Development: SSRIs, Pregnancy and the Harms on Unborn Children

RECAPITULATION: THE PROBLEMS & DANGERS ASSOCIATED WITH SSRIs
SSRI usage among pregnant women and the harms to unborn babies; and we ought to begin with some contextualisation. Most holistic doctors consider Selective Serotonin Re-uptake Inhibitors (or SSRI) antidepressants to be one of most harmful mass-prescribed drugs on the market. However, unlike the most other drugs, which are just unsafe and ineffective, SSRIs also have a fairly unique problem—which is that they have been culpable in violin outbreaks that have resulted in the loss of lives beyond the person taking them.
More specifically, since SSRIs first entered the market, many have noticed the unusual correlation between their consumption and completely out of character violently psychotic behavior, such as extremely disturbing homicides or suicides being committed by the individual. As the years have gone by, more and more evidence has accumulated (e.g., through lawsuits against the drug companies) that SSRIs cause psychotic violence, and in parallel, as the usage of these drugs has spiked, more and more grisly killings have occurred.
The pharmaceutical lobby and the mainstream media’s response has been to dismiss this as mere correlation that does not point to causation. However, the violent risks of SSRIs have gradually become more acceptable to talk about (e.g., after the Minneapolis Catholic School shooting, they once again came under scrutiny). In turn, each time a mass shooting happens, the mainstream media would try to monopolise the discussion with the same, tired script, in which they state that we need to ban all guns and have more mental health care (which is code for prescribing more psychiatric meds or SSRIs for everyone). Fortunately, this script is losing its appeal and SSRIs are more and more frequently being mentioned each time a mass shooting happens.
Secondly, one of the most common arguments used to dismiss the link between SSRIs and psychotic violence is that people who are mentally ill are more likely to be on psyche meds, so the “correlation” between psych meds and psychotic violence is simply a product of pre-existing mental illness and would have happened independently of the psyche med.
However, while claiming “correlation is not causation” makes it possible to refute this link while sounding intelligent in the process, there are a number of major problems with this argument. First, there is a lot of evidence tying SSRI usage to these events, including clinical trial data that was hidden from the public. Second, there is often a black-box warning on the SSRIs for them increasing the risk of suicide, something which can only be possible if some degree of causation does in fact exist. Third, these psychotic events are completely out of character for the individuals who commit them, and in many cases they report a very similar (and disconcerting) narrative of what they experienced prior to and during the shooting.
Furthermore, selective serotonin reuptake inhibitors (being SSRIs) have a similar primary mechanism of action to cocaine! More specifically, SSRIs block the reuptake of Serotonin, and serotonin-norepinephrine reuptake inhibitors (or SNRIs), which are also commonly prescribed, block the reuptake of Serotonin and Nore-pine-phrine (but, henceforth “SSRI refers to both SSRI and SNRI). These are similar to cocaine in that cocaine blocks the reuptake of Serotonin, Norepinephrine, and Dopamine. And so, considering that SSRIs have this chemical effect, much like cocaine does, clearly, correlation between SSRIs and mass shootings or psychotic behaviour DOES equal causation. And this is why SSRIs keep reappearing in discussions of people with mental illnesses that are found at the centre of mass shootings or other questionable and fatal behaviours. And so, evidently, they are a drug that is reasonably dangerous both to those who consume it directly and those who do not.
DEVELOPMENT: SSRIs, PREGNANCY AND THE HARMS ON UNBORN CHILDREN
Now with all that we have discussed, as far as the problems and dangers associated with SSRIs, this problem takes another concerning form when it comes to pregnant women and their unborn babies. As we alluded to at the beginning of our discussion, across the world, thousands of pregnant women are being prescribed antidepressants while few are warned about the potential harms to their unborn babies.
This concern came to the forefront at a 2-hour expert panel convened on the 21st of July this year, by the US Food and Drug Administration (FDA), and moderated by Dr Tracy Beth Høeg, who is the agency’s senior adviser for clinical sciences. During the expert panel, a lineup of doctors, scientists, and former regulators gathered to examine a thorny question, which is: Do selective serotonin reuptake inhibitors (or SSRIs) cause more harm than good when used during pregnancy? As you would expect, their opinions were not unanimous, HOWEVER, all agreed on one striking fact being that there are no “gold-standard” randomised trials that have addressed the issue.
And not only is this an issue on its own, but it exposes a dangerous pattern in the medical and pharmaceutical industries where pregnant women and babies are often not considered as a primary demographic for which to have separate trials, that measure the impact of pharmaceuticals on their health – because as you would recall, this happened with the COVID jabs as well. For instance, Dr Marty Makary, who is now heading the FDA under this second Trump administration, well back in the year 2023, he noted that the COVID vaccine was recommended for pregnant women with zero data. They started a trial for pregnant women in an effort to prove the safety of the COVID jab, but then “they mysteriously stopped the trial after 349 women enrolled in the study… and the results of those 349 women have never been made public”.
So, yes, much like how there were no “gold standard” randomised trials before the  COVID jabs were given to pregnant women, there ALSO are no “gold-standard” randomised trials that have addressed the issue on whether SSRIs are safe for unborn babies.
ADDRESSING THE QUIET CENSORSHIP IN DISCUSSIONS ON MENTAL HEALTH
But, now, instead of sparking serious debate, the just alluded to FDA panel was savaged by the media. And the ferocity of the reaction served to highlight how unnecessarily difficult it has become for some to speak honestly when the message challenges psychiatric drugs. And there are two underlying reasons behind this quiet censorship in discussions on mental health and psychiatric drugs that require urgent attention.
The first reason is that psychiatric issues were re-defined to be a chronic, life long struggle as opposed to an illness that one can be alleviated from. In particular, though psychiatric medications have existed since the 1950s, the idea of taking them permanently gained ground around the 1980s, as a biological view of mental “illness” replaced a more psychological one. Drugs like Prozac were promoted as correcting the “chemical imbalance” causing depression, an imbalance that would theoretically be lifelong. Pharmaceutical companies, seeing lifelong patients of psychiatric drugs as a profit making avenue, obviously embraced the idea.
As a result of this, a shift occurred then from defining [mental states] as episodic, temporary experiences to incurable brain diseases. Psychiatric language ALSO shifted from using terms like “reaction” or “disturbance” to “disorder” and “disease.” This was intended in part to reduce stigma. BUT the shift also had striking consequences for big pharma’s ability to have life long patients. This is to say that depression (for example) that is a “reaction” or “disturbance” implies not just a limit but an origin, while “disorder” does not—furthermore, the former terms emphasises cause over chemicals.
But, beyond the definitional changes, there was also a practical problem with this shift in seeing mental illness as a chronic suffering. In particular, medications like antipsychotics, anti-anxiety drugs, and antidepressants were in most cases developed for short-term use. Many trials of psychiatric drugs last less than two months, even though the length of time spent on a medication increases the difficulty of stopping it.
Then the second reason behind the quiet censorship in discussions on mental health and psychiatric drugs is that in a world where being able to claim victimisation has been made a means of political currency, in a broader victim economy, many have thus opted to form an identity around some form of suffering, and mental health is one of the options. More specifically, being afflicted with a mental health disorder is turned into an identity: you often hear this when people discuss mental health disorders with possessive language, in statements such as “I am depressed, or I am schizophrenic”, or I have ADHD. This possessive language suggests that the speaker has embraced the illness as being an intrinsic part of who they are, and thus often also build a dependent relationship with drugs associated with the disorder.
As a result of this, when those critical of psychiatric drugs or the perception of mental health disorders being a permanent and incurable state speak up, it becomes almost inevitable for those who’ve taken possession of the mental health disorder to push against this because they cannot differentiate between constructive discourse and an attack on their personality. And so, this is why even the media (which is often financed by pharma advertising money) savaged the FDA panel when they pushed back on SSRIs from pregnant women.
So, with this in mind, let’s proceed to discuss the concerns articulated by the panel. First, FDA Commissioner Dr Marty Makary opened the session with a stark warning. He stated that the US government is at risk of losing the broader battle of addressing mental health in the United States, because the more antidepressants are prescribed, the more depression there is. He cautioned that serotonin plays a crucial role in foetal development and warned that SSRIs have been “implicated in postpartum haemorrhage, pulmonary hypertension, cognitive downstream effects in the baby, as well as cardiac birth defects.”
Similarly, maternal–foetal medicine specialist Dr Adam Urato was unequivocal. He stated that never before in human history have we chemically altered developing babies like this…and this is happening without any real public warning”, meaning that patients are routinely misled. In fact, according to Dr Urato, the only counselling pregnant mothers often receive is that SSRIs do NOT affect the baby or cause complications. But, this is simply not accurate or adequate, especially because FDA’s own labels fail to warn about harms such as preterm birth, pre-eclampsia, or the fact that SSRIs alter foetal brain development.
Dr Adam Urato also pointed to ultrasound studies showing SSRI-exposed foetuses with “different movement and behaviour patterns,” and noted that newborns can present with “jitteriness, breathing difficulties, and higher rates of admission to the neonatal intensive care unit.”  By his count, “a dozen consecutive MRI studies” now demonstrate that prenatal SSRI exposure alters the developing brain. And this should not be a surprise considering that SSRIs have been found to cross the placenta and enter the foetal brain. Therefore, if these drugs alter the mom’s brain, they likely can also affect the babies.
And by the way, published research has raised similar concerns. For instance, a BMJ study found birth defects occurred 2 to 3.5 times more frequently in babies exposed to paroxetine or fluoxetine early in pregnancy. A JAMA Psychiatry study found venla-faxine was associated with the highest number of defects. And a 2018 meta-analysis covering more than nine million births found a modestly increased risk (11%) of congenital malformations linked to early SSRI use. But, here’s more on some of the critical takes that were shared in the course of the FDA panel.
TAPERING OFF SSRIs IS ALSO HARDLY DISCUSSED WITH PREGNANT WOMEN
However, it is not just the harm of the foetus that is seldom discussed with pregnant mothers, because Dr Josef Witt-Doerring, who is a psychiatrist and former FDA official, said that women often come to him unaware of the risks, and as such they feel incredibly betrayed by the medical establishment. So, he helps patients then taper off psychiatric drugs, but warns that there’s a black hole of knowledge on how to taper these medications – which is  a systemic issue intentionally curated because pharmaceutical companies want long term patients, so they keep making more money.
The interest in tapering pregnant women off SSRIs is further underscored by a 2021 meta-analysis, which reviewed 13 studies and found that up to 30% of infants exposed to SSRIs in the womb developed withdrawal symptoms—tremors, muscle tone abnormalities, rapid breathing, and respiratory distress—while unexposed infants showed none. The authors concluded that “tapering and discontinuation of antidepressant drugs before and during the early phase of pregnancy are worth attempting to prevent the occurrence of this syndrome.” They recommended non-drug therapies such as cognitive-behavioural therapy as the first choice.
IS THE AUTISM RISK FROM SSRIs REAL?
So, let’s proceed to what I think was a lingering thought in your mind as well, in the duration of this discussion on SSRIs, pregnant women and harms to unborn babies, which is: is there a link between a pregnant mother’s ingestion of SSRIs and autism in their unborn baby? Well, in light of this question, several experts said the potential for SSRIs to influence neurodevelopment is being brushed aside too quickly.
For instance, Dr Jay Gingrich, who is a professor of psychiatry at Columbia University, pointed to animal studies showing serotonin’s vital role in brain development, particularly in forming cortical maps. However, SSRIs may disrupt that process. While he cautioned that translating animal data to humans is difficult, Dr Jay Gingrich added that these effects are relatively subtle, but they are there.
Furthermore, in 2018, Dr Gingrich and colleagues found that SSRI-exposed infants had enlarged gray matter in the amygdala and insula, and stronger white matter connections, compared with babies whose mothers had untreated depression or no depression.
Similarly, during the FDA panel on the 21st of July, Psychiatrist Dr David Healy reminded the panel that this concern is hardly new. In 2009, a jury found that Paxil caused birth defects and GlaxoSmithKline paid over $1 billion to settle 800 related lawsuits. And yet, since that verdict, five times more women have taken SSRIs during pregnancy.
Furthermore, Dr David Healy Data added that linking SSRIs to autism has actually existed for more than a decade! And yet, despite this, media outlets continue to insist the autism link has been debunked. But as psychiatrist Dr Joanna Moncrieff put it, most studies that claim to disprove the link between autism and SSRI intake by pregnant mothers are underpowered…in that they fail to rule out harm, or the causal link. And so, it remains that autism is indeed an orchestrated crisis, largely curated through pharmaceutical interventions.
Written By Lindokuhle Mabaso