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Pregnant women and those who might become pregnant should avoid administering the antidepressant Paxil because of a high risk of birth defects, according to a committee of obstetricians who published their opinion yesterday in the December issue of the journal Obstetrics & Gynecology.
The obstetric practice committee of the American College of Obstetricians and Gynecologists said pregnant women should not take Paxil -- a member of a class of antidepressants known as SSRIs because two previous studies found that the medication posed up to double the risk of heart defects in fetuses.
Last year, the U.S. Food and Drug Administration and GlaxoSmithKline which makes Paxil -- changed the precautions on the drug to include the results of the studies. The Food and Drug Administration then advised pregnant women to merely switch from Paxil to another SSRI drug, such as Prozac or Zoloft.
The Food and Drug Administration enhanced warning on Paxil followed the results of a review of Sweden's birth registry that found pregnant women who took Paxil were 1.5 to 2 times more likely to give birth to a baby with cardiovascular defects than women who took other SSRIs or who did not administer the antidepressants at all.
The most common defects caused by antidepressants were holes or other malformations in the four chambers of the heart. Often the defects heal on its own, but more severe cases require surgical procedure. Glaxo said last December that it was investigating how Paxil could be the main cause of the defects.
The obstetricians went a step further than Food and Drug Administration in recommending that women avoid Paxil and reconsider using any SSRI antidepressant during pregnancy. Other physicians claim that the benefits of mothers getting treatment regimen for their depression outweigh the risks to the fetus.
However, consumer health advocate Mike Adams calls the FDA's warning last year and the obstetricians' current opinion "after-the-fact warnings," since Paxil and other SSRIs are still being prescribed to pregnant women, often without warning of the possible harm to unborn children.