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About SSRI Antidepressants

pregnant bellyAntidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are a commonly prescribed medication to treat symptoms of clinical depression, a condition that affects approximately 6.7 percent of U.S. adults at any given time. About 20 to 25 percent of adults will experience a bout of clinical depression at some point in their lives. Though feelings of sadness from time to time are common, a patient with clinical depression suffers from severe symptoms that interfere with daily life. Constant feelings of worthlessness, hopelessness, and despair can interfere with a person’s productivity and concentration, and even impair physical health.

For these patients, SSRIs present the opportunity to regain control of their mental and emotional well-being. Unfortunately, these drugs also pose the risk of serious side effects. While men and women are both subject to the common complications linked to antidepressants, women who take antidepressants during pregnancy face a particularly worrisome risk that their babies will develop SSRI birth defects.

Types of antidepressants

Antidepressants come in several forms. The first one was discovered by accident in 1952 while researchers were investigating treatments for tuberculosis. This class of antidepressant was called an monoamine oxidase inhibitor (MAOI) because it worked by inhibiting the mitochondrial enzyme monoamine oxidase, which delayed the breakdown of serotonin, dopamine, and norepinephrine, thus elevating one’s mood.

Tricyclic and tetracyclic antidepressants are other examples of older forms of antidepressants. Today they are less commonly prescribed due to the established risks of overdose and death.  Atypical antidepressants, such as Wellbutrin (bupropion) and Remeron (mirtazapine) are called “atypical” because they don’t quite fit into any particular category. Serotonin and norepinephrine reuptake inhibitors (SNRIs) include drugs such as Cymbalta (duloxetine) and Effexor XR (venlafaxine).

Of all the classes of antidepressants, SSRIs are the most commonly prescribed. Today, most healthcare professionals opt for SSRI treatment.

Some examples of SSRIs include:

  • Zoloft (sertraline)
  • Paxil (paroxetine)
  • Luvox (fluvoxamine)
  • Lexapro (escitalopram)
  • Celexa (citalopram)
  • Prozac (fluoxetine)

SSRI manufacturers, lawsuit defendants

The three most commonly used SSRIs are the target of the most antidepressant lawsuits. Patients have sued the makers of Zoloft, Paxil, and Prozac, claiming that they were not sufficiently warned of the potential for serious side effects, including birth defects when used during pregnancy. These lawsuits seek to hold the drug manufacturers liable for negligence and fraudulent misrepresentation.

Plaintiffs who file antidepressant lawsuits may recover compensatory damages for their medical expenses and other economic losses. Compensation can also help families care for the children who were born with the resulting birth defects.

Recent lawsuit filings include a a Paxil lawsuit filed by a mother and daughter in June 2013 in Pennsylvania wherein the mother claimed her minor child’s neural tube birth defect was a direct result of the use of the antidepressant during pregnancy. Another family from Pennsylvania filed a lawsuit against Pfizer in January 2014, claiming that the mother’s use of Zoloft during pregnancy caused her daughter to be born with multiple birth defects, including pupillary asymmetry, nose asymmetry, right facial palsy, and persistent fetal vasculature.

Given the prevalence of antidepressant use in the U.S. and around the world, it’s expected that many more lawsuits will continue to be filed.

SSRI side effects

Patients who take selective serotonin reuptake inhibitors may not always be properly warned of the potential for side effects.

Some of the side effects that have been linked to SSRIs include:

  • Sexual side effects: Diminished libido, impaired performance, diminished desire, and impaired satisfaction (in both men and women)
  • Physical side effects: Diarrhea, muscle pain, nausea, headaches, joint pain, insomnia, rashes, stomach upset, dry mouth, fatigue, weight loss, weight gain, and excessive sweating.
  • Bleeding problems: Patients taking SSRIs run the risk of serious bleeding problems, particularly when SSRIs are taken with nonsteroidal anti-inflammatory drugs (NSAIDs). Bleeding problems may include stomach or uterine bleeding resulting from a reduced blood clotting ability.
  • Psychiatric side effects: SSRIs are linked to a doubled risk of thoughts of suicide or engagement in self-destructive behaviors for both children and adults. The FDA has required a black box warning for SSRIs regarding the risk of suicide. This is the strongest possible warning the FDA can issue for medications.

SSRIs and pregnancy

Many of the lawsuits that have been filed with regards to the risk of birth defects when SSRIs are taken during pregnancy allege that the patients were unaware of the risks to their unborn children.

Some of the birth defects that have been linked to SSRI antidepressants include:

  • Anencephaly: a neural tube birth defect in which a significant portion of the skull and brain is absent. There is no known treatment for this condition and death is expected within a few days of birth.
  • Autism spectrum disorder (ASD): ASD poses a wide range of types of challenges that vary in their severity from child to child. It is a lifelong developmental disorder that can impair a child’s communication skills, social skills, self-help skills, and more. Parents can expect the child to require expensive, long-term therapies, such as applied behavior analysis, occupational therapy and speech therapy.
  • Cleft lip and cleft palate: these birth defects are malformations of the oral and facial structures. There are insufficient tissues in the area, and they do not fuse together properly, which results in a gap between the two sides of the upper lip and/or the upper palate.
  • Craniosynostosis: Normally, the sutures between the bony plates of a child’s skull close by age two or three. With this birth defect, they close prematurely, resulting in seizures and developmental delays.
  • Persistent pulmonary hypertension of the newborn (PPHN): this occurs when the fetal blood circulation does not switch to the typical blood circulation of a newborn, causing oxygen deprivation to the lungs.
  • Septal defects: ventricular septal defects (VSDs) and atrial septal defects (ASDs) are the formation of a hole in the wall of a heart’s chamber, posing problems with circulation.
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