New research shows that antidepressant pharmacotherapy does not appear to pose a risk for cardiac defects in infants born to women taking the medicines during the first trimester of pregnancy—including those that are contraindicated for pregnant women.
A research team led by Krista Huybrechts, Ph.D., of Harvard Medical School conducted a large-scalestudy with nearly 950,000 pregnant women from 2000 to 2007 to compare the potential risk of congenital cardiac birth defects in offspring of mothers exposed to antidepressants during the first trimester of pregnancy with those who were not taking the drugs.
Study findings, published in the New England Journal of Medicine, showed no significant difference between infants in terms of congenital cardiac defect born to women who took antidepressants during the first trimester and those who did not. In addition, the study found no association between cardiac abnormalities in offspring and maternal exposure to paroxetine or sertraline, drugs classified by the Food and Drug Administration as pregnancy category C and D for potential risks for ventricular defects in the fetus. The study was funded by the Agency for Healthcare Research and Quality and the National Institutes of Health.
“This is very reassuring news,” stated Nada Stotland, M.D., a professor of psychiatry at Rush University and expert in OB-GYN psychiatry, during an interview with Psychiatric News. “Nevertheless, psychotherapy is the optimal first choice for treatment for mild to moderate depression during pregnancy; there are no negative side effects, and the patient can also benefit from the support and insight intrinsic to psychotherapy.” Stotland, a former APA president, emphasized that more-serious episodes of depression warrant a trial of antidepressant medication, because “untreated depression poses risk for mother, fetus, and newborn.”