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SSRI Side Effect: Neural Tube Birth Defects

Healthy Infant without SSRI birth defectsA growing body of evidence points to a connection between SSRI antidepressants, known as “selective serotonin reuptake inhibitors” and, when taken in pregnancy, serious side effects such as neural tube defects (“anencephaly”). Until recently, there were only unanswered questions regarding a possible relationship between SSRI use in pregnancy and certain birth defects such as neural tube defects. Now, a new spate of research suggests that SSRI use during pregnancy may result in a small increase in the chances of having a baby with certain birth defects.

Types of SSRIs and their use

During their lifetime, 10 to 25 percent of women, many of them in their childbearing years, will experience clinical depression. Clinical depression is defined as a period of more than 2 weeks of feeling sad, down or gloomy to the degree that one is no longer able to carry out one’s usual functions and routine and, in the worst cases, may be inclined to suicide. Enter SSRI’s. These pills come packaged in many forms these days with different pharmaceutical tweaks, and they remain the healthcare industry’s latest, most popular answer to the mystery of depression.

The evidence of their popularity is everywhere. One in four women in the U.S. now takes an antidepressant, and in most cases, they are taking an SSRI antidepressant. Since 2001 the use of antidepressants among women has seen a 29 percent increase. That means more women are taking SSRI’s and more women are likely to become pregnant on these same drugs.

SSRI’s are thought to help alleviate symptoms of depression by blocking inhibitors of the neurotransmitter “serotonin,” levels of which influence the mood and at optimum levels are often linked with feelings of contentment and happiness. With less interference and absorption, serotonin can circulate more quickly through the brain, providing a boost to one’s mood.

There are at least 5 main kinds of SSRI, each of them packaged by a different manufacturer. They include:

  • Prozac, the oldest of the SSRI’s
  • Celexa
  • Lexapro
  • Paxil
  • Zoloft

SSRI birth defects—studies of serious side effects like neural tube defects

A 2007 National Birth Defects Prevention study published in The New England Journal of Medicine lays out the results of years of research into possible risk factors associated with SSRI use in pregnancy, specifically, the likelihood of developing birth defects. The study, led by members of the Center for Disease Control, looked at a sample of nearly 15,000 infants (of whom just under 10,000 of had major birth defects, and just under 5,000 served as a control group), and concluded that while SSRI’s could be ruled out with respect to a number of major birth defects, they did present a heightened risk of neural tube defects.

In other words, neural tube defects proved to be significantly more common among babies born to mothers prescribed SSRI’s—doubling the risk of anencephaly in babies born to mothers on SSRI’s. This antidepressant birth defect risk, while not so glaringly high as to prevent doctors from prescribing SSRI’s to expectant mothers (at least for the time being), gives cause for concern and warrants further study.

SSRIs and neural tube defects

Neural tube defects are rare: every year, 1 in 4,859 babies in the U.S. will be born with anencephaly, or the absence of a large portion of the brain, skull and scalp; these babies will inevitably die, leaving bereft families behind. So, while the defect itself is rare, its impact is severe. For that reason, scientists on the heels of new research are eager to explore to what extent expectant mothers’ use of SSRIs may contribute to neural tube defects—and, to what extent these birth defects can be prevented by not taking SSRIs.

SSRI birth defect lawsuits allege neural tube defects, anencephaly

If the jury is out in the scientific realm when it comes to the safety of SSRI antidepressant use during pregnancy, juries are also facing a growing number of birth defect lawsuits blaming SSRIs for neural tube defects and other injuries discovered at birth and after.

These injuries allegedly linked to SSRIs include:

  • Respiratory distress
  • Respiratory issues
  • Persistent Pulmonary Hypertension (PPHN), a rare condition that occurs when insufficient oxygen damages the heart, lungs and brain, in some cases causing death
  • Cardiac problems, such as atrial septal defects (holes in the walls of the heart)

Birth defect litigation awards handsome settlements to plaintiffs

So far the maker of Paxil, Glaxo Smith Kline (GSK), has borne the biggest brunt of expensive settlements relating to allegations that Paxil is dangerous to expectant mothers and their babies. In July 2010, GSK agreed to a settlement of more than $1 billion to resolve some 800 Paxil birth defect lawsuits, and the average settlement amount allocated to affected families is in the whereabouts of $1.2 million.

In some cases, settlements are even larger. A Philadelphia jury, for example, found GSK to be liable for the heart defects of a three-year-old boy, awarding the boy’s family a sum of $2.5 million. Now other drug makers, such as Pfizer, the maker of Zoloft, are facing similar allegations.

  1. The New England Journal of Medicine, “Use of Selective Serotonin Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects,”
  2. Mayo Clinic, “Depression,”
  3. The Huffington Post, “Women and Prescription Drugs: One in Four Takes Mental Health Meds,”