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Doctors urge new guidelines for pregnant women using anti-depressants

From Jennifer Pifer

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ATLANTA, Georgia (CNN) -- -- A leading group of women's doctors called Wednesday for closer consultations with pregnant women using anti-depressants, particularly singling out one of the medicines -- paroxetine or Paxil -- as a risk for birth defects.

In a statement released Wednesday, The American College of Obstetricians and Gynecologists said doctors and expectant mothers together need to weigh the risks and benefits of using selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors during pregnancy.

The group also advised that paroxetine, known by the brand name Paxil, be avoided by pregnant women when possible because of a potential risk of birth defects. It also recommended that women who used Paxil during the first few months of pregnancy undergo a fetal echocardiography to monitor the fetus' heart development. (Watch the story one one toddlers heart defect. )

The recommendation follows a public health advisory released last year by the Food and Drug Administration after two studies showed that women who took Paxil during the first trimester were about one and a half to two times as likely to have a baby with a heart defect as women who received other antidepressants or women in the general population.

At the FDA's request, GlaxoSmithKline, the makers of Paxil, changed its labeling in September 2005 to warn about the risk of birth defects.

At least three lawsuits have been filed against GlaxoSmithKline in relation to Paxil use and birth defects. In one of them, Anthony and Matilda Vasquez of Bedford, Texas, filed suit against in July alleging their 2 1/2 -year-old son Adrian's heart defect is the result of Paxil that the mother took while pregnant. Adrian has undergone three open heart surgeries since birth and has a pacemaker.

But ACOG also stressed that treatment with all antidepressants during pregnancy should be based on the individual needs of the expectant mother. It said discussions about treating depression should include the expertise of mental health experts and obstetricians along with the personal history of the expectant mother.

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