Antidepressants Causing Birth
Defects and Are Found in Water Supplies
July 23, 2015
Story at-a-glance
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Use of selective serotonin reuptake inhibitors (SSRIs)
during the first trimester of pregnancy was associated with
an increased risk of birth defects
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Paxil and Prozac use were linked to heart defects,
anencephaly, and craniosynostosis (abnormal skull shape)
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Antidepressants and other pharmaceuticals are routinely
detected in water supplies, which means you could
potentially be exposed to low levels via your drinking water
By Dr. Mercola
It’s estimated that 14 percent of US pregnant women use
antidepressants,1
and it’s often suggested to be safe to do so. New research,
however, adds to the growing number of studies showing such
drugs may harm your unborn baby while offering little benefits
to mom.
The new study, published in BMJ, specifically looked
at the effects of selective serotonin reuptake inhibitors
(SSRIs) used during the first trimester of pregnancy and in the
month before.
They analyzed data from nearly 30,000 women and revealed the
use of the antidepressant Paxil (paroxetine) was associated with
an increased risk of five birth defects, including heart
defects, and anencephaly, which is abnormal brain and skull
formation.2
The use of Prozac (fluoxetine) was associated with two birth
defects, including heart wall defects and abnormal skull shape
(craniosynostosis).
The increase in absolute risk was low; for instance, 10 out of
10,000 women may give birth to a baby with a heart defect but
this increased to 24 out of 10,000 among those using Paxil.3
Still, some birth defects occurred two to three times more
often in babies born women taking the drugs, and when the
increased risk is combined with the many other studies showing
harm, and few showing benefit, it poses a serious concern.
Tinkering with Serotonin in Utero Might Be Dangerous
The US Food and Drug Administration (FDA) first published a
warning about the association between Paxil and heart defects in
infants exposed in utero in 2005.4
In 2009, research again confirmed the SSRIs increase the risk of
congenital heart defects when used in early pregnancy.5
Other reports have linked SSRIs to long-term developmental
effects, both of which make logical sense when you consider
SSRIs’ mode of action. The drugs work by blocking reuptake of
serotonin, thereby altering levels of this neurotransmitter in
pregnant women.
The drugs are also known to cross the placental barrier and
reach the fetus. Dr. Adam Urato, a maternal-fetal medicine
specialist at Tufts Medical Center, explained to The
New York Times:6
“Serotonin is a critical neurotransmitter and
cell-signaling molecule… From the brain, it signals the
neurons where to go, what to do, and how to develop.
It signals the heart; it plays an active role in the gut;
and it plays an important role in the formation of the
lungs. What it does during development is basically
everything.”
SSRIs Linked to Long-Term Developmental Effects, Heart Problems
Tinkering with serotonin levels in utero may have serious
repercussions. To date, the drugs have been linked to a rash of
serious side effects, including the following:
- Boys with autism were three times more likely to have
been exposed to SSRIs before birth than boys without autism7
- Children born to women who took antidepressants during
pregnancy were nearly twice as likely to develop
attention-deficit hyperactivity disorder (ADHD)8
- Prolonged use of SSRIs during pregnancy was associated
with lower language competence at the age of 39
- Women using antidepressants during the second and third
trimesters are more likely to give birth prematurely10
- Babies exposed to SSRIs in utero have an increased risk
of clubfoot, low birth weight and persistent pulmonary
hypertension11
There’s even research showing babies exposed prenatally to
SSRIs had lower Apgar scores at birth, which is a measure of
newborn well-being.12
It’s also thought the drugs disrupt fetal deep sleep, which is
crucial for normal growth and development.
They’ve also been linked to an increased risk of miscarriage,13
and many babies exposed in utero even display withdrawal
symptoms to SSRIs at birth.
Do SSRIs Help Pregnant Women with Depression?
There’s no doubt that
depression, whether it occurs during pregnancy or otherwise,
is a serious issue that needs treatment. But whether
antidepressants are the best treatment is easily debatable.
As Barbara Mintzes, an associate professor at the University
of British Columbia School of Population and Public Health,
pointed out in The New York Times, the drugs
often appear to cause far more harm than good:14
“If antidepressants made such a big difference, and
women on them were eating better, sleeping better, and
taking better care of themselves, then one would expect to
see better birth outcomes among the women who took
medication than among similar women who did not…
What’s striking is that there’s no research evidence
showing that… when you look for it, all you find are harms.”
Likewise, a study in the January 2010 issue of JAMA
concluded there is little evidence that SSRIs have any benefit
to people with mild to moderate depression (the group to which
they’re most often prescribed), and they work no better than a
placebo.15
Those researchers concluded:
“The magnitude of benefit of antidepressant
medication compared with placebo increases with severity of
depression symptoms and may be minimal or nonexistent, on
average, in patients with mild or moderate symptoms.”
A meta-analysis published in PLoS Medicine also
concluded that the difference between antidepressants and
placebo pills is very small — and that both are ineffective for
most depressed patients.16
Only the most severely depressed showed any response to
antidepressants at all, and that response was quite minimal.
Antidepressants Might Promote Relapses into Depression
Meanwhile, in
an interview, Pulitzer Prize nominee Robert Whitaker also
explained that research suggests the use of antidepressant drugs
may actually result in more relapses back into depression in the
long run. In other words, these drugs may be turning depression
into a more chronic condition.
According to Whitaker’s research, this tendency to sensitize
your brain to long-term depression appears to be the same both
for the earlier tricyclic antidepressants and the newer SSRIs.
Another famous psycho pharmacologist named Ross Baldessarini
at the Harvard Medical School also began asking whether or not
these drugs may in fact be depressogenic (causing depression).
Unfortunately, the evidence points that way, and the long-term
prognosis when taking antidepressants is quite bleak, as this
type of drug treatment has a whopping 85 percent chronic relapse
rate.
Making matters worse, if you do not have low serotonin levels
when you’re depressed, but you start taking an SSRI drug that
blocks the normal reuptake of serotonin, you end up with the
very physiological problem the drug is designed to treat low
serotonin levels.
Which, ironically, is the state hypothesized to bring on
depression in the first place. In 1996, neuroscientist Steven
Hyman, who was head of the National Institute of Mental Health
(NIMH) at the time, published the paper “Initiation and
Adaptation: A Paradigm for Understanding Psychotropic Drugs,”17
in which he explains this chain of events.
According to Dr. Hyman, once your brain has undergone these
compensatory adaptations to the drug, your brain operates in a
manner that is “both qualitatively and quantitatively different
than normal.” As Whitaker explained, antidepressants are not
actually “normalizing” agents but could be more aptly described
as “abnormalizing” agents.
Antidepressants Are Found in Water Supplies
If you’re considering taking an antidepressant while you’re
pregnant, you should discuss it carefully with your holistic
physician. However, even pregnant women not directly
using such drugs may be exposed via another route – their
drinking water.
In an analysis of marine water from 30 sites in Australia,
significant levels of painkillers and antidepressants were
detected.18
It’s thought that sewage water may be leaking into storm water
pipes and contaminating the water. Other chemicals of concern
were also detected, including beta blockers, an epilepsy
medication, and pesticides.
Although the levels detected were generally low, it’s unknown
what health effects such exposures will have on the general
population, especially one that’s particularly vulnerable, such
as pregnant women. Your best protection at this point is to
install a high-quality water filter in your home (at both your
tap and your shower/bath) to minimize your exposure to
pharmaceuticals and other contaminants in your drinking water.
Most Medications Are Not Tested for Safety During Pregnancy
It’s not only antidepressants that deserve careful
consideration before use if you’re pregnant. The truth is you
need to be very careful when taking any drugs during
this time. The nine months of development that take place in the
womb are the most rapid and most vulnerable period of your
baby's life. For this reason, it is generally best to avoid
taking any medications unless absolutely necessary, including
while you're trying to conceive, as you could become pregnant
and not know it.
Most medications have never been tested on pregnant women and
their effects on a developing baby are completely unknown. Even
the U.S. Centers for Disease Control and Prevention (CDC)
acknowledges that very little is known about the impacts of most
medications on unborn babies:19
"We do not have enough information about the effects
of many medications when they are taken by pregnant women…
All prescription and over-the-counter medications are tested
to see if they are safe and effective before they become
available to the public.
Pregnant women usually are not included in these tests
because of the possible risks to the unborn baby.
As a result, little information is available about the
safety of most medications during pregnancy — including
those available over the counter — when they first become
available."
Even presumably “safe” medications like
acetaminophen (Tylenol) can be risky. For instance,
acetaminophen use during pregnancy was linked to a 30 percent
increased risk for ADHD in the child, and a 37 percent increased
risk of hyperkinetic disorder (HKD), a severe form of ADHD.20
If You’re Pregnant and Depressed, What Options Do You Have?
If you are experiencing severe depression and you’re
pregnant, please seek help from a professional. For milder
depression, and in addition to professional treatment for severe
depression, the place to start is to return balance —
to your body and your life. Fortunately, research confirms that
there are safe and effective ways to address depression
that do not involve unsafe drugs. This includes
addressing your gut health and more, as described below:
- Dramatically decrease your consumption of sugar
(particularly fructose), grains, and processed foods. (In
addition to being high in sugar and grains, processed foods
also contain a variety of additives that can affect your
brain function and mental state, especially MSG and
artificial sweeteners such as aspartame.) There's a great
book on this subject,
The Sugar Blues, written by William Dufty more
than 30 years ago, that delves into the topic of sugar and
mental health in great detail.
- Increase consumption of probiotic foods, such as
fermented vegetables, to promote healthy gut flora.
Mounting evidence shows that having a healthy gut is
profoundly important for both physical and mental health,
and the latter can be severely impacted by an imbalance of
intestinal bacteria. Avoiding sugar will also help
toward this end.
This is especially important during pregnancy, because if
mother's flora is abnormal, her baby's flora will
also be abnormal. Whatever organisms live in her vagina end
up coating her baby's body and lining his or her intestinal
tract.
- Get adequate vitamin B12.
Vitamin B12 deficiency can contribute to depression and
affects one in four people.
- Optimize your
vitamin D levels, ideally through regular sun exposure.
Vitamin D is very important for your mood. In one study,
people with the lowest levels of
vitamin D were found to be 11 times more prone to be
depressed than those who had normal levels.21
The best way to get vitamin D is through exposure to
sunshine. Optimizing your vitamin D levels is also
essential during pregnancy.
- Get plenty of animal-based
omega-3 fats. Many people don't realize that their brain
is 60 percent fat, but not just any fat. It is DHA, an
animal-based omega-3 fat, which, along with EPA, is crucial
for good brain function and mental health.22
Unfortunately, most people don't get enough from diet alone.
Make sure you take a
high-quality omega-3 fat, such as krill oil, or consume
sardines or anchovies regularly.
Dr. Stoll, a Harvard psychiatrist, was one of the early
leaders in compiling the evidence supporting the use of
animal based omega-3 fats for the treatment of depression.
He wrote an excellent book that details his experience in
this area called The Omega-3 Connection. Here
again, consuming adequate levels of omega-3 fats will also
promote
better pregnancy outcomes.
- Evaluate your salt intake. Sodium deficiency actually
creates symptoms that are very much like those of
depression. Make sure you do NOT use processed salt (regular
table salt), however. You'll want to use an all-natural,
unprocessed salt like Himalayan salt, which contains more
than 80 different micronutrients.
- Get adequate daily
exercise, which is one of the most effective strategies
for preventing and overcoming depression. Studies on
exercise as a treatment for depression have shown there is a
strong correlation between improved mood and aerobic
capacity. So there's a growing acceptance that the mind-body
connection is very real, and that maintaining good physical
health can significantly lower your risk of developing
depression in the first place.
- Get adequate amounts of sleep. You can have the best
diet and exercise program possible, but if you aren't
sleeping well you can easily become depressed. Sleep and
depression are so intimately linked that a sleep disorder is
actually part of the definition of the symptom complex that
gives the label depression.
© Copyright 1997-2015 Dr. Joseph Mercola. All Rights Reserved.
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