Over the past decade or so, prescriptions of antidepressants have gone up in the United States and other developed nations in nearly astronomical proportions. Of the estimated 30 million Americans who take drugs to treat depression, many are expectant mothers. As a result, infants born to mothers who take selective serotonin reuptake inhibitors (SSRI) such as escitalopram oxalate, commonly known as Lexapro, are at risk of having serious birth defects.
For nearly 30 years, physicians in the United States, Great Britain, and other wealthy countries have been treating increasing cases of depression and other emotional disorders. According to recent British medical studies, extended periods marked by stressful events such as the Great Recession trigger increases in cases of depression, general anxiety disorder (GAD), and social anxiety disorder (SAD).
It is estimated that one in five Britons will be diagnosed with depression due to better diagnoses by physicians. In the U.S., the Centers for Disease Control and Prevention (CDC) reports that 1 in 10 Americans over age 12 takes antidepressants, including SSRIs such as Lexapro.
Birth Defect Risks Associated with Lexapro
Escitalopram oxalate was developed in the late 1990s as a joint venture by Lundbeck and Forest Laboratories. The Food and Drug Administration (FDA) approved Lexapro in 2002 to treat depression. In 2003, the FDA approved its use for generalized anxiety disorder.
According to the CDC, more women than men take antidepressant drugs. This statistic includes pregnant women being treated for depression or other anxiety disorders. SSRIs such as Lexapro are among these antidepressants and pose an increased risk of causing the following birth defects and injuries:
Persistent Pulmonary Hypertension of the Newborn (PPHN)
PPHN occurs when the blood flow to the lungs is confined and constricted, which in turn limits an infant’s oxygen intake. PPHN, especially if not diagnosed and treated immediately, can be fatal. The New England Journal of Medicine states infants born to mothers who take Lexapro have an increased risk of 6 times of developing PPHN.
Anencephaly, a neural tube defect, is a fatal condition marked by the loss of a large portion of an infant’s brain and skull. The New England Journal of Medicine suggests that the risk for anencephaly increases 2.5 times if mothers are taking Lexapro.
Club foot, which is also called congenital talipes equinovarus (CTEV), is a congenital deformity that affects one or both feet. A foot with CTEV looks as though it has been turned inside at the ankle. CETV gets its common name because the distinctive internal twist gives the foot a resemblance to a golf club. Half of all babies born with clubfeet have the deformity in both feet.
According to several studies, mothers who are taking SSRIs such as Lexapro increase the risk of having a baby with the condition by a factor of five times.
Cleft Lip and Cleft Palate
Cleft lip and cleft palate are congenital deformities caused by abnormal development of a baby’s face before birth. When the two conditions manifest themselves together, the resulting birth defect is called “cleft lip and palate.” In 2011, a study on cleft lip and cleft palate cases revealed that SSR medications taken during the first trimester of pregnancy, including Lexapro, was associated with a heightened risk of infants developing the disorder.
Other types of birth defects and health problems associated with SSRI medication include:
- Heart problems
- Low birth weight and preterm birth
- Poor feeding
- High-pitched crying
- Autism and cognitive disorders
- Abnormal reactions to startling sounds
- Spina Bifida
Maternal Risks and Lexapro
If a pregnant woman is currently using Lexapro and is suddenly taken off, the maternal risks are often times more hazardous than the risks of birth defects. For instance, in cases of severe depression, suicide is a real possibility, and research suggests that the onset of pregnancy, in some cases, heightens depression. In other instances, pregnant women may be at risk for miscarriage, preeclampsia, and other related health issues.
It’s up to the physician and each woman’s individual circumstances when determining if continuing Lexapro would be more beneficial than harmful.
Should Mothers Breastfeed While on Lexapro?
In a few studies of new mothers who are taking SSRIs, including Lexapro, trace amounts of antidepressants have been found in breast milk. There is some risk that a newborn may suffer adverse effects such as sleepiness and some weight loss. Although there have been no recorded cases of intellectual impairment in babies whose mothers were on Lexapro, women should tell their doctors if they’re taking antidepressants while nursing.
Who is Liable if Lexapro Causes Birth Defects?
Over the last several years, medical research studies have made a connection between the use of SSRI antidepressants by pregnant women and a higher risk of newborns with birth defects. Healthcare professionals have a moral and legal obligation to inform expectant mothers about the negative side effects of taking Lexapro and other SSRI drugs during gestation. Most doctors cover themselves legally before prescribing Lexapro by asking patients to sign a statement declaring that they are not expecting a baby nor are they planning to get pregnant within a certain time period.
However, there are doctors who don’t warn their pregnant patients about the possible negative effects of Lexapro. By failing to keep the patients informed and not informing them about other treatment options for depression, those doctors may be liable for damages.
Additionally, Forest Laboratories, the pharmaceutical company that manufactures Lexapro, has faced legal action regarding its aggressive sales tactics and for the SSRI drug’s connection to increased risks for birth defects. Similar to physicians, drug manufacturers also have the obligation and duty to inform consumers of any risks and hazards associated with the medications they create.