SSRI antidepressants pose higher risks of spontaneous abortion in pregnant women

Women taking SSRI (selective serotonin reuptake inhibitor) antidepressants like Lexapro and Celexa during pregnancy have a higher risk of spontaneous abortion than women who don't take those medications, according to authors of a new study published in the November issue of Reproductive Toxicology. According to the researchers, pregnant women taking SSRIs for depression face between 1 to 2 times greater risk for spontaneous abortion.

Using existing medical research as their data, the researchers wanted to know if women on antidepressants face higher risks of spontaneous abortion and if the fetus faces higher risks of birth defects. The researchers found no higher risks of birth defects in the fetuses of women taking SSRIs.

Catch-22 for depressed pregnant women

Even with this knowledge, choosing the best treatment for depression is difficult. The researchers note that

"Due to concern that antidepressants may harm the fetus women frequently discontinue medications during pregnancy; however, for pregnant women with recurrent major depression who discontinue medication, the risk of relapse is high and untreated maternal mental illness itself may compromise prenatal care, obstetrical outcome, and the postpartum course. The decision for administration of antidepressants during pregnancy is thus complex and evaluation of the safety of this type of drugs during pregnancy is very important."

So pregnant women who are also depressed find themselves in a catch-22 bind. Left untreated, they risk higher rates of spontaneous abortion, but left depressed, they risk all the negative effects of untreated mental illness.

The researchers didn't study other classes of drugs, such as tricyclic antidepressants (TCAs), MAOIs, or multiple reuptake inhibitors like Wellbutrin, Effexor, or Cymbalta. I'll follow up and find out if there's more research out there.

The most commonly prescribed SSRI antidepressants in the US include Prozac (fluoetine), Lexapro (escitalopram), Celexa (citalopram), Zoloft (sertraline), Luvox (luvoxamine), and Paxil (paroxetine).