(The Center Square) – Doctors on Monday urged the U.S. Food and Drug Administration to issue warnings to pregnant women against the use of certain medications to treat depression, obsessive compulsive disorder and anxiety.
In a panel discussion Monday, doctors across the medical field and officials at the FDA said women taking selective serotonin reuptake inhibitors to treat illnesses like depression can negatively impact the development of a child in the womb.
“SSRIs may be unique because serotonin may have an interaction with the physiology of a woman and a woman who is pregnant,” said FDA director Commissioner Marty Makary. “Serotonin may play a crucial role in the development of organs of a baby in utero, specifically heart, brain and even the gut.”
Several experts on the panel said the FDA does not adequately warn pregnant women about the negative effects of SSRIs on a baby’s development.
Adam Urato, chief of maternal fetal medicine at MetroWest Medical Center in Massachusetts, said there is widespread scientific support for the dangers of SSRIs on the development of a baby in its mother’s womb.
“When a pregnant mom takes an SSRI chemical, that chemical enters the mom, crosses the placenta, goes into the developing brain and has chemical effects,” Urato said.
“Ultrasound studies show SSRI-exposed fetuses have different movement and behavior patterns,” Urato said.
Urato said the newborn babies can experience jitteriness, breathing difficulties and higher rates of admission to the neonatal intensive care unit if their mother used SSRIs.
A 2023 study from the National Institutes of Health partly agreed with Urato, but didn’t directly link a mother’s SSRI intake to long term health outcomes for a child.
Some experts on the panel said SSRIs are still necessary to treat a mother’s depression and prevent a child from inheriting the same illness.
Kay Russos-Ross, a gynecologist at the University of Florida’s women’s health center, said mothers with mental health issues who do not have access to SSRIs face a greater risk than those continuing the medication throughout pregnancy.
Russos-Ross said women who are not treated for mental health conditions during pregnancy risk suicide, overdose and inadequate bonding with children. She said lack of treatment can cause decreased socialization, IQ issues, behavioral disorders like attention deficit hyperactivity disorder and depression in children.
“The risks of untreated mental health conditions are significant and SSRI should be considered as one of the treatment options with shared decision making with our patients,” Russos-Ross said.
A study from the National Institutes of Health found that a mother’s preexisting psychological condition has more of an effect on the child’s outcomes than exposure to SSRIs in the womb.
Regardless of the proposed risks, experts across the panel urged the FDA to implement more warnings for pregnant mothers on SSRIs.
“We should take pride in informing the people who live here, our citizens, about the risks of these medications and we can do a better job,” said Josef Witt-Doerring, a psychiatrist and former FDA medical officer.
“A big part of compassionate care is giving patients the proper information about risks and benefits of treatment and then supporting their choices,” Urato said.
