Medical experts are concerned that a July Food and Drug Administration panel discussion could lead to more cases of untreated depression and anxiety in pregnancy. During the discussion, panel members expressed concern about selective serotonin reuptake inhibitors (SSRIs), such as Zoloft, and linked the drugs to increased risks of miscarriage, birth defects, and autism in exposed children. However, the American College of Obstetricians and Gynecologists called these claims “outlandish and unfounded,” and the Society for Maternal-Fetal Medicine said its members were “alarmed by the unsubstantiated and inaccurate claims made by FDA panelists.”
Treatment Gap and Evidence
An estimated 20% of women in the U.S. experience depression or anxiety during or after pregnancy, yet only half receive adequate treatment. Just 5% take an SSRI, according to Kay Roussos-Ross, who runs the perinatal mood disorders program at the University of Florida. SSRIs are “probably the most well-studied medicine in pregnancy,” said Christena Raines, a nurse practitioner who in 2011 helped found the nation’s first inpatient perinatal psychiatric unit in North Carolina. In long-term studies of children exposed to the drugs in utero, researchers have not observed problems.
Kay Roussos-Ross, the sole panelist who was both a board-certified psychiatrist and an OB-GYN, noted: “Research shows that in women who stop their medications in pregnancy, they are five times more likely to experience a relapse.” Mothers with moderate to severe depression and anxiety during pregnancy are more likely to give birth early and have low-birth-weight infants. Without treatment, they face increased risk of suicide, substance misuse, and difficulty bonding with babies. Their children are at higher risk for ADHD, depression, or anxiety due to untreated maternal mental illness, not SSRIs. Mental health and suicide and overdoses are the leading causes of maternal death in the country, according to ACOG President Steven Fleischman.
Deepening Disparities
The issue is especially urgent for Black and Latina mothers, who experience higher rates of depression and anxiety than white, non-Latina mothers but are less likely to receive adequate treatment. Many factors contribute to this disparity, including systemic racism, exposure to violence, misdiagnosis, and lack of access to care. Shanna Williams, a perinatal mental health therapist treating African American mothers in Philadelphia, said many clients were already likely to distrust their doctors about antidepressant safety during pregnancy, and the FDA panel adds another discouraging voice.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.ourmidland.com/news/article/fda-panelists-questioned-antidepressants-21259427.php