Ethics in Medicine

Anti depressants and heart defects

Kristen Sparrow • September 27, 2009
THURSDAY, Sept. 24 (HealthDay News) —
“Women who take certain antidepressants during the first three months of pregnancy may have a slightly increased risk of giving birth to babies with heart defects.

Septal heart defects — malformations in the wall separating the right side of the heart from the left — were more common among women taking antidepressants in the first trimester, Danish researchers found. Some of these heart defects resolve on their own, while others require surgery.

The risks were seen in sertraline (trade names Zoloft and Lustral) and in citalopram (Celexa), both of which belong to the class of medications known as selective serotonin reuptake inhibitors (SSRIs).”

Women who took more than one SSRI early in their pregnancy had a fourfold higher risk of having babies with this problem, said the authors of a study appearing online Sept. 24 in BMJ.”

Overall, it doesn’t sound as if the threat is particularly large from the way the data is presented, but this topic is certainly worth keeping an eye on. The article goes on to underscore the risk of women with major depression going off anti-depressants in pregnancy implying that the risk/benefit ratio is in favor of keeping the medications in place. I doubt many would argue with that, but the fact of the matter is that these medications are not only prescribed for women with severe depression. On the contrary, these medications are one of the most prescribed medications out there, and often women do not know they are pregnant until well into the second month so there is some cause for concern.