Drug Warnings Can Be a Double-Edged Sword

Back in 2003, the U.S. Food and Drug Administration (FDA) required that a particular class of antidepressants called selective serotonin reuptake inhibitors (SSRI) carry a “black box” warning that for children and teens, side effects may include an increased risk of suicidal thoughts. Sounds perfectly reasonable, doesn’t it?

But then, along comes the Law of Unintended Consequences, which revealed that since that FDA mandate came out, doctors wrote 20 percent fewer prescriptions for SSRIs (which include Prozac, Zoloft, Paxil, and Celexa) for their teen patients. (Adult use of SSRI antidepressants went down by 14 perent—and they weren’t even covered by the FDA warnings). At the same time, teen suicide attempts rose by about the same amount—21.7 percent for teens, 33.7 percent for young adults under 25.
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Depressed pregnant moms much less likely to breastfeed

A study just published in the Journal of Human Lactation found that women who took certain antidepressants during pregnancy were significantly less likely to breastfeed their babies compared to women who didn’t. One might reasonably ask why I’m reading Journal of Human Lactation at all. Simple answer: It’s a magazine about breasts. Do I really need any other excuse? Sadly, unlike Playboy–another magazine about breasts that people also read for the articles–this one has no pictures. Or cartoons, for that matter.

The drugs in question are Selective Serotonin Reuptake Inhibitors (SSRIs, which include Prozac, Zoloft, and many others. And the researchers found that women who took SSRIs at any point during the pregnancy were 60 percent less likely to begin breastfeeding than those who didn’t take any at all.

“While the benefits of breastfeeding an infant are very clear, this study suggests that women who are taking antidepressants in pregnancy are not engaging in this behavior as often as we would like to see,” said Christina Chambers PhD, MPH, professor of pediatrics at UC San Diego and co-author of the study. “Whether this is due to the mother’s fear of harming her baby by breastfeeding while taking the medication, or due to the mother’s depression itself is unclear.”