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FDA Panel Sparks Controversy Over SSRI Use in Pregnancy
A recent FDA panel discussion on the use of Selective Serotonin Reuptake Inhibitors (SSRIs) during pregnancy has ignited meaningful debate and drawn sharp criticism from many in the psychiatric community. The panel, intended to review the safety and efficacy of these antidepressants for expectant mothers, featured several voices that challenged established medical consensus, leading to concerns about the potential impact on patient care.
David Healy, a fellow at the Royal college of Psychiatrists in the UK and a panelist, reportedly suggested that the effectiveness of SSRIs is not definitively proven, a claim met with strong disagreement. Dr. Harold Goldberg, a past president of the American Society of Clinical Psychopharmacology, countered this assertion, stating, “There is not a doubt about whether ssris work.” Goldberg, who declined an invitation to join the panel due to concerns about its perceived bias, emphasized that questioning the efficacy of SSRIs is akin to promoting conspiracy theories.
Further contributing to the controversy, Healy also suggested that some individuals experience spontaneous recovery from depression. Another panelist, psychologist Roger McFillin, who hosts a podcast critical of conventional mental health approaches, proposed that depression might not be an illness but rather a manifestation of women experiencing emotions more intensely. He also,without providing evidence,posited that many women feel pressured into taking antidepressants.
These statements were widely condemned by psychiatrists not involved in the panel. Goldberg specifically refuted the notion of a “third party pushing a prescription in pregnancy,” though he acknowledged that some obstetrician-gynecologists, lacking in-depth knowledge of ssris, have incorrectly advised pregnant patients to discontinue their medication.
The American College of Obstetricians and Gynecologists (ACOG) issued a statement on Monday affirming that SSRIs can be life-saving for some pregnant individuals. ACOG expressed alarm at the panel’s “alarmingly unbalanced” nature, noting that it failed to adequately address the detrimental effects of untreated perinatal mood disorders. They highlighted that out of ten experts, only one emphasized the critical role of SSRIs in managing anxiety and depression during pregnancy.
Dr. Kay Roussos-Ross, a psychiatrist and OB-GYN at the University of Florida College of Medicine, was recognized by external psychiatrists for her strong, science-based advocacy for SSRI use and her pushback against other panelists’ risk assessments. Roussos-Ross urged the panel to approach data with objectivity, acknowledging that while studies can be found to support any viewpoint, a balanced outlook is crucial.
Concerns have been raised by several unaffiliated psychiatrists that the panel’s discourse could lead to regulatory changes that restrict access to SSRIs. Dr.Adam Urato,chief of maternal-fetal medicine at MetroWest Medical Center,advocated for more stringent warnings on SSRI labels. Dr. Lindsay Lebin, an assistant professor of psychiatry at the University of Colorado Anschutz Medical Campus, voiced her apprehension that the discussion surrounding antidepressant risks might create further obstacles for individuals seeking necessary mental health treatment.
