Celexa® and Pregnancy
Celexa® Use and Pregnancy Risks
If you are taking the antidepressant medication Celexa® you should tell your doctor if you are pregnant or if you become pregnant, according to the U.S. Food and Drug Administration (FDA). You also should let your doctor know if you are breast feeding.
Celexa® is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Such medications have been associated with a number of birth defects in infants whose mothers took them while they were pregnant.
Celexa® is known to cross the placenta. The manufacturer has reported the drug has been associated with "spontaneous abortions" or miscarriages.
"Citalopram may cause problems in newborns following delivery if it is taken during the last months of pregnancy," the FDA has warned.
Two of the main side effects reported in babies born to pregnant women taking Celexa® are:
- Persistent pulmonary hypertension of the newborn (PPHN)
- Serotonin syndrome
Persistent pulmonary hypertension of the newborn (PPHN)
PPHN occurs when the newborn's circulation remains the same as when it was a fetus in the womb. While in the womb, the fetus receives oxygen through the mother's umbilical cord. After birth, the newborn's heart, blood vessels and lungs should take over from the mother's job of oxygenating the fetus' blood.
Major symptoms of PPHN include:
- Rapid breathing
- Rapid heart rate
- Problems breathing or other symptoms of respiratory difficulties such as flared nostrils and grunting
- Skin that has a bluish tint, even when the infant is supplied with oxygen
Occurring in about one in every 500 to 1,500 births, PPHN is relatively rare, but potentially very serious. It is associated with significant illness and death, according to the FDA. The agency is gathering data on the association between SSRIs and neonatal PPHN.
According to an FDA alert, which reported results of a case-control study, the infants of mothers who took SSRIs after the twentieth week of their pregnancies were six times more likely to have PPHN as mothers who did not take antidepressants during their pregnancies.
In the meantime, the FDA "recommends that physicians carefully consider and discuss with patients the potential risks and benefits of SSRI treatment throughout pregnancy, including late pregnancy." It is also important to consider the correct Celexa® dosage during pregnancy.
Serotonin syndrome may be another effect occurring in the newborn as a result of a mother's taking Celexa® during the last part of a pregnancy.
Serotonin is a drug produced in the body's nerve cells. When used as an antidepressant, an SSRI makes serotonin more available to the brain and helps to stabilize mood.
Studies have shown that some newborns exposed in the uterus to the mother's serotonin medication may exhibit serotonin syndrome. Some newborns who are exposed to SSRIs and SNRIs (another class of antidepressants) late in the third trimester develop complications needing extended hospitalization, respiratory support and tube feeding.
These complications may include:
- Respiratory distress
- Cyanosis (bluish tinge to the skin indicating low blood oxygen levels)
- Apnea (long pauses between breaths)
- Temperature instability
- Problems feeding
- Low blood sugar
- Low muscle tension
- Excess muscle tension and hyper responsive reflexes
- Constant crying
It is unclear however if these complications are a direct toxic effect of the drug or result from stopping the drug, causing withdrawal symptoms.
Celexa® Drug and Pregnancy Category
The FDA classifies Celexa® as pregnancy category C. This categorization means that the drug has been shown to cause abnormal effects in the fetus in animal studies, but there are no well-controlled human studies to determine if this applies to people. The FDA adds to the classification, however, that potential benefits may outweigh the potential risks in pregnant women.