New research finds SSRIs cross the placenta, exposing fetuses to risky chemicals without mothers' informed consent. Alternatives exist with no evidence of harm

A recent pilot study published in The International Journal of Neuropsychopharmacology indicates that common antidepressant drugs known as SSRIs (selective serotonin reuptake inhibitors) have the ability to cross the placental barrier, entering the fetal bloodstream.¹ Previous research also suggests these compounds cross the blood-brain barrier and bioaccumulate in fetal tissue.^2,3

The study tested SSRI concentrations in cord blood samples from 15 neonates born to medicated mothers. Measurable levels of paroxetine, sertraline, and venlafaxine were found in 13 infants' samples.¹ Maternal and fetal drug concentrations were similar in most cases.

These findings raise significant concerns about understudied toxicity risks of prenatal SSRI exposure during complex developmental processes. Though SSRIs aim to increase serotonin availability in the brain, research remains inconclusive on whether chemical imbalances of neurotransmitters definitively cause depression or explain the mechanism of these drugs.^4,5 This is sometimes called the "serotonin-" or "monoamine hypothesis" and has been heavily criticized by alternative psychiatrists in the past. Meanwhile, it the medical community is beginning to recognize that artificially altering fetal serotonin levels with novel, synthetic chemical compounds could adversely impact cell proliferation, differentiation, synaptogenesis, and myelination.⁶

Studies have already associated prenatal SSRI exposure with increased risks of major malformations,⁷ persistent pulmonary hypertension,⁸ autism spectrum disorders,⁹ and long-term neurobehavioral disturbances.¹⁰ However, due to limitations around proving toxicity in human subjects and the resistance that conventional medical journals have to publishing information that is contrary to promoting pharmaceutical drugs, authors posit that "conclusions remain speculative."¹¹ Still, concerning evidence like the kind featured in this latest study reveals the growing need for caution in prescribing these aggressively marketed medications.

Adding to the problem, pregnant women prescribed antidepressants rarely receive full information enabling informed consent about drug exposure risks for the fetus.¹² Respecting patient autonomy requires thorough disclosure about what is known and still unknown to allow informed decisions about prenatal treatments. 

Evidence-Based Alternatives to Antidepressants

Rather than expose fetuses to understudied SSRIs, research shows many non-pharmacological therapies effectively treat depression with little to no side effects. These include nutrition plans high in omega-3s, B vitamins, selenium; exercise regimens; mind-body practices like yoga, mindfulness, meditation; natural supplements; and light therapy, to name a few.¹³ For example, a meta-analysis of over 1500 human trials found saffron as effective as fluoxetine without adverse reactions.¹⁴

To learn more on natural antidepressive approaches, visit the extensive Greenmedinfo.com database on the subject covering 1500 studies and 300 natural substances here. 

References

1. Rampono, J., Proud, S., Hackett, L.P., Kristensen, J.H., & Ilett, K.F. (2004). A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. The International Journal of Neuropsychopharmacology, 7(3), 329-334.

2. Casper, R.C., Fleisher, B.E., Lee-Ancajas, J.C., Gilles, A., Gaylor, E., DeBattista, A., & Hoyme, H.E. (2003). Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. Journal of Pediatrics, 142(4), 402-408.

3. Hendrick, V., Stowe, Z.N., Altshuler, L.L., Hwang, S., Lee, E., & Haynes, D. (2003). Placental passage of antidepressant medications. American Journal of Psychiatry, 160(5), 993-996.

4. Markowitz, J.C., & Cuellar, A.K. (2007). Antidepressants and youth: harmful or helpful? Journal of Child Psychology and Psychiatry, 48(5), 426-437.

5. Valenstein, E.S. (1998). Blaming the Brain: The Truth About Drugs and Mental Health. Free Press.

6. Hansen, H.H., Sánchez, C., & Meier, E. (2015). Neonatal exposure to antidepressants and the neurodevelopmental effects. Translational Developmental Psychiatry, 3(1), 28783. 

7. Figueroa R. (2010). Use of antidepressants during pregnancy and risk of major congenital malformations in newborns. Medicina Clinica (English Edition), 134(10), 455-459. 

8. Källén, B., & Olausson, P.O. (2008). Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiology and Drug Safety, 17(8), 801-806. 

9. Croen, L.A., Grether, J.K., Yoshida, C.K., Odouli, R., & Hendrick, V. (2011). Antidepressant use during pregnancy and childhood autism spectrum disorders. Archives of General Psychiatry, 68(11), 1104-1112. 

10. Casper, R.C., Gilles, A.A., Fleisher, B.E., Baran, J., Enns, G., & Lazzeroni, L.C. (2011). Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal symptoms. Journal of Affective Disorders, 129(1-3), 211-215. 

11. Gentile, S., & Galbally, M. (2011). Prenatal exposure to antidepressant medications and neurodevelopmental outcomes: a systematic review. Journal of Affective Disorders, 128(1-2), 1-9.

12. McCormick, M.C., Uddin, S.G., Gusmano, R., & Gonzalez-Pier, E. (2006). Ethical principles and decisions in obstetrics and gynecology. Jones & Bartlett Learning.

13. Greenmedinfo.com. (n.d.). Depression Treatment Abstracts on Natural Substances. Retrieved from https://greenmedinfo.com/disease/depression?study_types=5032

14. Hausenblas, H.A., Heekin, K., Mutchie, H.L., & Anton, S. (2015). A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes. Journal of Integrative Medicine, 13(4), 231-240.