Antidepressants Increase Hypertension Risks

Selective serotonin reuptake inhibitors increase the risk of pulmonary hypertension two fold

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Several research teams have focused on the effects of antidepressants taken while pregnant. A new study suggests medications taken during pregnancy may increase the risk of a pulmonary disease in newborns.

An investigation into the use of a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) during pregnancy suggests the use of SSRIs significantly increases the risk of high blood pressure in the lungs for newborns.

"Ask your OB/GYN about antidepressant use duriing pregnancy."

“The risk of persistent pulmonary hypertension of the newborn is low, but use of SSRIs in late pregnancy increases that risk more than twofold,” notes corresponding author Helle Kieler, M.D., Ph.D., and associate professor in obstetrics and gynecology in Sweden.

Dr. Kieler and a team of ten researchers sorted through data from 1.6 million infants born between 1996 and 2007. Working with the research of women and children living in Nordic countries, the data was gathered through state birth registrars.

Information on maternal characteristics, prenatal issues, delivery, as well as the neonatal period was available to investigators for analysis.

Registrars used the International Classification of Diseases to record complications, and all prescription records included information on the date and composition of all prescriptions for both the mother and child.

Findings showed that of the 11,014 newborns whose mothers took SSRIs in late pregnancy, there were 33 with persistent pulmonary hypertension, three of which had meconium aspiration.

According to the National Institute of Health, meconium aspiration syndrome occurs when a newborn breathes a mixture of amniotic fluid and their own feces into their lungs during delivery, causing breathing issues and bluish skin tone. In excluding newborns with these issues, the presumed risks of pulmonary hypertension increased within the study.

Furthermore, the research reports different risks associated with different antidepressants. “For fluoxetine, citalopram, sertraline, and paroxetine the risk estimates ranged from two to three [percent]. The risk estimate for escitalopram was lower, but imprecise,” Dr. Kieler notes. “No infants with persistent pulmonary hypertension of the newborn had been exposed to fluvoxamine.”

Harvard Medical School explains that antidepressant usage by pregnant women used to be considered safe until 2005.

At that time, the FDA sent out warnings regarding the SSRI paroxetine (Paxil), citing an increased risk of birth defects associated with usage during the first trimester.

Since then, paroxetine has been linked to “transient withdrawal symptoms” within the newborn when a mother takes the drug shortly before birth.

The publication further identifies the risk of cardiac malformations in newborns associated with SSRI usage, supporting the results from the study.  

Nonetheless, the risks of continued depression can outweigh minute risks of newborn defect, and the choice to sustain antidepressant usage while pregnant should be made with the insight of a medical healthcare provider.  

The study was published in the British Medical Journal.

Reviewed by: 
Review Date: 
January 14, 2012
Last Updated:
January 19, 2012