Antidepressant in Pregnancy Not a Great IdeaUsing the antidepressant Paxil late in pregnancy seems to be associated with a higher rate of complications in the newborn, but the findings do not mean women should not take the drug.
In a new study, Paxil did not increase the risk of birth defects when taken during any trimester. However, 12 infants born to 55 women who took the drug late in pregnancy had complications that required prolonged hospitalization. Nine of the babies had respiratory distress, two had hypoglycemia (abnormally low blood sugar) and one had jaundice -- a yellowing of the skin due to reduced liver function.
Paxil is a newer type of antidepressant known as a selective serotonin-reuptake inhibitor (SSRI), and is known to cause a "discontinuation" syndrome in adults -- a type of withdrawal. There had been case reports of a similar syndrome in infants born to mothers who have taken the drug during pregnancy.
Motherisk counsels physicians and women about the safety of medications during pregnancy, largely based on a huge database of its own safety studies.
In this study researchers compared outcomes for infants exposed to Paxil during the third trimester of pregnancy, to 27 babies exposed only during the first or second trimester, and to 27 infants whose mothers took other types of medication during pregnancy. Only three babies of the women who used Paxil during the first or second trimester or who used other medications ended up having complications.
The higher rate of complications in infants exposed to Paxil late in gestation suggests they may have been experiencing discontinuation syndrome.
Pediatric Academic Societies Meeting Baltimore, MD May 7, 2002
New England Journal of Medicine April 11, 2002;346(15):1175-6
http://www.ncbi.nlm.nih.gov/pubmed/11948284?dopt=AbstractDrugs 2002;62(5):757-73
http://www.ncbi.nlm.nih.gov/pubmed/11929330?dopt=Abstract
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