Even though antidepressant use in early pregnancy may increase the risk of some birth defects, many pregnant women are treated with these drugs, according to the Centers for Disease Control and Prevention (CDC). Doctors and pregnant women must weigh the risk of untreated depression against the risk of taking an antidepressant.

A new study from CDC researchers used data from the National Birth Defects Prevention Study to shed light on which antidepressants are linked to specific birth defects. They also looked at how much depression and anxiety may contribute to the risk of birth defects without medication. The findings were published in JAMA Psychiatry.

Study details: The researchers looked at antidepressant use in more than 30,000 mothers of babies born with birth defects and compared them to a control group of more than 11,000 mothers of babies without birth defects. Just over 5% of the birth-defect group reported taking an antidepressant compared with just over 4% of the control group. These were the key findings…

  • (Effexor) in early pregnancy was linked to several birth defects including heart, brain, spine and cleft palate defects.
  • Selective serotonin reuptake inhibitors (SSRIs), including sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil) and citalopram (Celexa), were linked to a small number of birth defects, including heart defects.

To learn how much depression, anxiety or other mental health disorders contribute to birth defects, the researchers compared women exposed to antidepressants in the first three months of pregnancy to women with mental health disorders not exposed to antidepressants in early pregnancy. This comparison suggested that some of the risks linked to SSRI antidepressants may be caused by mental health conditions and not medication.

Overall, venlafaxine was associated with the highest number of birth defects, and this risk was not decreased by accounting for mental health conditions.

Takeaway: This study does not suggest that women who are pregnant and on antidepressants should stop taking their medication. Stopping an antidepressant during pregnancy may be more harmful than taking it. Women should talk to their doctor about the risks and benefits of managing depression during pregnancy with antidepressants. Psychotherapy without medication may be another option.

Source: Study titled “Maternal Use of Specific Antidepressant Medications During Early Pregnancy and the Risk of Selected Birth Defects,” by researchers at National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, published in JAMA Psychiatry.