Highlights

• In December 2006, the FDA announced that antidepressant medications’ labels will include information on increased suicidal behavior risk for young adults ages 18 – 25. In October 2004, the FDA issued warnings concerning antidepressants’ suicide risk for children and adolescents.
• In May 2006, the manufacturer of paroxetine (Paxil) warned that the drug may increase suicidal behavior risk in adults ages 18 – 30.

First-time mothers have a high risk of developing postpartum depression during the first 3 months following birth, especially the first 10 – 19 days.

• Women who are pregnant or thinking about becoming pregnant should not take paroxetine. This drug can cause heart birth defects if taken during the first trimester of pregnancy.
• Other selective serotonin receptor uptake inhibitors (SSRIs) may also cause birth complications if taken during the second and third trimesters. A 2006 study indicated that babies born to mothers who took SSRIs after the 20th week of pregnancy have a high risk of developing primary pulmonary hypertension, a serious lung condition.
• However, pregnant women who need to take antidepressant drugs should not discontinue their medication without first talking to their doctors. An important 2006 study reported that women who stop their medication during pregnancy are 5 times more likely to suffer a relapse of depression than women who continue their medication.

• Patients who are not helped by one type of depression treatment may benefit from other forms of treatment, but their odds of recovering diminish the more treatment strategies they need. Results from the important STAR*D trials also suggested that patients who become symptom-free have a better chance of staying well than patients whose symptoms only improve.
• Ketamine, an anesthetic drug, may quickly improve symptoms in severely depressed patients, according to a preliminary study.

Review Date: 12/21/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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