Most SSRIs Free of Birth Defect Risk Early in Pregnancy, Fluoxetine and Paroxetine are Exceptions

August 26, 2015 · Posted in Current Treatments, Risk Factors · Comment 

antidepressants during pregnancy

A large study of women who took selective serotonin reuptake inhibitor (SSRI) antidepressants in the month before pregnancy and throughout the first trimester suggests that there is a smaller risk of birth defects associated with SSRI use than previously thought, though some risks were elevated in women who took paroxetine or fluoxetine.

The 2015 study, by Jennita Reefhuis and colleagues in the journal BMJ, investigated the drugs citalopram, escitalopram, fluoxetine, paroxetine, and sertraline, and examined birth defects that had previously been associated with SSRI use in smaller studies. The participants were 17,952 mothers of infants with birth defects and 9,857 mothers of infants without birth defects who had delivered between 1997 and 2009.

Sertraline was the most commonly used SSRI among the women in the study. None of the birth defects included in the study were associated with sertraline use early in pregnancy. The study found that some birth defects were 2 to 3.5 times more likely to occur in women who had taken fluoxetine or paroxetine early in their pregnancies.

Five different birth defects, while uncommon, were statistically linked to paroxetine use: anencephaly (undersized brain), heart problems including atrial septal defects and right ventricular outflow tract obstruction defects, and defects in the abdominal wall including gastroschisis and omphalocele. Two types of birth defects were associated with fluoxetine use: right ventricular outflow tract obstruction defects and craniosynostosis (premature fusion of the skull bones). Absolute incidence of these defects was also low.

Acupuncture with Paroxetine Better Than Paroxetine Alone

February 26, 2014 · Posted in Current Treatments, Potential Treatments · Comment 
electrical acupuncture

Electrical acupuncture

In a six-week study published by S.S. Qu et al. in the Journal of Psychiatric Research in 2013, participants with depression who received manual or electrical acupuncture along with the selective serotonin reuptake inhibitor (SSRI) antidepressant paroxetine (Paxil) improved more than those participants taking paroxetine alone.

More patients taking paroxetine alone needed increased doses to deal with symptom aggravation.

Patients who had received electrical acupuncture continued to show improvement four weeks after the treatment ended.

Lamotrigine Effective Adjunct for Lithium in Bipolar Disorder

March 7, 2012 · Posted in Peer-Reviewed Published Data · Comment 

lamotrigineIn a long-term study of bipolar patients taking lithium published in Bipolar Disorders last year, the addition of lamotrigine (or paroxetine for those who did not respond to lamotrigine) was significantly better than the addition of placebo.  Patients taking lamotrigine with lithium averaged 10 months until a recurrence of a depressive or manic episode, while patients taking placebo with lithium averaged 3.5 months until an episode.