“Pregnant women warned about anti-depressants”

Canadian Press - August 10, 2004

OTTAWA (CP) - Women who take some anti-depressant drugs during late pregnancy may be putting their babies at risk, Health Canada is warning.

The department issued an advisory yesterday about the following drugs: bupropion (used for depression or for smoking cessation), citalopram, fluoxetine, fluvoxamine,
mirtazapine, paroxetine, sertraline, and venlafaxine.

   The brand names involved are Zyban, Wellbutrin, Celexa, Prozac, Luvox, Remeron, Paxil, Zoloft, and Effexor.

   International and Canadian reports reveal that some newborns whose mothers took medications containing Selective Serotonin Re-uptake Inhibitors or other newer
anti-depressants during late pregnancy developed complications at birth requiring prolonged hospitalization, breathing support, and tube feeding.

   Reported symptoms include feeding and/or breathing difficulties, seizures, muscle rigidity, jitters, and constant crying. In most cases, the anti-depressant was taken during the last three months of pregnancy.

   The symptoms could indicate a direct adverse effect on the baby, or possibly a discontinuation syndrome caused by sudden withdrawal from the drug.

   Health Canada urged pregnant women who may be affected to consult their doctor.

   “If a woman is pregnant and is taking an SSRI, or other newer anti-depressant, she should discuss the risks and benefits of the various treatment options with her healthcare professional,” the advisory said.

   “It is very important that patients do not stop taking these medications without first consulting with their doctor.”

   The health regulator said it also will ask manufacturers to provide stronger warnings on the labels of drugs.

   Wendy Wood, a psychiatric pharmacist at the Centre for Addiction and Mental Health in Toronto, said the warning has to be taken in context.

   “There is a risk from these drugs, but we have to balance that against not being treated for depression during pregnancy and for post-partum depression,” she stressed.

   Wood said women who are depressed eat poorly and tend to self-medicate with tobacco, alcohol, and non-prescription drugs—all of which can cause far more severe damage to the fetus.

   Health Canada said it issued the advisory to increase awareness so symptoms can be recognized and addressed quickly.

   To report an adverse reaction, consumers and health professionals can call 1-866-234-2345 or fax 1-866-678-6789.