On Monday, July 21, a 10-member panel headed by Marty Makary, MD, MPH, commissioner of the FDA convened to discuss the use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy. Rather than recruiting a wide range of experts to discuss the best data available, the administration mainly invited clinicians and researchers who have a record of deep skepticism of antidepressants. Most of the panelists expressed a common view that antidepressants are harmful to developing babies, and the FDA should do more to tell women about their risks.
Leading medical organizations responded including the American College of Obstetricians and Gynecologists (ACOG) who stated that “robust evidence” shows SSRIs are safe in pregnancy and that most do not increase the risk for birth defects.
ACOG pointed out that untreated depression in pregnancy can put patients at risk for substance use, preterm birth, preeclampsia, limited engagement in medical care and self-care, low birth weight, impaired attachment with their infant, and suicide.
In its statement ACOG noted also that “for pregnant people who need SSRIs, they are life-changing and lifesaving” adding that “mental health conditions are already the most frequent cause of pregnancy-related death.” Furthermore, a 2023 ACOG practice guideline recommends SSRIs as first-line treatment for perinatal depression.