Antidepressants in Pregnancy Increase Risk of Miscarriage

A new study has found a 68% increase in the overall risk of miscarriage in pregnant women using antidepressants.

Researchers from the University of Montreal (Canada) and the CHU Ste-Justine (Montreal, Canada) examined data on 5,124 women in Quebec (Canada) from a large population-based cohort of pregnant women who had clinically verified miscarriages at up to 20 weeks of gestation, and a large sample of women from the same registry who did not have a miscarriage. Of those who miscarried, 284 (5.5%) had taken antidepressants during pregnancy.

The researchers found that selective serotonin reuptake inhibitors (SSRIs), especially paroxetine and venlafaxine, were associated with increased risk of miscarriage, as were higher daily doses of either antidepressant; a combination of different antidepressants further doubled the risk of miscarriages. The researchers urged physicians who have patients of childbearing age taking antidepressants, or pregnant patients who require antidepressant therapy early in pregnancy, to discuss the risks and benefits with them. The study was published in the June 2010 issue of the Canadian Medical Association Journal (CMAJ).

"These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied,” said senior author Anick Bérard, Ph.D., and colleagues of the faculty of pharmacy at the University of Montreal.

SSRIs are typically used in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating premature ejaculation problems as well as some cases of insomnia. SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor.

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University of Montreal
CHU Ste-Justine