Posted by Larry Hoover on November 16, 2002, at 20:18:46
In reply to Re: The truth to this study, posted by leslieg on November 16, 2002, at 19:41:44
> This leads to a major concern of mine (and why I had to get off the Effexor in the first place). What does the presence of these drugs do to an embryo? How can it be that the developing brain doesn't develop differently when constantly subjected to a chemical enviornment different from normal?
These are very important questions you're asking, and you can be sure that others share your concern. There is a recent report that you might find interesting (published this month).
Am J Psychiatry 2002 Nov;159(11):1889-95
Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study.Nulman I, Rovet J, Stewart DE, Wolpin J, Pace-Asciak P, Shuhaiber S, Koren G.
OBJECTIVE: Previous work suggested that first-trimester exposure to tricyclic antidepressants or fluoxetine does not affect adversely child IQ and language development. However, many women need antidepressants throughout pregnancy to avoid morbidity and suicide attempts. Little is known about the fetal safety of tricyclic antidepressants and fluoxetine when taken throughout pregnancy. The goal of this study was to assess the effects of tricyclic antidepressants and fluoxetine used throughout gestation on child IQ, language, and behavior. METHOD: In a prospective study, mother-child pairs exposed throughout gestation to tricyclic antidepressants (N=46) or fluoxetine (N=40) and an unexposed, not depressed comparison group (N=36) were blindly assessed. The three groups were compared in terms of the children's IQ, language, behavior, and temperament between ages 15 and 71 months. The authors adjusted for independent variables such as duration and severity of maternal depression, duration of pharmacological treatment, number of depression episodes after delivery, maternal IQ, socioeconomic status, cigarette smoking, and alcohol use. RESULTS: Neither tricyclic antidepressants nor fluoxetine adversely affected the child's global IQ, language development, or behavior. IQ was significantly and negatively associated with duration of depression, whereas language was negatively associated with number of depression episodes after delivery. CONCLUSIONS: Exposure to tricyclic antidepressants or fluoxetine throughout gestation does not appear to adversely affect cognition, language development, or the temperament of preschool and early-school children. In contrast, mothers' depression is associated with less cognitive and language achievement by their children. When needed, adequate antidepressant therapy should be instituted and maintained during pregnancy and postpartum.
>How many children born to moms who were on ADs have gone through the brain changes of puberty?We haven't gotten that far yet.
>How can we *know* there isn't damage that shows up as the brain matures? It amazes me that I could have been arrested for taking ritalin when pregnant, yet plenty of pdocs (including mine) don't see a problem with keeping a moderatly depressed woman on ADs during pregnancy.
They're paying attention to the outcome. The decision should be made on a case-by-case basis, according to the known risk arising from untreated depression during pregnancy.
Am J Psychiatry 2001 Oct;158(10):1728-30
Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study.Einarson A, Fatoye B, Sarkar M, Lavigne SV, Brochu J, Chambers C, Mastroiacovo P, Addis A, Matsui D, Schuler L, Einarson TR, Koren G.
The Motherisk Program, The Hospital for Sick Children, University of Toronto, Ontario, Canada. einarson@sickkids.on.ca
OBJECTIVE: Because there are no studies available on the safety of venlafaxine during pregnancy, the authors' goal in this study was to determine whether venlafaxine increases the risk for major malformations. METHOD: Data on 150 women exposed to venlafaxine during pregnancy in seven pregnancy counseling centers were compared with data from studies of pregnant women who 1) received selective serotonin reuptake inhibitor antidepressants (SSRIs) (N=150) and 2) who received nonteratogenic drugs (N=150). RESULTS: Among the 150 women who were exposed to venlafaxine during pregnancy, 125 had live births, 18 had spontaneous abortions, and seven had therapeutic abortions; two of the babies had major malformations. There were no significant differences between these women and the two comparison groups on any of the measures analyzed. CONCLUSIONS: These results suggest that the use of venlafaxine during pregnancy does not increase the rates of major malformations above the baseline rate of 1%-3%.
> I think there are too many people who see SSRIs as harmless; this type of study took saccharine off the market for years and made people think twice about artificial sweeteners. More people do need to think twice about taking SSRIs.Serious medication should be reserved for serious medical problems.
poster:Larry Hoover
thread:127552
URL: http://www.dr-bob.org/babble/20021116/msgs/127970.html