The risk posed by some popular antidepressants in early pregnancy is not worth taking for women with mild to moderate depression, an expert has warned.
Professor Stephen Pilling says evidence suggests SSRIs can double the risk of a child being born with a heart defect.
The drugs have been used by up to one in six women of child-bearing age.
A manufacturer contacted by the BBC denies any link to major foetal malformations.
Panorama has spoken to eight mothers who had babies born with serious heart defects after taking a commonly used SSRI (selective serotonin reuptake inhibitors) antidepressant while pregnant. Currently, prescription guidelines for doctors only warn specifically against taking the SSRI, paroxetine, in early pregnancy.
But Prof Pilling, expert adviser to the National Institute for Health and Care Excellence (NICE), says that advice is about to be updated.
“The available evidence suggests that there is a risk associated with the SSRIs. We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we’re perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar – if not greater – risks,” he said.
When Anna Wilson, from Ayrshire, had her 20-week scan, doctors realised her son had a serious heart problem and would need immediate heart surgery when he was born.
“He’s got a lot of suffering ahead of him before anything else,” his mother said. “We know that’s a certainty and that’s pretty awful.”
Four years before she became pregnant, Mrs Wilson was prescribed the drug Citalopram by her GP because she was suffering from anxiety.
Her doctor told her it was fine to continue using the drug when trying for a baby. But after David was born she asked what might have caused his heart condition.
“We did meet with a cardiologist at one of the scan appointments, and he explained that as far as he knew there were no environmental factors and it wasn’t because of anything we as parents had done. It was just one of those things – couldn’t be prevented,” she said.
Prof Pilling says the guidance will now be re-written to take in to account evidence that the SSRI antidepressants, as a group, are linked to heart defects.
He says the risk of any baby being born with a heart defect is around two in 100; but the evidence suggests if the mother took an SSRI in early pregnancy that risk increases to around four in 100.
“You’ve got double the risk. And for women who are mild to moderately depressed, I don’t think that those risks, in most cases, are really worth taking” he said.
“It’s not just when a woman who’s pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that’s the large majority of women aged between 15 and 45.”
Mrs Wilson will never know for sure what caused David’s heart defect, but said if she had known there was even a very small risk associated with the drug she would have stopped taking it.
“If David’s condition was preventable, and it wasn’t prevented, that’s really, really awful.
“If somebody had given me the choice in pregnancy and said ‘there’s a risk of this’, I would have stopped taking those tablets in a flash.”
Lundbeck, the manufacturer of Citalopram, says a recent review of scientific literature concluded that the drug “does not appear to be associated with an increased risk of major foetal malformations”.
“The decision not to prescribe anti-depressants to a woman who is depressed… may generate greater risks to the woman and her foetus than the risks of exposure to the medication.”
#RT via Andrea via http://www.bbc.co.uk
BBC documentary lifts the lid on ‘offensive’ code used to describe disabled and jobless.
A BBC documentary investigation into one of the firms responsible for delivering the government’s £5bn Work Programme claims to have found evidence of staff using an ‘offensive’ code to describe disabled and jobless people.
Clients of Triage, a key player in the government’s plan to pay private companies to move people from benefit into work, were referred to as ‘LTB’ – code for “lying, thieving bastards”, a former employee alleges.
Linda Smith, who worked for Triage, which operates in Scotland and the north of England, told the BBC that the term was used to describe jobless and disabled clients, and that the company used a practice known as ‘parking’ to keep disabled people on their books.
Mrs Smith said that under the scheme firms can earn more money from taking on the disabled people as clients, but that once they are on the company’s books staff are told to spend as little time as possible helping them find work.
“They would be put on telephone interviews… just to make sure that there was this contact made so they could tick a box to say, ‘Yeah, they’re still on the Work Programme’,” Mrs Smith said.
The BBC claims that four other former Triage employees confirmed the use of the LTB code and told the BBC similar stories about clients on their books being ‘parked’.
Tony Wilson, 34, from Middlesbrough was referred to the Work Programme through Triage in February 2012, told the BBC he believes he has been ‘parked’: “They haven’t done a single thing to help me in any way.”
He also condemned the use of the LTB label allegedly given to those on long-term benefits: “That’s offensive. It’s unprofessional. It’s – so many words I could say about that. It’s just wrong.”
In response to the allegations Triage said: “It is standard practice, particularly for those clients that are sick or who have otherwise been unable to attend, to telephone them to check on their progress and maintain contact. Triage’s delivery structure of the Work Programme does not allow for ‘parking’.
“The compliance requirements of the programme demand a frequency of contact and this together with our own commitment to excellence and meeting client needs means that ‘parking’ is not an option.”
Triage also claimed that use of the term LTB was an isolated incident, adding: “This is not a phraseology used or accepted by Triage.”
Panorama: The Great Disability Scam? is on BBC One, Monday, 28 January at 20:30 GMT and then available in the UK via the BBC iPlayer.
#RT via http://www.independent.co.uk
Just to let you all know that the Panorama programme on BBC 1 this Monday is about the effects of the welfare benefits on disability and a focus on mental health – some of the report is from the Maudsley.