SSRI’s & Neural Tube Birth Defects

SSRI antidepressants (selective serotonin reuptake inhibitors) – which include top-selling drugs like Zoloft, Prozac, and Paxil – have been associated with an increased risk, when taken by a mother during pregnancy, for severe and potentially fatal birth defects.

One of the most serious SSRI birth defects risks is that of neural tube defects. Neural tube defects (NTDs) develop during early pregnancy, often before a woman knows she’s pregnant. One of the most well-known NTDs is spina bifida, but SSRI drugs are most often associated with anencephaly, a birth defect that prevents the brain from developing properly. It is fatal in 100% of cases. A 2007 study associated with the Center for Disease Control and Prevention (CDC) showed that taking an SSRI medication increases the risk of anencephaly by 240%.

What are neural tube defects?

Neural tube defects are birth defects that occur early in pregnancy (often before a woman knows she is pregnant) and affect the spine, spinal cord, or brain. In children with neural tube defects, the brain or spinal cord does not develop properly, and thus causes permanent birth defects. The most common risk factors for this type of birth defect is a mother who is obese, who has uncontrolled or poorly controlled diabetes, or who takes certain anti-seizure medications. Studies have also linked certain SSRI antidepressants to the development of neural tube defects.

Types of neural tube defects

The two most common types of neural tube defects are anencephaly and spina bifida. A full list includes:

• Anencephaly: Anencephaly (pronounced an-en-sef-uh-lee) occurs when the upper section of the neural tube does not close completely. Usually, the baby’s forebrain (front section) and cerebrum (thinking and coordination) do not form, and the remaining brain is often exposed. Anencephaly is fatal.
• Spina bifida: This NTD occurs when any section of the neural tube fails to close properly, causing damage to the spine and surrounding nerves. Depending on the size and location of the opening, and the nerve damage, the results range from mild to severe physical and intellectual disabilities.
• Spina bifida occulta: This is the mildest form of spina bifida, sometimes called “hidden” (hence occulta) spina bifida. There is a gap in the spine, but no actual opening or sac. Spina bifida occulta is so mild that it is often not identified until adolescence or adulthood. It does not usually cause any type of disability.
• Meningocele: Meningocele (pronounced ma-nin-jo-seal) is a type of spina bifida in which a fluid sac protrudes through the spinal tube opening. It causes little or minor nerve damage, and therefore results in only mild disabilities.
• Myelomeningocele: Myelomeningocele (pronounced my-low-ma-nin-jo-seal) is the most serious form of spina bifida. It occurs when a fluid sac protrudes through the spinal tube opening, and the sac contains part of the spinal cord and nerves. It causes moderate to severe disabilities.
• Encephalocele: When the neural tube does not close completely, it can cause an opening in the upper part of the skull, or encephalocele (pronounced en-sef-a-lo-seal). The condition can cause developmental delays, seizures, mental and physical retardation, and other serious problems.
• Iniencephaly: This rare NTD also occurs when the neural tube fails to close properly, but results in an extreme backward bending of the head (retroflexion) and a distorted spine. Iniencephaly is fatal in all cases.

SSRIs may cause serious birth defects

Almost since their introduction, SSRI antidepressants have also been associated with a variety of severe and life-threatening side effects. In October 2004, the FDA issued a warning linking Prozac (an SSRI medication) use in children to suicidal thoughts. In 2006, the FDA upgraded the warning to involve young adults up to age 24. In 2007, the FDA required SSRI medications to carry a black-box warning (the most serious) for suicide risk in children.

In 2006, SSRI patients learned that their medications could not only cause serious complications for them, but for their unborn children. That year, the FDA warned the public of SSRI birth defects, specifically persistent pulmonary hypertension of the newborn (PPHN).

In 2007, The New England Journal of Medicine published a study linking SSRI medications to anencephaly, a fatal neural tube defect. The study, which was led by Sura Alwan and members of the Center for Disease Control and Prevention (CDC) examined 9622 cases in which children were born with birth defects, versus 4092 control cases of newborns with no birth defects.

Researchers ultimately found that taking SSRI medications more than doubled the risk of anencephaly, a fatal neural tube defect, as well as other serious birth defects.

Among the study’s conclusions, researchers stated that, “Anencephaly–birth without a forebrain–showed a 2.4 times greater occurrence in women who had taken SSRIs in the first trimester.” In other words, women who take SSRI medications like Prozac or Zoloft during pregnancy have a 240% increased chance of giving birth to babies with anencephaly. The study also found that SSRIs could increase the risk of omphalocele (organs that form outside the body) by 280% and craniosynostosis (malformations of the skull) by 250%.

Popular SSRI linked to neural tube defects

Some of the country’s most popular SSRI medications have been linked to anencephaly, the most common neural tube defect linked to this class of antidepressants. The result is an influx of SSRI lawsuits brought by families looking to recover medical costs and other damages from their children’s injuries. Neural tube defects, and specifically anencephaly, have been cited in litigation involving Celexa, Prozac, Paxil, and Zoloft.

Parents who believe their child has suffered from SSRI birth defects are encouraged to contact a qualified products liability and/or personal injury lawyer to determine their eligibility for filing a Prozac, Paxil, or Zoloft lawsuit.