not been widely noted in people who discontinue antidepressant use.
"All we are saying is that the data we have points to the possibility of withdrawal problem, but we would have to investigate each case closely to determine the overall risk," Dr. Emilio Sanz, of La Laguna Medical School in the Canary Islands, Spain, the paper's lead author, said in a telephone interview.
That newborns would show some reaction to a months-long course of mood-changing medication is not surprising to many doctors. The most widely prescribed antidepressants, called selective-serotonin reuptake inhibitors, or S.S.R.I.'s, induce alterations in the sensitivity of nerve cells, among other things; and abruptly stopping these drug forces the brain to readjust again, experts say.
"I can tell you that the newborn nurses here will not be surprised at these results," said Dr. DiPietro. "They have a term for it: S.S.R.I. syndrome," which includes jitteriness and agitation.
The antidepressant most often linked to reported withdrawal effects in the study was Paxil, a potent agent that is cleared more quickly from the body than similar drugs. Dr. Sanz said the withdrawal signal was stronger for Paxil but acknowledged that factors unrelated to the drug's chemistry - its prescription rate, for example - could also have accounted for the difference. "Our monitoring so far has not provided clear evidence that Paxil causes neonatal complications," said Mary Anne Rhyne, a spokeswoman for Glaxo. The Food and Drug Administration asked antidepressant manufacturers to list possible neonatal complications on product labels more than a year ago, after infants in small studies exposed to the drugs suffered respiratory distress, irritability and seizures, among other troubles. It was not yet clear whether the new study will add to these cautions, an agency spokesperson said.
Some experts said that severe maternal depression during or after pregnancy is still a larger threat to a child's well being than the often mild and transient effects from discontinuing a drug.
"But for the worried well, for women who want antidepressants to feel better as opposed to treating serious depression," Dr. DiPietro said, "they may want to ask whether the benefit they are getting outweighs the potential risks to the developing child."
A couple years ago I started having what appeared to be panic attacks, and the doctor put me on Paxil. For the first couple weeks, it gave me some of the most lucid, weird dreams I had ever had. It also caused some disturbing emotional outbursts.
When I decided to stop a year ago, I discovered the wonderful world of withdrawal, which included tinnitus, tunnel vision, dizzines...and several days of hell. What's sad is that people had been reporting these effects for years, yet no warnings were ever given...even by doctors who were aware of it. If you don't need it...don't take it.
How much money did it cost to state the obvious?
Let's see.... inorganic toxic chemicals, flowing through soon to be born babies........ D-U-H!
FReepmail me if you want on or off my health and science ping list.
Paxil is the worst SSRI but if you think that is bad, the benzodiazipines like Klonopin, valium, xanax are almost impossible to come off and if you one of the 15% like me that go into severe protratced WD, it took me 3 years to recover the devestation to my central nervous system, immune system and adrenals etc.....there are hundreds more like me I found thru Yahoo groups that went thru the same hell and none of them are druggies.....we all were and are professionals.......don't mess with pyschotropic drugs even with perscription unless it is life or death
ping
Thanks for the link.
bump and thanks!
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