roman bystrianyk

http://www.healthsentinel.com/news.p...st_item&id=592

Amanda Gardner, "Use of Antidepressants While Pregnant Can Affect
Baby", Forbes, February 3, 2005,
Link:
http://www.forbes.com/lifestyle/heal...out523808.html

Women who take antidepressants like Paxil or Prozac while pregnant may
have babies who experience withdrawal syndrome in the first few days of
life, a new study finds.

Spanish scientists, using a worldwide drug alert system, found a
higher-than-expected incidence of neonatal withdrawal syndrome,
consisting of convulsions, irritability, abnormal crying and tremors,
among babies of women who took selective serotonin reuptake inhibitors
(SSRIs), the class of drugs that includes Paxil and Prozac.

Their report, which is published in the Feb. 5 issue of The Lancet,
found the association seemed to be highest among women who used Paxil.

"There is an association in some cases, not in every single case," said
Dr. Emilio Sanz, the lead author of the paper and a clinical
pharmacology professor at the University of La Laguna School of
Medicine in Tenerife. "If you have a pregnant woman that is depressed
and is treated with anti-depressants, you should use the lowest
effective dose or psychotherapy or other approaches if you can."

"Doctors should be more careful in prescribing SSRIs, especially
paroxetine [Paxil] during pregnancy," added Dr. Vladislav Ruchkin, an
associate research scientist at Yale University School of Medicine and
the author of an accompanying editorial in the journal.

SSRIs, which first hit the market in 1988, are widely used to treat
depression, anxiety and other mood and behavioral disorders in adults
as well as children. But the drugs have been the subject of much recent
controversy.

Reports last year of suicidal thinking in adolescents who use them led
to a U.S. Food and Drug Administration review of clinical trials of
antidepressants, which confirmed the association. That, in turn, led to
the FDA's ordering a "black box" warning on the labels.

There has also been concern that SSRIs triggers manic behavior in 10 to
14 year olds, although a study released just this week found that the
benefits of antidepressants appeared to outweigh the risk of suicide.

Several smaller studies, however, have already shown an increased risk
of complications for pregnant women taking SSRIs.

For this latest research, investigators screened an international drug
surveillance system maintained by the World Health Organization (WHO).
The database contains three million records from 72 countries dating
back to 1968. A signaling system sends alerts when there are more cases
than there should be.

The investigators found a total of 93 cases of neonatal convulsions or
withdrawal syndrome associated with SSRI use. About two thirds of the
cases (64) were associated with Paxil, 14 with Prozac, nine with Zoloft
and seven with Celexa, they said.

The database had incomplete information on dosage and duration of
treatment and also doesn't include information on how many people were
or are using these drugs.

Although those babies who experienced withdrawal syndrome appear to
recover within a short period of time, Ruchkin is concerned that there
may be a developmental impact on the infant brain, a subject on which
there is little research.

"A number of studies suggest that SSRIs may have a long-term impact on
the child's brain," he said, adding, however, that most such studies
have been done with mice and that human studies need to be done.

For the moment, there is no clear guidance other than to exercise
caution, Sanz said, with doctors assessing the severity of each woman's
case before prescribing antidepressants.

anne rogers

Do you have any information as to if breastfeeding helps reduce the
withdrawral effect?

Thanks

Anne

roman bystrianyk

I am sorry I checked my files and I do not have any information in this
regard. I do have many articles on breastfeeding, but none that
address this issue. I imagine someone has done some research in this
area as well as what medications may be excreted through the breast
milk. Good luck on your search.

the amount of SSRIs excreted into the milk is very small- but it may be
possible that it is larger in colostrum. Even if breastfeeding
*didn't* help the withdrawal symptoms themselves, a bottle fed baby
is more stressed while feeding than a breastfed baby. A baby in arms,
especially skin-to-skin is a calm baby, and of course it's easy to do
that whilst breastfeeding.

bottle feeding formula has been repeatedly shown to be a risky
activity- breastfeeding while taking SSRI's has not been shown to be
risky. You really don't know what is in artificial baby milks, and
what is missing.

so be safe and encourage breastfeeding-

It's also generally safer to not use medications if possible and try
very hard to avoid them during the first trimester.

Kate, mom to Ursula (10), Sage (7.5) and Benno (4!)
http://systems.cs.colorado.edu/~koli...f-formula.html

Self-respect is the fruit of discipline; the sense of dignity grows
with the ability to say no to oneself. ~Rabbi Abraham Heschel

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