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Antidepressants

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Antidepressants are used to treat depression, obsessive-compulsive disorder, post-traumatic stress disorder, and panic and social anxiety issues.  Antidepressants work  by normalizing naturally occurring mood regulators in the brain such as serotonin, norepinephrine, and dopamine.  There are several different classes of antidepressants:
  • Selective Serotonin Reuptake Inhibitors (SSRIs) (e.g. Zoloft, Prozac, Celexa, and Paxil)
  • Serotonin and Norepinephrine Reuptake Inhibitors (SSNIs) (e.g. Effexor and Cymbalta)
  • Tricyclic antidepressants (TCAs) (e.g. Elavil, Tofranil, and Pamelor)
  • Monoamine Oxidase Inhibitors (MAOIs) (e.g. Nardil and Parnate)
Antidepressants that don't fall into any of these classes include Remeron and Wellbutrin.  

Side effects of taking antidepressants can include: headache, night sweats, nausea, agitation, sexual problems, dry mouth, and constipation.  Additionally, there are serious risks that have been associated with antidepressants including: suicidal thinking (especially in young adults), mania, high blood pressure, and birth defects.  

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FDA Pregnancy categories measure the teratogenic effects a drug has on a fetus.  The FDA initially classified SSRI antidepressants as pregnancy "Category C" medications, meaning that although there are no well-controlled studies in humans, animal reproduction studies have shown adverse effects on the fetus.  

In a study published by the New England Journal of Medicine, researchers found that first trimester use of sertraline (generic name for Zoloft) was significantly associated with omphalocele, a defect that causes an infant's abdominal organs to protrude outside the body, and septal defect, defects in the walls that separate the chambers of the heart.   Sertraline doubled the risk of septal defects and increased the risk of omphalocele more than five times.  They also found an association between the use of paroxetine and right ventricular outflow tract obstruction defects.  Although the specific defects are rare, infants who have been afflicted have required extensive surgeries to correct these defects.

A number of individual and class action lawsuits have been filed against the maker of Zoloft, Pfizer, alleging birth defects in infants as a result of the mother taking Zoloft during pregnancy.  Plaintiffs seek compensatory and punitive damages and the disgorgement of profits resulting from the sale of Zoloft.  In 2012, the federal birth-defect cases were transferred for consolidated pre-trial proceedings to a multdistrict litigation in the U.S. District Court for the Eastern District of Pennsylvania.

[1] "Understanding Antidepressant Medications" FDA.gov (posted January 9, 2009).
[2] Louik, C. et al., "First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects," N. Engl. J. Med 2007; 356:2675-2683 (June 28, 2007).
[3] Pfizer Annual Report 2013.
[4]  In re Zoloft Products Liability Litigation MDL-2342.

Antidepressant Alerts

400,000 bottles of Generic Effexor and Antihistimine Cetirizine Recalled by Sun Pharma
05/17/2014


Teva Recalls 1M bottles of Generic Cymbalta Antidepressant and 257K Cylinders of Asthma Drug QVAR® 
04/15/2014

2 Lots of Effexor XR® and 1 Lot of Venlafaxine HCl Recalled
03/07/2014

Class Action: Antidepressants Lexapro and Celexa  
02/27/2014
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If you have experienced adverse events or side effects from antidepressants find help here.

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