danielle gansky

It's clear that SSRIs are linked to pregnancy complications & alteration of the developing fetal brain. However, some argue SSRI drug labels shouldn't warn about this because of the risks of untreated depression. This argument has at least 3 flaws: 1. An accurate warning on the drug label is not a call for pregnant women to be ignored or untreated. There are many ways to treat depression, including meds & non-drug options. It's up to the patient to decide how she is going to approach her mental health. 2. Many health conditions have risks, but the drug labels still need to properly warn about the risks of the drugs themselves. For example, untreated cancer carries risks but chemotherapy agents still have proper warnings on their labels. In fact, a major function of the drug label is to communicate safety risks. Risk of an untreated medical condition doesn't eliminate the need for proper warnings on the drug itself. 3. If a woman discontinues her SSRI, there are 2 outcome categories to consider (see box below): Re: maternal psychiatric complications, results are mixed. There is some evidence that SSRI discontinuers have worse outcomes. Other studies do not show this. Re: pregnancy outcomes, studies consistently show that discontinuers have BETTER pregnancy outcomes. For example, there are lower rates of preterm birth & low birth weight in the women who stop their SSRI.

SSRIs can cause severe withdrawal symptoms. Almost no one is tapering them correctly. While the meds themselves cause issues, it is the withdrawal that can trigger outbursts, creating false justification for staying on, or, worse, giving the doc reason to consider polypharmacy.