Antidepressant – Celexa Birth Defects, SSRI Drug Class

Celexa is in a class of antidepressants called selective serotonin reuptake inhibitors or SSRI.

The Celexa website advises: It is recommended that women not take Celexa if they are pregnant or plan to become pregnant. It is not known if Celexa will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy.

Celexa falls into Pregnancy Category C drug rating. This means in animal reproduction studies, Celexa has been shown to have adverse effects on embryo/fetal and postnatal development, including teratogenic effects, when administered at doses greater than human therapeutic doses. Teratogenic means a drug that disturbs the development of the fetus or embryo.

There are no adequate and well-controlled studies in pregnant women as this kind of study would be unethical. Therefore in regard to the potential of birth defects, Celexa should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

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Neonates exposed to Celexa and other SSRIs late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can happen immediately upon delivery.

Reported clinical findings have demonstrated respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These features are consistent with either a direct toxic effect of SSRIs or, possibly, a drug discontinuation syndrome. It should be noted that, in some cases, the clinical picture is consistent with serotonin syndrome

Infants exposed to SSRIs in late pregnancy may have an increased risk for persistent pulmonary hypertension of the newborn (PPHN). PPHN occurs in 1 to 2 per 1,000 live births in the general population and is associated with substantial neonatal morbidity and mortality.

In a retrospective, case-control study of 377 women whose infants were born with PPHN and 836 women whose infants were born healthy, the risk for developing PPHN was approximately six-fold higher for infants exposed to SSRIs after the 20th week of gestation compared to infants who had not been exposed to antidepressants during pregnancy. There is currently no corroborative evidence regarding the risk for PPHN following exposure to SSRIs in pregnancy; this is the first study that has investigated the potential risk. The study did not include enough cases with exposure to individual SSRIs to determine if all SSRIs posed similar levels of PPHN risk.

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For pregnant women who are taking Celexa during their third trimester, doctors must consider the potential risks and benefits of treatment to both mother and child, perhaps tapering the dosage during the third trimester.

Were you advised of the birth defect risks associated with Celexa antidepressant? Has your baby suffered serious heart defects regard PPHN?

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