December 5, 2008 — Fluoxetine and paroxetine, 2 of the most commonly used selective serotonin reuptake inhibitors (SSRIs), have been linked to an increased risk for congenital cardiac abnormalities in the offspring of women who took these medications in early pregnancy, new research suggests.
However, say investigators, the findings do not warrant cessation of antidepressant therapy with these agents in this patient population.
"We did find an increased risk of cardiac anomalies, but the vast majority were not severe, and most were treatable, so we do not recommend women stop their treatment," principal investigator Asher Ornoy, MD, from Israeli Teratology Information Service, in Jerusalem, Israel, told Medscape Psychiatry.
Of much greater concern, said Dr. Ornoy, is the finding that smoking while taking either of these agents has a synergistic effect. The researchers found women taking these medications who smoked more than 10 cigarettes per day while pregnant had a significantly increased risk of giving birth to a child with a major cardiac malformation.
"Pregnant women who take these medications and who smoke should stop smoking immediately," said Dr. Ornoy.
The study is published in the November issue of the British Journal of Clinical Pharmacology.