Antidepressants like Paxil, Effexor may lead to spontaneous abortion

Antidepressant pills containing paroxetine (Paxil) and venlafaxine (Effexor) may lead to spontaneous abortions if consumed during pregnancy, studies indicate.

Pregnant women taking antidepressant pills for depression and anxiety are at increased risk for miscarriages than those who do not use antidepressants, say researchers at the University of Montreal.

Generally, antidepressant pills are classified into various categories.

The abortion risk is higher with classes of antidepressants including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and the older tricyclics.

Paroxetine marketed by GlaxoSmithKline as Paxil belongs to SNRI class of drugs.   While venlafaxine marketed by Pfizer as Effexor is an SNRI.

Both these pills pose a greater risk of spontaneous abortion than other commonly used medications, researchers found.

Paroxetine is also sold under the brand names including Seroxat, Sereupin, Aropax, Deroxat, Divarius, Rexetin, Xetanor, Paroxat and Loxamine.

SSRIs are a popular class of antidepressant medications. The first drug in this class was fluoxetine (Prozac), which hit the U.S. market in 1987.

Other commonly used pills in SSRIs category of antidepressant pills are: fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Ladose, Fluctin, Fluox, Depress, Lovan); dapoxetine (Priligy); citalopram (Celexa, Cipramil, Cipram, Dalsan, Recital, Emocal, Sepram, Seropram, Citox); escitalopram (Lexapro, Cipralex, Esertia); fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox) and sertraline (Zoloft, Lustral, Serlain).

One of the newest classes of antidepressants, the selective serotonin and norepinephrine reuptake inhibitors (SNRIs) affect both norepinephrine and serotonin.

While low levels of both neurotransmitters are associated with depression, norepinephrine is thought to be involved more with alertness and energy, while serotonin influences mood.
By increasing levels of both, SNRIs work on different aspects of depression.

Desvenlafaxine (Pristiq), duloxetine (Cymbalta, Yentreve), milnacipran (Dalcipran, Ixel, Savella), sibutramine (Meridia, Reductil) are among the commonly prescribed pills in this category.

The spontaneous abortion risk also seen increased with higher drug dosage.

Some studies show that antidepressants may increase miscarriage risk by 68%.

“These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied,” according to senior author Dr. Anick Bérard, from the University of Montreal and the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine.

US FDA has notified healthcare professionals and consumers on a life-threatening condition called serotonin syndrome when triptans are used together with a selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephrine reuptake inhibitors (SNRIs).

Serotonin syndrome occurs when the body has too much of a chemical found in the nervous system (serotonin).

Each of the above medications (triptans, SSRIs, and SNRIs), cause an increase in serotonin levels.

Symptoms of serotonin syndrome may include restlessness, hallucinations, loss of coordination, fast heart beat, rapid changes in blood pressure, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea.

Healthcare professionals prescribing a triptan, SSRI or SNRI should weigh the potential risk of serotonin syndrome with the expected benefit of using the above combination, US FDA had said.