Birth defects. Several studies, but not all, have suggested that Paxil, when used in the first trimester of pregnancy, may be associated with an increased risk for certain birth defects.
A 2005 study of nearly 6,000 pregnant women who took antidepressants during the first trimester found a 4 percent prevalence of birth defects, especially ventricular septal defect, or a hole in the wall between two of the heart's chambers, in women taking Paxil as compared to 2 percent in those on other antidepressants. "The heart problems are sometimes treatable without surgery, but they're certainly something we want to avoid if we can," says Kimberly Yonkers, M.D., associate professor in the departments of psychiatry and obstetrics, gynecology and reproductive sciences at Yale University School of Medicine.
Earlier this year, two large studies in The New England Journal of Medicine found the risk of birth defects from first-trimester use of selective serotonin reuptake inhibitors (SSRIs), the most common type of antidepressant, to be low. "These studies suggest that antidepressants are not very dangerous," says Dr.
Yonkers. "There's not zero risk of birth defects, but there's no major risk, even from Paxil."Persistent pulmonary hypertension.
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