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Post by Samir Nirola on Aug 27, 2015 18:07:18 GMT -4
This article was a pretty interesting as it demonstrates certain SSRI’s can be harmful in pregnancy and certain may not have any effects on the child. Providers and pregnant mother need to be educated on the side effects of these harmful drugs as this can reduce the morbidity and mortality in newborns. Also it is important to address these concerns to future moms as this may lead to fewer lawsuits. The article overall was very educating and accurate as it lacked many flaws. The study did not show any bias and was a controlled experiment, which gave a more accurate result. Side effects are very rare but can happen so it is better to learn from these results and make a better-informed decisions regarding treatment.
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Post by Sasha P on Aug 27, 2015 18:41:34 GMT -4
Neonatal complications associated with exposure to SSRI use during pregnancy were previously reported to have minimal adverse effects on the baby in both the short and long term according to UpToDate. Adverse effects in children exposed to SSRIs and SNRIs during pregnancy are mostly attributed to relatively mild nonspecific signs of restlessness, irritability, poor feeding, etc. but these signs are reported to be transient and do not last long. This study however demonstrated associations between much more severe birth defect and the use of SSRIs. It is interesting to note that several of the birth defects were not necessarily cognitively related but found to be more anatomically related causing heart defects, gastroschisis or omphalecele, to name a few. I think it would very interesting to investigate how the effects of depression alone without any pharmacological or cognitive therapy during pregnancy can harm one’s baby. Considering there is a biochemical disturbance as well as a physiological response to depression, it would be very interesting to determine what physiological as well as cognitive consequences this may have on a baby. The effects of a mother’s mental health and the health of her baby would definitely be something to investigate as the number of people affected by mental health issues is on the rise. Paroxetine was one of the SSRIs heavily investigate in this study and although paroxetine is labeled as a category D medication pregnant females were still using it during their pregnancies. This illustrates the need for proper education among patients.
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Post by Elham Rahmani on Aug 27, 2015 22:33:36 GMT -4
This article was very shocking for me as I had been taught in medical school that SSRIs are relatively safe in pregnancy. Although this study also confirms that the risk of developing birth defects in mothers taking SSRIs is not very big; however it shows that some SSRIs (Fluoxetine and Paroxetine) are actually linked to some birth defects. I think this article shows the importance of evidence based medicine and continued medical education. Thanks to this article, as a future psychiatrist, I am going to keep educating myself about potential risks of SSRIs for pregnant women to help my patients make better decesion about whether to continue taking SSRIs during their pregnancy or not; and if so, which medication to choose.
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Post by Venkateshram Singa on Aug 27, 2015 23:38:06 GMT -4
This is an outrageous article about birth defects with the use of Selective Serotonin Reuptake Inhibitors (SSRI's). According to the article, Zoloft was the most common medication prescribed for mental illness that was used among pregnant women along with Celexa (citalopram) and Lexapro (escitalopram) following behind to Paxil (paroxetine) which cause anencephaly and cardiac defects. Pregnancy is an interesting, exciting, stressful time for the expecting mother and she should not be depressed except for the usual post partum blues but still if she is on these medications that cause birth defects, then those medications should be stopped.
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Post by Daman Pannu on Aug 28, 2015 11:14:08 GMT -4
It’s extremely surprising that women believe that’s its acceptable to take SSRI when pregnant even when studies show an increase in birth defects. It could be due to the insufficient information of risks or many believe they are willing to take the risk. The study looks review literature looking for links between SSRI and birth defects. It found heart and right ventricular outflow tract obstruction cardiac defects and anencephaly association in infants whose mothers used SSRI, especially with fluoxetine or paroxetine. Even though this study looks at associations between SSRI and birth defects, information needs to be provided to expecting mothers so they can make more informed decisions regarding it they wish to switch to a different medication while they are pregnant.
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Post by Deepika Tanwar on Aug 28, 2015 11:29:36 GMT -4
In general, pregnancy is a very stressful time for all parties involved. Once medications are brought in the mix however, it circumstances can change even more quickly. Psychiatric medications can have many side effects even on women who are not pregnant. There are still studies being done about the effect of psychiatric medications on pregnant women and their fetus. SSRIs is the one of the gold standard classes when treating many psychiatric illnesses, especially depression which women can be even more susceptible to during pregnancy. It is understandable to be wary of such drugs, especially during the 1st trimester of pregnancy when the many of fetus major organs are being formed.
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Post by Gaganjit Dillon on Sept 2, 2015 20:23:08 GMT -4
The study was done to examine SSRI use during pregnancy and its associated side effects. Interestingly enough, it was found that sertraline was not shown to be associated with fetal anomalies/ defects such as those found with paroxetine and fluoxetine. This begs to question why the other medications should be used in women of reproductive age in the first place. Furthermore, like the study pointed out itself, there are limitations suggesting the possibility of confounding variables that may have resulted in birth defects: “underlying maternal disease, or some other factor”. Although fair measures were taken to limit bias, it may be important to look further into family and psychosocial history.
Also, it may advantageous to spend time counseling young women, and all women desiring pregnancy at some point about the adverse effects of SSRI treatment; and the time needed to stop medication before becoming pregnant. Unlike stopping alcohol use on the first thought of perhaps being pregnant, I do not feel it is effective enough to stop using antidepressants once pregnancy is confirmed; more time may be needed-precautions are necessary, especially to come up with an effective treatment/plan for a desired pregnancy considering both maternal and fetal well being.
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