This week I discovered something that I need to share with you all because it was something I have never come across before.
A study, linked here, looking into SSRI antidepressants and birth defects and congenital disabilities got me onto the topic of learning about how SSRIs (anti-depressant meds to most of us) are being implicated in a possible increase in the risk of congenital malformations and birth defects. I consider this to be crazy and quite scary, considering that SSRIs like prozac, zoloft, paxil etc. are the most widely prescribed drugs for depression worldwide, and millions and millions of women take them during pregnancy every day.
A lot of the research to date focuses on women who take antidepressants during pregnancy having a small but increased risk for a specific heart defect (a septal heart defect where there is an issue with the formation of the wall that divides the right and left-hand side of the heart).
This risk, although modest, has also been shown to get even more significant when the Mom takes:
- More than one SSRI antidepressant during pregnancy (a 4x increase in septal heart defects for women who take more than one); or
- Switches SSRIs early in pregnancy.
Do all SSRIs carry risk?
Like with anything, the risks need to be continued to be investigated, but these studies definitely add confusion to the safety of these drugs. Over 10 years ago, back in 2005, the FDA already warned against Moms using Paxil because of this suggested connection to heart defects. Since then, it has become a standard procedure for Doctors to move women onto a new SSRI, away from Paxil, when they get pregnant or are trying to conceive.
There is little clarity, however, about the different types of SSRIs and which are better than the other. It's confusing territory. A Danish study further added complexity to this, suggesting that Celexa and Zoloft *were* associated with a slight risk for the defect, but they found no increased risk with Paxil or Prozac. This study was big in scale as well - covering over 400,000 women born between 1996 and 2003.
The conclusion was that septal heart defects occurred in 0.5% of the children of mothers who did not take the SSRIs and 0.09% for people who did, a difference between 200 and 390 children.
It's not just heart defects though...
Other studies have looked into how prenatal exposure to antidepressants can also be connected to a baby's risk of exhibiting withdrawal symptoms and respiratory abnormalities when they are born.
Two studies showed that the use of SSRIs increased the risk of a respiratory-based disorder called persistent pulmonary hypertension in newborns by 600%, which is dangerous as, although it can be treated, it can be fatal. The analysis confirmed that using the SSRIs after the 20th week of gestation increased the risk of the baby being born with this condition.
So, some studies are saying this is dangerous, and some are saying it is inconclusive, but what is more important to understand is that there is risk, whichever SSRI you are taking.
One of the things that concerned me the most when I was reading about this topic was that so many women are taking, or being given, SSRIs as a band-aid approach to a condition where there are so many root causes that are going overlooked.
The idea that depression and other mental health conditions are *only* caused by an imbalance of chemicals (particularly serotonin and norepinephrine) in the brain is so deeply ingrained in our beings that it seems almost impossible to question it. However, there is so much more to it. I recently wrote an article on the 9 nutritional deficiencies and imbalances that might be silently contributing to depression and anxiety, linked here for you, as well as the 9 functional medicine tests that will get to the root cause of depression, anxiety, or panic attacks, also linked here.
Things like vitamin D deficiency, low B vitamins (particularly Vitamin B6), low iron levels, low zinc levels, and low lithium, magnesium, amino acids and Omega 3s can all drive neurotransmitter imbalances and root causes of depression. It is also well known that the gut-brain connection is very much 'real' and that many neurotransmitters that influence our mental health are created in our gut. The bacterial strains present in our gut impact follow on activities such as the functioning of our immune system, the creation of microbial metabolites, and impact inflammation levels in the body. If your gut health isn't up to scratch, or you have an imbalance in bacterial strains or are experiencing some level of gut 'dysbiosis' and or 'dysfunction', this might likely be impacting your mental health by inhibiting the correct number and type of neurotransmitters being created.
On top of all of these specific root-cause drivers, I believe that society today is missing one huge part of the jigsaw which is that depression is most likely (as backed up by a large body or research) an inflammatory condition - one that is driven by a low-grade, all over the body, chronic and ongoing inflammatory response - as well as being accompanied by increased oxidative stress all over the body.
Starting with tackling your inflammation could be a better place to start before jumping onto SSRIs (except for extreme and emergency cases and situations).
If this is something that you are struggling with, whether you are pregnant, trying to conceive, or neither, understanding the concept of root cause medicine is critical. Getting to the root cause of what you are experiencing is how you will start your true health and healing journey - rather than painting over the cracks of the problem.
If you're thinking about getting pregnant and are interested in coming off your SSRIs, I would look to work with a Doctor or health care professional to help move off the meds and onto a new course of healing.
As ever, there is no shaming here, we understand that life can be difficult, and we are often making the most informed decisions with the information at the time. Still, I hope this article can shed some light on the fact that there may be different ways that we can navigate pregnancy - and our mental health.
***THESE STATEMENTS HAVE NOT BEEN APPROVED OR REGULATED BY THE FDA. WE ARE NOT DOCTORS, THEREFORE ALWAYS CONSULT WITH YOUR DOCTOR FIRST.