Are pregnant women being told the truth about antidepressants?
Antidepressant use in pregnancy is increasing, yet few women are warned of the harms. When experts raised the alarm at an FDA panel, the backlash was fierce. So what are women not being told?
Across the world, thousands of pregnant women are being prescribed antidepressants. Yet few are warned about the potential harms to their unborn babies.
That concern came to the forefront at a 2-hour expert panel convened last month by the US Food and Drug Administration (FDA), moderated by Dr Tracy Beth Høeg, the agency’s senior adviser for clinical sciences.
A lineup of doctors, scientists, and former regulators gathered to examine a thorny question: do selective serotonin reuptake inhibitors (SSRIs) cause more harm than good when used during pregnancy?
Their opinions were not unanimous, but all agreed on one striking fact—there are no “gold-standard” randomised trials that have addressed the issue.
Instead of sparking serious debate, the panel was savaged by the media. The ferocity of the reaction only highlighted how difficult it has become to speak honestly when the message challenges psychiatric drugs.
A long overdue discussion
FDA Commissioner Dr Marty Makary opened the session with a stark warning. “We’re losing the broader battle of addressing mental health in the United States,” he said. “The more antidepressants we prescribe, the more depression there is.”
He cautioned that serotonin plays a crucial role in foetal development and warned that SSRIs have been “implicated in postpartum haemorrhage, pulmonary hypertension, cognitive downstream effects in the baby, as well as cardiac birth defects.”