Use of common antidepressant drug paroxetine may lead to increased risk of birth defects

The use of the antidepressant drug called paroxetine in early pregnancy has been found to potentially increase the risk of congenital and cardiac malformations in newborns. Paroxetine is commonly used to treat depression, obsessive-compulsive disorder, anxiety and posttraumatic stress disorder.

Pregnant women are at risk of experiencing depressive symptoms that could lead to mild to moderate depression. Paroxetine, a selective serotonin reuptake inhibitor, is considered safe for use during pregnancy and one of the most common drugs for treating depression.

However, a new study, published in the British Journal of Clinical Pharmacology, found that the use of the drug during the first trimester of pregnancy has been linked to the increased risk of birth defects. With the use of paroxetine, the risk of any major congenital malformations in newborns has increased to 23 percent, and the risk of major cardiac malformations increased to 28 percent.

The findings come from the analysis of 23 studies published from 1966 to 2015. Researchers assessed the effects of paroxetine on newborns.

The team said that the baseline risk of major malformations is 3 percent and 1 percent for cardiac malformations. Despite the low level of risk, they noted that any increase in risk is significant.

"Given that the benefits of antidepressants overall, and selective serotonin reuptake inhibitors including paroxetine specifically, during pregnancy is questionable at best, any increase in risk--small or large--is too high," said lead researcher Professor Anick Bérard, PhD, of CHU Sainte-Justine and the University of Montreal.

Bérard said that women with mild to moderately depressive symptoms should stop using the treatments. He added that it is important to have pregnancy plans and treatment options like psychotherapy or exercise regimens, which could serve as an alternative to the antidepressant drug.