Pregnancy
Psychiatrists challenge FDA panel on antidepressants in pregnancy

Leading psychiatrists say a US panel promoted false claims about antidepressants in pregnancy, including that they are ineffective and linked to autism or birth defects.
The meeting on Monday featured 10 panellists, several of whom rejected the prevailing medical view on the safety of antidepressants during pregnancy.
They raised concerns about conditions such as autism, miscarriage and birth defects, and in some cases claimed depression resolves without treatment.
Three of the experts were based outside the US, while another runs a clinic that supports people stopping psychiatric medication.
Much of the discussion centred on selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac and Zoloft, which boost serotonin levels in the brain to help improve mood.
Dr Joseph Goldberg is clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.
He said: “They were really rousing concerns about safety that are not evidence-based or established and not at all balanced with concerns about the risks of untreated depression.”
Goldberg, a past president of the American Society of Clinical Psychopharmacology who has previously consulted for pharmaceutical companies, said he was invited to join the FDA panel but declined because the invitation suggested it would not be a fair discussion.
Dr Jennifer Payne, director of the Reproductive Psychiatry Research Programme at the University of Virginia, said: “I’m disappointed that the FDA brought people in from outside of the United States when there’s so many experts here in the United States who truly know this [medical] literature inside and out.”
The general medical consensus is that continuing SSRIs during pregnancy is often safer than stopping, particularly because untreated depression can lead to thoughts of self-harm or low birth weight.
Babies may sometimes show temporary symptoms such as irritability or jitteriness after birth – known as neonatal adaptation syndrome – which typically pass quickly.
While some studies have suggested a slightly higher risk of miscarriage, there is no solid evidence linking SSRIs with autism or birth defects.
“Well-controlled studies continue to not find an association,” said Payne.
Women with a history of depression are also at risk of recurrence during pregnancy, which carries its own potential harms.
One panellist, David Healy – a fellow of the Royal College of Psychiatrists in the UK – claimed: “It’s been said that SSRIs help people who are severely depressed. They don’t.”
Goldberg called that statement “simply untrue”, adding: “You can say the moon landing was faked. Conspiracy theories abound in our world. But there is not a doubt about whether SSRIs work.”
Psychologist Roger McFillin, who hosts a podcast critical of mainstream psychiatry, suggested depression is not an illness but an intense emotional state, particularly in women.
He also claimed, without evidence, that many women are pressured into taking antidepressants during pregnancy.
“I have never, ever, ever, ever heard of a third party pushing a prescription in pregnancy,” Goldberg said.
He added that some obstetrician-gynaecologists unfamiliar with SSRIs have wrongly advised patients to stop taking them.
The American College of Obstetricians and Gynecologists described the panel as “alarmingly unbalanced”.
In a statement, it said: “On a panel of 10 experts, only one spoke to the importance of SSRIs in pregnancy as a critical tool, among others, in preventing the potentially devastating effects of anxiety and depression when left untreated during pregnancy.”
That panellist was Dr Kay Roussos-Ross, a psychiatrist and obstetrician-gynaecologist at the University of Florida College of Medicine, who repeatedly questioned the panel’s conclusions.
“All of us can find a study that agrees with exactly what we think,” Roussos-Ross told the panel.
“But we need to look at the data very objectively.”
An FDA spokesperson defended the panel, saying Commissioner Martin Makary “has an interest in ensuring policies reflect the latest gold standard science and protect public health” and calling criticism of the event “insulting to the independent scientists, clinicians, and researchers who dedicate their expertise to these panels.”
The event followed Health and Human Services Secretary Robert F. Kennedy Jr’s call for a review of antidepressant use.
His “Make America Healthy Again” report warned of “potentially major long-term repercussions” from childhood use of the medications.
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