Mom's SSRI use may raise risk of birth defects

- The use of selective serotonin reuptake inhibitor (SSRI) antidepressant drugs early in pregnancy seems to moderately raise the risk of congenital malformations in offspring, suggests the results of a Danish population-based cohort study. (reuters.co.uk 8.11.2006)

Fullterm infants exposed to SSRIs during the third trimester had an increased risk for respiratory distress syndrome, endocrine and metabolic disturbances, hypoglycemia, temperature regulation disorders, and convulsions. (Pharmacoepidemiol Drug Saf. 2007 Aug 30)

Positive screening for autism in ex-preterm infants: prevalence and risk factors (Pediatrics. 2008 Apr;121(4):758-65)

5 av 6 gravide går på medisiner (aftenposten.no 3.3.2008)

Professor: Vi får flere retarderede børn (berlingske.dk 8.3.2008)

Tidlig fødsel øker dødeligheten (vg.no 27.3.2008)

- Mødre kan få råd om trygg medisin

Mødre kan få råd om trygg medisin
vg.no 30.8.2011
Gravide og ammende mødre som er usikre på hvilke medisiner de trygt kan bruke, kan nå få hjelp på et nytt offentlig basert nettsted.

NY TJENESTE: Den nye siden gir informasjon om hva slags medisin som er trygg for kommende og nybakte mødre.

På nettstedet www.tryggmammamedisin.no kan mødre stille spørsmål og få dem besvart av erfarne farmasøyter og leger.

Det er de Regionale legemiddelinformasjonssentrene (RELIS) som driver tjenesten. RELIS har siden 1995 gitt informasjon til helsepersonell om medisiner. Nå utvides tilbudet slik at mødre kan benytte seg av det.

- Vi ønsker å bidra til økt kunnskap og trygghet hos dem som trenger medisiner, men samtidig unngå at gravide og ammende bruker medisiner som kan være skadelige sier farmasøyt Sofia Frost Widnes ved RELIS Vest, Haukeland universitetssjukehus. (...)

(Anm: Drug labelling and pregnancy Lancet 2014;384(9960):2084, (13 December 2014).)

(Anm: Medication use during pregnancy - Editorials BMJ 2014;349:g5252 (Published 22 August 2014).)

(Anm: Functional brain organization of newborns altered by prenatal cocaine exposure. A new study by UNC researchers, based on MRI brain scans of 152 infants, found disruptions in functional connectivity within part of the amygdala-prefrontal network - a pathway thought to play an important role in arousal regulation. (medicalnewstoday.com 10.4.2015).)

(Anm: Antidepressant use in pregnancy: study investigates benefits and risks. (medicalnewstoday.com 5.8.2015).)

(Anm: Forskere finner link mellom bruk av antidepressiva, medfødte misdannelser eller dødfødsler. (Researchers Find Link Between Antidepressant Use, Congenital Anomalies or Stillbirths) (…) "Mens denne ekstra risikoen kan virke liten er resultatene etter mitt syn så alvorlig som de kan være." (“While this extra risk may seem small, in my view, the outcomes are as serious as they can be.”) (dgnews.docguide.com 5.12.2016).)

- Eksponering av foster for antidepressiva kan endre Corpus Callosums mikrostruktur.

(Anm: Eksponering av foster for antidepressiva kan endre Corpus Callosums mikrostruktur: Presentert ved PAS / ASPN. (…) Fordi "den neonate (nyfødtes) corpus callosum mikrostruktur er assosiert med utero (livmor) SSRI-eksponering og prenatal (før fødsel) mødredepresjon, er tidlige modningsprosesser i denne regionen følsomme for endret 5-hydroksytryptamin (5-HT) signalering under tiden i utero (livmor)," bemerket Campbell. "Disse resultatene - sammen med forstyrret hvit substans’ mikrostruktur i genu hos premature spedbarn - tyder dette på at utviklingen av [corpus callosum] kan være følsom for tidlige uheldige påvirkninger. (Fetal Exposure to Antidepressants May Alter Corpus Callosum Microstructure.) (dgnews.docguide.com 10.5.2017).)

(Anm: Unormal sæd med SSRI antidepressiva. Flere studier har funnet endrede sædparametere etter eksponering for SSRI-antidepressiva. Selv om SSRIs rolle er usikker, er det berettiget å ta hensyn til de observerte effektene på sædkvalitet og informere eksponerte pasienter. (Semen abnormalities with SSRI antidepressants. Several studies have found altered semen parameters after exposure to SSRI antidepressants. Although the role of SSRIs is uncertain, it is justified to take into account the observed effects on sperm quality and to inform exposed patients.) Prescrire Int 2015; 24 (156): 16-17.)

(Anm: Gravide kvinner som tar antidepressiva er mer sannsynlig å få barn med autisme, ifølge studie. Pregnant women who take antidepressants more likely to have a child with autism, study finds. Research data published in the BMJ reveal that antidepressant use during pregnancy increases the risk of autism in children, as reported The Independent Thursday. (firstwordpharma.com 20.7.2017).)

(Anm: - Nye data viser økt risiko for misdannelser når antidepressiva brukes under graviditet. (…) En studie publisert i British Medical Journal (BMJ) avslører at antidepressiva forskrevet til gravide kan øke sjansen for å få en baby med misdannelser.) (New Data Show Heightened Risk of Birth Defects When Antidepressants Are Used During Pregnancy.) (dgnews.docguide.com 19.1.2017).)

- Høyt nivå av serotonin i blodvæske (serum) ved krybbedød (Sudden Infant Death Syndrome – SIDS).

(Anm: Høyt nivå av serotonin i blodvæske (serum) ved krybbedød (Sudden Infant Death Syndrome – SIDS). High serum serotonin in sudden infant death syndrome. Proc Natl Acad Sci U S A. 2017 Jul 3. pii: 201617374. [Epub ahead of print].)

(Anm: - Utviklingen av et potensielt livstruende serotonergt syndrom eller nevroleptisk malignt syndrom (NMS)-lignende reaksjoner er rapportert for SNRI-er og SSRI-er alene, inkludert Celexa-behandling, men spesielt ved samtidig bruk av serotonerge legemidler (inklusive triptaner) og legemidler som svekker metabolisme av serotonin (inklusive MAO-hemmere), eller med antipsykotika eller andre dopaminantagonister (fda.gov 6.3.2009).)

(Anm: Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. (…) Conclusions Antidepressants with effects on serotonin reuptake during embryogenesis increased the risk of some organ-specific malformations in a cohort of pregnant women with depression. BMJ Open 2017;7:e013372.)

(Anm: Mødre til børn med misdannelser har øget dødelighed. (…) Bivirkninger har ført til to dødsfald. Den største del af bivirkningerne (42 procent) af de 429 blev indberettet for såkaldte psykostimulerende lægemidler - eksempelvis til behandling af ADHD - efterfulgt af 31 procent for antidepressiver og 24 procent for antipsykotiske lægemidler. (videnskab.dk 20.12.2016).)

(Anm: Antikolinerge effekter av vanlige legemidler knyttet til økt dødelighet hos mennesker over 65. De kombinerte antikolinerge effektene av mange vanlige legemidler øker risikoen for kognitiv svekkelse og død hos personer over 65 år, ifølge resultater fra en storskala studie på den langsiktige helseeffekten av legemidler.(Anticholinergic effects of common drugs are associated with increased mortality in over 65s. The combined anticholinergic effects of many common drugs increase the risk of cognitive impairment and death in people aged over 65, a large scale study of the long term effect of drugs on health has found.) BMJ 2011; 342:d4037 (28 June).)

(Anm: Men experience greater cognitive impairment and increased risk of death following hip surgery. In a study of hip fracture patients, men displayed greater levels of cognitive impairment within the first 22 days of fracture than women, and cognitive limitations increased the risk of dying within six months in both men and women. "While men make up only about 25 percent of all hip fractures, the number of men who fracture their hip is increasing and we know men are more likely to die than women after a hip fracture," said Dr. Ann Gruber-Baldini, lead author of the Journal of the American Geriatrics Society study. (medicalnewstoday.com 10.2.2017).)

(Anm: Det autonome nervesystemet. Det autonome nervesystemets hovedoppgave er å bidra til likevekt i kroppens basale funksjoner. Det vil blant annet si kroppstemperatur, blodtrykk, åndedrett og fordøyelse. (nhi.no 4.3.2015).)

(Anm: Ulike selektive serotonin reopptakshemmeres (SSRI-er) cytotoksisitet mot kreftceller. (Cytotoxicity of different selective serotonin reuptake inhibitors (SSRIs) against cancer cells.) (…) Vi har funnet at paroxetine (paroksetin; Seroxat; Paxil etc.) har cytotoksisk aktivitet mot tumorceller. J Exp Ther Oncol. 2006;6(1):23-9.)

(Anm: Could antidepressants stop prostate cancer from spreading? In almost all cases where prostate cancer spreads to other areas of the body, the disease spreads to the bone first. In a new study, researchers reveal the discovery of an enzyme that helps prostate cancer cells to invade bone. Furthermore, certain antidepressant medications may have the potential to block this enzyme. Study co-author Jason Wu, of Washington State University-Spokane, and colleagues recently reported their findings in the journal Cancer Cell. (medicalnewstoday.com 13.3.2017).)

- Tusindvis af franske børn fik fosterskader af epilepsimedicin. Nye undersøgelser viser nu, at op til 4100 børn har fået svære fosterskader, siden medicinen første gang blev bragt på markedet i 1967.)

Tusindvis af franske børn fik fosterskader af epilepsimedicin
medwatch 20.4.2017
Nye undersøgelser viser sammenhæng mellem brugen af epilepsimedicinen Valproat og svære fosterskader hos langt flere børn i Frankrig, end først rapporteret.

I Frankrig er mellem 2150 og 4100 børn blevet ramt af mindst en alvorlig fosterskade, efter at deres mødre blev behandlet med epilepsimedicinen Valproat. Det oplyser landets sundhedsmyndigheder.

Lægemidlet blev allerede sidste år kædet direkte sammen med misdannelser hos omkring 450 nyfødte børn i Frankrig.

Nye undersøgelser viser nu, at op til 4100 børn har fået svære fosterskader, siden medicinen første gang blev bragt på markedet i 1967.

Kvinder, som har taget medicinen under deres graviditet, har fire gange så høj risiko for at få børn med misdannelser.Det fremgår af en rapport, der er udsendt i fællesskab af Frankrigs Nationale Agentur for Sikker Medicin, ANSM, og den nationale sygesikring.

"Undersøgelserne viser, hvordan Valproat er i stand til at forårsage fosterskader," siger Mahmoud Zureik, som er videnskabelig leder hos ANSM og medforfatter til rapporten.

Gravide kvinder har taget Sanofi-middel trods risiko for fosterskader (...)

Medicinalfirmaerne Sanofi-Aventis, Orion Pharma og Desitin Pharma udsendte allerede for halvandet år siden skærpede advarsler om lægemidler, der indeholder Valproat. Det gælder for eksempel Deprakine og Delepsine.

Det skete efter aftale med Det Europæiske Lægemiddelagentur (EMA) og Sundhedsstyrelsen. (…)

- Dépakin (valproinsyre)-skandalen. Jeg kunne ikke være stille. (- The Dépakine (valproic acid) scandal. I could not remain silent. Martin M "Dépakine, le scandale. Je ne pouvais pas me taire")

(Anm: The Dépakine (valproic acid) scandal. I could not remain silent. Martin M "Dépakine, le scandale. Je ne pouvais pas me taire" Robert Laffont, Paris 2017: 239 pages, 19.50 euros. This work in French, "Dépakine, le scandale. Je ne pouvais pas me taire", chronicles the author’s struggle to raise awareness about the risks for unborn children from the use of valproic acid during pregnancy. Where regulatory authorities, healthcare professionals and the pharmaceutical company Sanofi had all failed, her actions led to a re-evaluation of the harm-benefit balance of valproic acid and to better information for patients. This book deserves to be read and widely distributed amongst both healthcare professionals and the public at large. Read Prescrire's review (in French) (prescrire.org 12.10.2017) (Dépakine° le scandale. Je ne pouvais pas me taire).)

- EMA vill höra allmänheten om användning av valproat. Säkerheten kring epilepsiläkemedlet granskas sedan franska kvinnor fött barn med fosterskador.

(Anm: EMA vill höra allmänheten om användning av valproat. Säkerheten kring epilepsiläkemedlet granskas sedan franska kvinnor fött barn med fosterskador. I sin första offentliga utfrågning någonsin bjuder den europeiska läkemedelsmyndigheten EMA in allmänheten att närvara och berätta om sina erfarenheter. Det är epilepsiläkemedlet valproat, i Sverige betecknat som valproinsyra, som är under luppen efter att den franska läkemedelsmyndigheten ANSM begärt en säkerhetsgranskning. Förra hösten presenterades en rapport som Läkemedelsvärlden.se tidigare skrivit om, som visade att tusentals gravida franska kvinnor ska ha fått läkemedlet mellan åren 2007 och 2014, trots att risken för fosterskador är känd. (lakemedelsvarlden.se 21.8.2017).)

Tiotusentals gravida fransyskor har fått läkemedel innehållande valproinsyra, trots risken för fosterskador. Nu förbereder offren en stämning mot tillverkaren Sanofi.

(Anm: Fransk läkemedelsskandal berör hela Europa. Tiotusentals gravida fransyskor har fått läkemedel innehållande valproinsyra, trots risken för fosterskador. Nu förbereder offren en stämning mot tillverkaren Sanofi. (lakemedelsvarlden.se 26.8.2016).)

(Anm: Tusindvis af franske børn fik fosterskader af epilepsimedicin. Nye undersøgelser viser nu, at op til 4100 børn har fået svære fosterskader, siden medicinen første gang blev bragt på markedet i 1967. (...) Gravide kvinder har taget Sanofi-middel trods risiko for fosterskader (...) Medicinalfirmaerne Sanofi-Aventis, Orion Pharma og Desitin Pharma udsendte allerede for halvandet år siden skærpede advarsler om lægemidler, der indeholder Valproat. Det gælder for eksempel Deprakine og Delepsine. (medwatch 20.4.2017).

(Anm: Thalidomide (Thalidomid) informasjon vs kunnskap og visdom - hvem visste hva? (mintankesmie.no).)

- Risiko for nedsatt kognisjon etter prenatal (før fødsel) eksponering for psykotrope legemidler. (- Konklusjon: Prenatal eksponering for psykotrope legemidler påvirker proxy utfall av kognitive funksjonshemminger i skolealderen. Eksponering for psykoleptika (N05 Psykoleptika N05A Antipsykotika N05B Anxiolytika N05C Hypnotika og sedativer) har størst risiko.)

(Anm: Risk of impaired cognition after prenatal exposure to psychotropic drugs. Abstract OBJECTIVE: Prenatal exposure to psychotropic drugs may affect the trajectories of brain development. In a register study, we investigated whether such exposure is associated with long-term impaired cognitive abilities. (…) CONCLUSION: Prenatal exposure to psychotropic drugs affects proxy outcomes of cognitive disabilities at school age. Exposure to psycholeptics carries the largest risk. The role of psychoanaleptics is currently unclear. Acta Psychiatr Scand. 2017 Aug;136(2):177-187.)

- Kobler bruk av angstdempende hos gravide til emosjonelle plager hos barn. Studien viste at barn som var eksponert for angstdempende legemidler i fosterlivet hadde flere symptomer på emosjonelle plager, sammenliknet med sine ueksponerte søsken.

(Anm: Kobler bruk av angstdempende hos gravide til emosjonelle plager hos barn. Studien viste at barn som var eksponert for angstdempende legemidler i fosterlivet hadde flere symptomer på emosjonelle plager, sammenliknet med sine ueksponerte søsken. En ny studie med data fra den norske Mor-Barn-undersøkelsen (MoBa) gir ny kunnskap om bruken av angstdempende legemidler og sovemedisiner blant gravide. Forskerne undersøkte nærmere 14.000 søsken i Den norske mor og barn-undersøkelsen med et såkalt søskendesign. Barn av mødre som brukte angstdempende medisiner og sovemedisiner under graviditeten ble sammenlignet med søsken som ikke hadde blitt påvirket av disse legemidlene i fosterlivet. Sammenligningen ble gjort da barna var ett og et halvt og tre år gamle. (dagensmedisin.no 31.7.2017).)

(Anm: Association of prenatal exposure to benzodiazepines and child internalizing problems: A sibling-controlled cohort study. A sibling-controlled cohort study. (…) Conclusion The findings suggest a moderate association between BZD-anxiolytic exposure and child internalizing problems that is not likely due to stable familial confounding factors. PLoS ONE 12(7): e0181042.)

- Tusenvis av kvinner tok Sanofis legemiddel mot epilepsi til tross for risikoen for fosterskader: media

Thousands of women took Sanofi epilepsy drug despite risk to fetuses: media
reuters.com 9.8.2016
Mer enn 10 000 gravide kvinner i Frankrike tok Sanofi legemiddel Depakine (Orfiril; valproat; valproate) mot epilepsi mellom 2007 og 2014 selv om risikoen for fostermisdannelser var kjent, ifølge en studie sitert av det ukentlige franske satiriske Le Canard Enchaine. (More than 10,000 pregnant women in France took Sanofi's anti-epilepsy drug Depakine between 2007 and 2014 although the risk of fetus malformation was known, according to a study quoted by French satirical weekly Le Canard Enchaine.)

Ukebladet rapporterte at det franske helsedepartementet hadde forsinket offentliggjøring av studien, hvilket departement benekter. (The weekly reported that the French health ministry had delayed publication of the study, which the ministry denied.)

Departementet bekreftet i en uttalelse at en studie ble utført av den nasjonale legemiddelkontrollen ANSM og helseforsikringsbyrået CNAMTS, men la til at den ikke hadde blitt skjult for familier og at første del av studien ville bli presentert den 24. august. (The ministry confirmed in a statement that a study was done by national drug agency ANSM and health insurance agency CNAMTS but added that it had not been hidden from families and that a first part of the study would be presented on August 24.)

Departementet sa det ville vurdere hvilke tiltak som trenges og at hele studien og en handlingsplan basert på dette ville bli offentliggjort i september. (The ministry said it would study measures that needed to be taken and that the full study and an action plan based on it would be made public in September.)

Sanofi sier firmaet ikke var oppmerksom på dataene i studien, og ikke kunne kommentere dem. (Sanofi said the company was not aware of the data in the study and could not comment on it.)

En talskvinne for Sanofi fortalte nyhetsbyrået Reuters at firmaet var blitt klar over risikoen for fostermisdannelser i 1980, og at disse hadde blitt detaljert redegjort for i legemidlets dokumentasjon. A (Sanofi spokeswoman told Reuters that the firm had become aware of the risk of fetus malformation in the 1980s and that these had been spelled out in the drug's documentation.) (…)

(Anm: Valproat eller valproinsyre er en fettsyre som brukes som et antiepileptikum. I tillegg til anfallsforebyggende behandlnig ved epilepsi, brukes legemiddelet ved bipolar lidelse (også behandling av akutt mani) og migrene. Valproat markedsføres i Norge under merkenavnene Orfiril (Desitin Arzneimittel GmbH) og Deprakine (Sanofi-Aventis). (no.wikipedia.org).)

(Anm: Valproate (VPA), and its valproic acid, sodium valproate, and divalproex sodium forms, are medications primarily used to treat epilepsy and bipolar disorder and to prevent migraine headaches.[2] It is useful for the prevention of seizures in those with absence seizures, partial seizures, and generalized seizures. It can be given intravenously or by mouth. Long acting formulations exist.[2] (...) In much of Europe, Depakine and Depakine Chrono (tablets) are equivalent to Epilim and Epilim Chrono above. (en.wikipedia.org).)

(Anm: Ødelagt cellulær "klokke" linket til hjerneskade (Broken Cellular 'Clock' Linked to Brain Damage) (sciencedaily.com 25.11.2013).)

(Anm: Signaling Pathways Linked to Serotonin-Induced Superoxide Anion Production: A Physiological Role for Mitochondria in Pulmonary Arteries. Abstract. Serotonin (5-HT) is a potent vasoconstrictor agonist and contributes to several vascular diseases including systemic or pulmonary hypertension and atherosclerosis. Although superoxide anion ([Formula: see text]) is commonly associated to cellular damages due to [Formula: see text] overproduction, we previously demonstrated that, in physiological conditions, [Formula: see text] also participates to the 5-HT contraction in intrapulmonary arteries (IPA). Front Physiol. 2017 Feb 9;8:76. eCollection 2017.)

(Anm: Antidepressiva linket til hjerterisiko: tvillingstudie. (Antidepressants linked to heart risk: twins study) - Middelaldrende menn som bruker antidepressiva er mer sannsynlig å ha en innsnevring av blodårer, noe som øker risikoen for hjerteinfarkt og slag, enn de som ikke bruker legemidlene, ifølge en studie presentert på lørdag. (Reuters) - Middle-age men who use antidepressants are more likely to have a narrowing of blood vessels, increasing the risk of heart attacks and strokes, than those who do not use the medications, according to a study presented on Saturday.) (reuters.com 2.4.2011).)

(Anm: Delirium is associated with 5-fold increased mortality in acute cardiac patients. (medicalnewstoday.com 16.3.2017).)

(Anm: Lager dokumentarfilm om legemiddelindustrien og psykofarmaka. Filmskaper Annikken Hoel vil ha svar på hvorfor søsteren plutselig døde. (Dødsårsak ukjent). (tv.nrk.no/serie/dagsrevyen 13.3.2017).)

(Anm: «Dødsårsak: ukjent»: Bør bli pensum for både leger og lekfolk. Viktig og skremmende om legemiddelindustriens makt. (...) Det er klart at regissøren har en agenda. Hun dveler ikke ved konspirasjonsteorier, men forsøker å finne frem til en sannhet. Det er klart at regissøren har en agenda. Hun dveler ikke ved konspirasjonsteorier, men forsøker å finne frem til en sannhet. Samtidig er mye av informasjonen i filmen kjent dersom du har fulgt med på store søksmål i USA. Hun greier likevel å få frem et oversiktlig og skremmende bilde av de sterke og korrupte båndene som eksisterer mellom politikere, byråkrater og de store farmasøytiske selskapene. (aftenposten.no 22.3.2017).)

(Anm: Norsk dokumentar: «Lykkepillen» Ti år i psykiatrien var som ti år med tortur for Silje Marie. Et møte med en sykepleier endret alt. (aftenposten.no 13.3.2017).)

(Anm: Uten obduksjoner begraver sykehusene feilene sine. (Without Autopsies, Hospitals Bury Their Mistakes) (…) Da Renee Royak-Schaler uventet kollapset og døde 22. mai beordret ingen obduksjon. (…) Diagnostiske feil, som studier viser er vanlig, forblir uoppdaget, og tillater at leger kan fortsette sin praksis på andre pasienter med en falsk følelse av trygghet. (…) Mulighetene for å lære om effektiviteten av medisinske behandlinger og progresjon av sykdommer går tapt. Unøyaktig informasjon ender opp i dødsattester, og undergraver påliteligheten for avgjørende helsestatistikk. (propublica.org 15.12.2011).)

- Nye data viser økt risiko for misdannelser når antidepressiva brukes under graviditet. (- En studie publisert i British Medical Journal (BMJ) avslører at antidepressiva forskrevet til gravide kan øke sjansen for å få en baby med misdannelser.)

New Data Show Heightened Risk of Birth Defects When Antidepressants Are Used During Pregnancy (Nye data viser økt risiko for misdannelser når antidepressiva brukes under graviditet.)
dgnews.docguide.com 19.1.2017
MONTREAL -- January 19, 2017 -- En studie publisert i British Medical Journal (BMJ) avslører at antidepressiva forskrevet til gravide kan øke sjansen for å få en baby med misdannelser. (A study published in the British Medical Journal (BMJ) reveals that antidepressants prescribed to pregnant women could increase the chance of having a baby with birth defects.)

Risikoen på 6 % til 10 %, sammenlignet med 3 % til 5 % hos kvinner som ikke tar antidepressiva er høy nok til å utvise forsiktighet ved bruk, særlig da de i de fleste tilfeller bare er marginalt effektive. (The 6% to 10% risk, compared with 3% to 5% in women who do not take antidepressants, is high enough to merit caution in their use, especially since in most cases, they are only marginally effective.)

"I svangerskapet behandles mor, men du er bekymret for det ufødte barnet, og nytte må oppveie risikoen," sier senior forfatter Anick Bérard, MD, Université de Montréal, og CHU Sainte-Justine, Montreal, Quebec. (“In pregnancy, you’re treating the mother but you’re worried about the unborn child, and the benefit needs to outweigh the risk,” said senior author Anick Bérard, MD, Université de Montréal, and CHU Sainte-Justine, Montreal, Quebec.)

I studien så forskerne på 18 487 kvinner med depresjon i Quebec Pregnancy Cohort, en longitudinell studie, populasjonsbasert gruppering av 289 688 svangerskap registrert mellom 1998 og 2009. Av kvinnene i studie tok 3 640 (~ 20%) antidepressiva i første 3 måneder. (For the study, the researchers looked at 18,487 women with depression in the Quebec Pregnancy Cohort, a longitudinal, population-based grouping of 289,688 pregnancies recorded between 1998 and 2009. Of the women studied, 3,640 (~20%) took antidepressants in the first 3 months.)

"Vi så bare på det første trimesteret fordi det er der alle organsystemer utvikles," sier Dr. Bérard. "Ved 12 uker av svangerskapet, er barnet formet." (“We only looked at the first trimester, because this is where all the organ systems are developing,” said Dr. Bérard. “At 12 weeks of gestation, the baby is formed.”)

Bruk av antidepressive i dette kritiske tidsvinduet har potensiale til å påvirke inntak av serotonin hos fosteret, noe som kan resultere i misdannelser. (Antidepressant use during this critical time-window has the potential to interfere with serotonin intake by the fetus, which can result in malformations.)

"Serotonin tidlig i svangerskapet er essensielt for utviklingen av alle embryonale celler, og har således en hvilken som helst påvirkning som forstyrrer signaleringsprosessen for serotonin har potensiale til å forårsake en lang rekke misdannelser,» skrev forfatterne. (“Serotonin during early pregnancy is essential for the development of all embryonic cells, and thus any insult that disturbs the serotonin signalling process has the potential to result in a wide variety of malformations,” the authors wrote.)

Når citalopram (Cipralex (Lexapro) (escitalopram) - Cipramil (Celexa) (cipramil) (citalopram) - H. Lundbeck A/S) ble tatt i første trimester økes risikoen for store fødselsskader fra 5 % til 8 %. I alt ble 88 tilfeller av misdannelser knyttet til bruk av legemidlet. (When citalopram was taken in the first trimester, the risk of major birth defects jumped from 5% to 8%. In all, 88 cases of malformations were linked to use of the drug.)

Tilsvarende bruk av paroksetin (paroxetine; Paxil; Seroxat etc.) forbundet med en økt risiko for hjertefeil; venlafaksin (Efexor; Effexor (venlafaxine); Pristiq (desvenlafaxine)); og lungeskader; og trisykliske antidepressiva med økt øye-, øre-, ansikt- og nakkedefekter. (Similarly, use of paroxetine was associated with an increased risk of heart defects; venlafaxine with lung defects; and tricyclic antidepressants with increased eye, ear, face, and neck defects.)

I løpet av omtrent et tiår i den gruppen som Bérard gransket var andelen av vordende mødre på antidepressiva i Quebec fordoblet, fra 21 brukere per 1000 graviditeter i 1998 til 43 tusen i 2009. (Over the decade or so that Bérard studied her cohort, the proportion of expectant mothers on antidepressants in Quebec doubled, from 21 users per 1,000 pregnancies in 1998 to 43 per 1,000 in 2009.) (…)

(Anm: Lene Skogstrøm. Når gravide tar medisiner mot depresjon, kan barnet få adferdsproblemer (aftenposten.no 27.8.2015).)

(Anm: Mona Skard Heier, dr.med., spesialist i nevrologi og klinisk nevrofysiologi. Større edruelighet i overskrifter! «Antidepressiver kan gi barn med adferdsproblemer». Under denne skremmende overskriften presenterer Aftenposten en nylig gjennomført studie ved Psykologisk Institutt ved Universitetet i Oslo. (aftenposten.no 2.9.2015).)

(Anm: Sertraline use during pregnancy and the risk of major malformations. OBJECTIVE: Given the current debate and growing public concerns on selective serotonin reuptake inhibitors (SSRIs) and birth defects generated by Food and Drug Administration warnings, we aim to quantify the association between first-trimester exposure to sertraline, a first-line treatment, and the risk of congenital malformations in a cohort of depressed women. (…) CONCLUSION: Sertraline use during the first trimester of pregnancy was associated with an increased risk of atrial/ventricular defects and craniosynostosis above and beyond the effect of maternal depression. Nonsertraline SSRIs were associated with an increased risk of craniosynostosis and musculoskeletal defects.Am J Obstet Gynecol. 2015 Jun;212(6):795.e1-795.e12. Epub 2015 Jan 28.)

(Anm: New studies show no long term effects of antidepressant use during pregnancy. The use of antidepressants during pregnancy has no long term neurodevelopmental or behavioural effects on the child, however they may be associated with an increased risk of postpartum haemorrhage, suggests the findings from three studies published in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG).  (…) Their children had a slight delay in the development of fine and gross motor skills compared to children unexposed during pregnancy. Marte Handal, lead author of the study from the Norwegian Institute of Public Health said: "Our results show that treatment with SSRIs during longer time periods in pregnancy was weakly associated with a delayed motor development at age three. However, only a very small number of children had a severe delay. (medicalnewstoday.com 17.9.2015).)

(Anm: Ingen betydningsfull sammenheng mellom bruk av antidepressiva under graviditeten og forsinket motorisk utvikling hos barnet. (…) Over 50 000 barn fra Den norske mor og barn-undersøkelsen (MoBa) deltok i studien. Blant mødrene til disse barna var det 159 som rapporterte langvarig bruk av SSRI under graviditeten. Deres barn hadde litt forsinket utvikling av fin- og grovmotoriske ferdigheter i forhold til barn som ikke var eksponert for SSRI under svangerskapet. Det var imidlertid bare et meget lite antall barn som ble betydelig forsinket i sin motoriske utvikling. (fhi.no 8.10.2015).)

(Anm: Handal M1, Skurtveit S1,2, Furu K1, Hernandez-Diaz S3, Skovlund E1, Nystad W1, Selmer R1. Motor development in children prenatally exposed to selective serotonin reuptake inhibitors: a large population-based pregnancy cohort study. BJOG. 2015 Sep 15. [Epub ahead of print].)

(Anm: Management of psychotropic drugs during pregnancy. BMJ 2016;352:h5918 (Published 20 January 2016).)

- Antidepressiva i svangerskapet kan påvirke spedbarn

Antidepressants during pregnancy may affect baby (antidepressiva i svangerskapet kan påvirke spedbarn)
reuters.co.uk 26.8.2006
- Babies born to women who took the newer type of antidepressants called selective serotonin reuptake inhibitors or SSRIs during pregnancy appear to be at increased risk of having a low birth weight and to develop respiratory distress, Canadian researchers report. (...)

There was a significantly greater incidence of respiratory distress (13.9% vs. 7.8%) and longer hospital stays for infants born to depressed mothers on SSRIs than those born to untreated depressed mothers, the team reports in the Archives of General Psychiatry. (...)

(Anm: Low Birth Weight Babies at Higher Risk for Mental Health Problems Later in Life. WASHINGTON, DC -- February 13, 2017 -- Babies born with extremely low birth weight are not only at risk for physical problems but are also more likely to experience mental health problems later in life, according to an analysis of research conducted over nearly 30 years. (dgnews.docguide.com 13.2.2017).)

SSRI treatment for maternal depression may affect neonate
reutershealth.com 25.8.2006
- Women who take selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy appear to be at increased risk of having offspring with low birth weight and respiratory distress, Canadian researchers report in the August issue of Archives of General Psychiatry. (...)

Birth weight and gestational age were also significantly less in SSRI-exposed infants and a significantly greater proportion was born before 37 weeks.

"Disse resultater er i strid med forventninger om at behandling av mødre med SSRI-er under svangerskap ville være assosiert med færre uheldige neonatale konsekvenser assosiert til depresjon hos mor," uttalte dr. Oberlander. (...) ("These findings are contrary to an expectation that treating depressed mothers with SSRIs during pregnancy would be associated with lessening of the adverse neonatal consequences associated with maternal depression," Dr. Oberlander said.)

Neonatal Outcomes After Prenatal Exposure to Selective Serotonin Reuptake Inhibitor Antidepressants and Maternal Depression Using Population-Based Linked Health Data
Arch Gen Psychiatry 2006;63:898-906
(...) Conclusion With linked population health data and propensity score matching, prenatal SE-D exposure was associated with an increased risk of low birth weight and respiratory distress, even when maternal illness severity was accounted for. (...)

- Abbvie taber sag om fødselsdefekter. Amerikanske Abbvie må endnu engang til lommerne i en sag om et af selskabets lægemidler. (- Depakote er godkendt mod epilepsi, bipolar lidelse og forebyggelse af migræne.)

(Anm: Abbvie taber sag om fødselsdefekter. Amerikanske Abbvie må endnu engang til lommerne i en sag om et af selskabets lægemidler, der blandt andet bruges til behandling af bipolar lidelse. Denne gang anklages lægemidlet for at medføre fødselsdefekter. Anklagerne fortsætter med at klæbe til Abbvies lægemiddel Depakote, der blandt andet bruges til behandling af bipolar lidelse.Denne gang har selskabet tabt en sag om fødselsdefekter, skriver Reuters.Derfor er Abbvie nu blevet dømt til at betale 15 mio. dollars, knap 100 mio. kr., til 10-årige Stevie Gonzales. Hans mor tog Depakote mod bipolar lidelse under sin gravidtet. Steve Gonzales blev født med spina bifida (rygmarksbrok). Moderen hævder, at hun ikke var advaret tilstrækkeligt om risikoen ved fødselsdefekter ved at indtage Depakote, mens hun var gravid.Søgsmålet var egentlig rettet mod Abbott Laboratories, men Abbvie blev spundet ud af Abbott i 2013, hvor Abbvie overtog alle rettighederne til lægemidlet. I øjeblikket er der 695 søgsmål rettet mod Depakote, oplyser Abbvie.Tilbage i 2012 indgik Abbott et historisk højt forlig på 1,6 mia. dollars med anklager om, at Depakote var blevet markedsført i indikationer, som lægemidlet ikke er godkendt til blandt andet demens. Depakote er godkendt mod epilepsi, bipolar lidelse og forebyggelse af migræne. (medwatch.dk 12.6.2017).)

Study Ties Epilepsy Drug to Fetal Risk
latimes.com 8.8.2006
One in five women who took the widely used epilepsy drug valproate in a clinical trial had pregnancies resulting in birth defects or fetal death, researchers said Monday.

The drug, sold as Depakote by Abbott Laboratories Inc., was substantially riskier to unborn children than three competing medicines examined in the study. The researchers found cases of malformed hearts and genitals, cleft palate and artery deformities among children born to women taking the drug.
The report in the journal Neurology was the latest to document the potential dangers of valproate to fetuses. The drug is also used to treat headaches and some psychiatric conditions, including bipolar disorder. (...)

Teratogenicity of antiepileptic drugs
Editorial
BMJ 2006;333:615-616 (23 September)
Women should consider stopping, minimising, or switching drugs before pregnancy

Prescribing for women with epilepsy is complicated by the potential teratogenicity of antiepileptic drugs. Current guidelines recommend that the most effective drug should be chosen before conception and prescribed at its lowest effective dose, ideally as monotherapy.1 2 But which antiepileptic drug is safest in pregnancy?

Early research on the safety of antiepileptic drugs in pregnancy was unreliable. Several countries set up pregnancy registries in the late 1990s, and data from these registries are now appearing. (...)

(Anm: teratogen; som skaper misfoster, som er årsak til lyte hos foster; særleg brukt om visse kjemiske stoff eller medikament. EN teratogenic. ET [gr teras misfoster + gennan skapa]. Kilde: Norsk medisinsk ordbok.)

Epilepsy drug warning for pregnancies
netdoctor.co.uk 8.8.2006
A drug used to treat epilepsy could increase the risk of foetal death and birth defects when taken by pregnant mothers, new research suggests.

According to a study published in the latest edition of the journal Neurology, the drug valproate was found to pose a significantly higher risk to unborn babies when compared with alternative epilepsy drug treatments.

In a study of 333 mothers, 20 per cent of those taking valproate while pregnant experienced still births or birth defects in their child.

The rate was much lower for the alternative drugs phenytoin, carbamazepine and lamotrigine. (...)

- Farmasøyten og rådgiveren er glad de tar kontakt med henne, ettersom mye av informasjonen på nettet kan være feil.

Mottar 160 telefoner fra bekymrede gravide hver dag (Video)
nrk.no 12.7.2015
Aldri før har så mye informasjon om hva man bør og ikke bør gjøre i svangerskapet vært tilgjengelig. Fødeavdelingen på Ullevål sykehus opplever stor pågang av blivende mødre som er urolige for å ha gjort noe feil.

«Gravid, farlig å bøye seg. Farlig med katt, farlig å nyse». Dette er noen av resultatene som dukker opp hvis en søker på «gravid + farlig» i søketjenester på nettet.

– Det her er et typisk eksempel på hva som kan skremme gravide, forteller farmasøyt Gro Cecilie Havnen. (…)

Spør om de bør ta abort
Hun jobber med å skrive skreddersydde svar til bekymrede gravide om hvilke medisiner man kan og ikke kan bruke under svangerskapet. Farmasøyten og rådgiveren er glad de tar kontakt med henne, ettersom mye av informasjonen på nettet kan være feil.

– Det mest utfordrende for gravide er vrimmelen av informasjon som er der ute, det er vanskelig å vite hva som er en god kilde og ikke. Noen spør til og med om det er grunn til å ta abort hvis de har tatt medisiner de har lest er farlige. Det er skremmende dersom det er på grunn for lite eller feil informasjon, forteller Havnen. (…)

Farmasøyten forteller at mange gravide er opptatt av å gjøre alt riktig både når det gjelder kosthold, trening og medisinbruk. (...)

(Anm: Informasjon versus kunnskap og makt (kommersialisering og monopolisering av kunnskap) (mintankesmie.no).)

(Anm: Lederartikler. Å gjøre pasientrelevant klinisk forskning til en realitet. Forskere, bidragsytere (sponsorer; finansiører) og utgivere har alle et arbeid å gjøre (Editorials. Making patient relevant clinical research a reality. Researchers, funders, and publishers all have work to do.) BMJ 2016;355:i6627 (Published 23 December 2016).)

(Anm: Mer kritisk tenkning blant folk med utdannelse? (…) Kritisk tenkning er vår beste sikkerhetsventil mot maktovergrep, tyrannisering, og overtro. (…) Mer kritisk tenkning blant folk med utdannelse?) (…) Er kritisk tenkning utbredt? I så fall blant hvem? (fritanke.no 14.6.2013).)

(Anm:- Jeg sørger over fattigdommen i vår kritiske tenkning. (I mourn the poverty of our critical thinking.) BMJ 2012;345:e5409 (10 August).)

(Anm: Aage Borchgrevink, forfatter og seniorrådgiver i Den norske Helsingforskomite. Ingenting er sant og alt er mulig. (…) I Russland ligger staten bak, mens amerikanske falske nyheter var en forretningsmodell. (…)  I en tid der det finnes mer informasjon enn noensinne, er folk relativt sett dårligere informert enn før. (nrk.no 5.2.2017).)

(Anm: George Orwells «1984» er en bestselger etter Trump-innsettelse. (…) Boken et en dystopisk fortelling om et fremtidig samfunn der fakta blir forvrengt og undertrykt. Folket overvåkes, opposisjonen forsvinner og historien omskrives. (vg.no 25.1.2017).)

(Anm: Michael Flynn trækker sig: Trumps sikkerhedsrådgiver blev ramt af sin egen løgn. Trump accepterer opsigelse fra sin nationale sikkerhedsrådgiver. Aflytning af den russiske ambassadørs telefon tog Michael Flynn i en løgn. (politiken.dk 14.2.2017).)

(Anm: Skrekken for åpenhet i forvaltning, byråkrati og politisk ledelse er et demokratisk problem (aftenposten.no 25.3.2015).)

(Anm: Margaret McCartney: Bevis i en post-fakta-verden (Evidence in a post-truth world.) Gjør internett oss dummere? Utfallet av det amerikanske presidentvalget vil bli analysert som en skarp case-studie lenge etter at vi alle er døde, men internett må i det minste ta noe av skylden. Vi lever i et post-faktum, post-sannhet, vi har fått nok av ekspert-æraen. (Is the internet making us more stupid? The outcome of the US presidential election will be analysed as a caustic case study long after we’re all dead, but the internet must take at least some of the blame. We’re in a post-fact, post-truth, we’ve-had-enough-of-experts era. BMJ 2016;355:i6363 (Published 28 November 2016.)

(Anm: - De som tror intelligens er fastlåst har selvtillit som overgår deres evner. (…) Forskerne bemerker at overdreven selvtillit er et dokumentert problem hos bilførere, motorsyklister, strikkhoppere, leger og advokater. Journal of Experimental Social Psychology 2016;63:94-100 (March 2016).)

(Anm: Internett gir gravide frykt for legemidler. Ifølge to mastergradsstudenter ved Farmasøytisk institutt ved Blindern unnlater kvinner å bruke trygge medisiner under svangerskap og amming på grunn av det de leser på internett. Det skriver nettavisen Titan, som skriver om forskning som gjøres ved Universitet i Oslo. Den vitenskapelige rapporten ble vurdert til å være så god at studentene fikk den publisert i det anerkjente internasjonale vitenskapelige tidsskriftet European Journal of Clinical Pharmacology. (farmatid.no 24.5.2016).)

- Over halvparten av gravide tar reseptmedisin. (- Gravide får motstridende medisinråd)

Over halvparten av gravide tar reseptmedisin
aftenposten.no 23.2.2008
En stor andel kvinner, 57 prosent, bruker reseptbelagte legemidler i løpet av svangerskapet. (...)

(Anm: Gravide ønsker mer medisin-info (dagensmedisin.no 12.8.2014).)

(Anm: Valproic acid after five decades of use in epilepsy: time to reconsider the indications of a time-honoured drug. (…) However, during the past few years increasing evidence has accumulated that intake of valproic acid during pregnancy is associated with a significant risk of dose-dependent teratogenic effects and impaired postnatal cognitive development in children. Because of these risks, valproic acid should not be used as a first-line drug in women of childbearing potential whenever equally or more effective alternative drugs are available—as in the case of focal epilepsy. Lancet Neurology 2016;15(2):210–218 (February 2016).)

(Anm: Prevensjon for kvinner som bruker antiepileptika. De fleste kvinner i fertil alder vil ha sikker prevensjon. Dette er særlig viktig hos kvinner med epilepsi, fordi noen antiepileptiske legemidler kan ha fosterskadelige effekter. Når man kombinerer hormonell antikonsepsjon med antiepileptiske midler, må man kjenne til at noen antiepileptika kan redusere effekten av hormonelle prevensjonsmidler – og omvendt, noe som kan resultere i nedsatt effekt av begge legemidlene. Ikke-hormonell prevensjon, som kobberspiral og barrieremetoder, kan imidlertid trygt brukes i denne pasientgruppen.Tidsskr Nor Legeforen 2016; 136:32 – 4 (12.1.2016).)

(Anm: Paucity of data on the safety of drugs for treating depression in pregnancy. BMJ 2016;353:i2582 (Published 11 May 2016).)

(Anm: Drug Commonly Used For Pain And Anxiety May Be Linked To Major Birth Defects. A drug commonly prescribed for pain and anxiety may be linked to major birth defects, new research suggests. Published in Neurology, the medical journal of the American Academy of Neurology, the prospective cohort study reviewed pregnancy outcomes following maternal use of pregabalin (Lyrica), a drug used to treat nerve and muscle pain. It’s commonly prescribed to patients with epilepsy, fibromyalgia and generalized anxiety disorder. (forbes.com 19.5.2016).)

(Anm: Fibromyalgi: Fibromyalgi rammer over 100.000 norske kvinner. - En del tror sykdommen bare er tøys. Også blant leger er det en del som flirer av den, forteller professor. (…)   Når leger blir bedt om å rangere hvilke sykdommer det er mest prestisje å jobbe med, så havner alltid fibromyalgi nederst, forteller hun. Professor Egil Andreas Fors ved Institutt for samfunnsmedisin og allmennmedisinsk forskningsenhet ved NTNU er blant Norges fremste eksperter på sykdommen. Han bekrefter holdningene Slydal beskriver. (…) Sykdommen kjennetegnes gjerne ved at man har kroniske muskelsmerter, andre symptomer kan være utmattelse, hodepine, stivhet i kroppen, svimmelhet, kvalme, indre frost, depresjoner, angst og søvnproblemer. (kk.no 8.3.2016).)

(Anm: Lettere at diagnosticere fibromyalgi. På University of Colorado har forskere opdaget en speciel hjernesignatur, der med 93 pct. sikkerhed kan fastslå, hvorvidt en person lider af fibromyalgi eller ej. (pharmadanmark.anp.se 27.10.2016).)

(Anm: Pregabalin Use During Pregnancy Tied to Birth Defects. small observational study of first trimester maternal exposure to pregabalin found a potential increased risk for major birth defects. The drug, used to treat neuropathic pain and partial-onset seizures, is often used off-label in women, according to a previous Swedish study. Although there is limited data for the use of pregabalin in pregnancy, animal studies have linked its use to reproductive toxicity. With many pregnancies unplanned, the risk of exposure to the developing fetus is high.  (neurologyadvisor.com 19.5.2016).)

- Gravide får motstridande medisinråd

Gravide får motstridande medisinråd
nrk.no/teksttv 21.8.2007
Gravide får motstridande råd om medisinar, avhengig av kjelda som gjev dei informasjon om legemiddel.

Ei ny undersøking viser at råda frå Felleskatalogen og den offentlege organisasjonen for legemiddel er ulike i halvparten av tilfella.

Felleskatalogen er produsert av legemiddelindustrien og er det mest brukte oppslagsverket for legemiddel.

Sofia Frost Widnes i den offentlege legemiddelinformasjonssentralen meiner slik ulik rådgjeving er urovekkjande.

(Anm: Nyhetsoppslag: forskjeller mellom RELIS og Felleskatalogen vedrørende graviditet. relis.no 21.8.2007 (RELIS – regionale legemiddelinformasjonssentre).)

- Fire av fem gravide kvinner i USA får utlevert et reseptbelagt legemiddel, og nesten halvparten får legemiler som kan være skadelig for fosteret, ifølge en studie på Medicaid-pasientjournaler.

Use of prescription drugs is common during pregnancy, US study finds (Bruk av reseptbelagte legemidler er vanlig under svangerskapet, finner amerikansk studie)
BMJ 2015;351:h4421 (Published 13 August 2015)
Fire av fem gravide kvinner i USA har får utlevert et reseptbelagt legemiddel, og nesten halvparten får legemiler som kan være skadelig for fosteret, ifølge en studie på Medicaid-pasientjournaler. (Four in five pregnant women in the United States have a prescription drug dispensed, and nearly half are given drugs that may be harmful to the fetus, a study of Medicaid records has found.)

In the study Kristin Palmsten, of the University of California, San Diego and colleagues reviewed outpatient pharmacy records from 2000 to 2007 on 1 106 757 pregnant women who were covered by Medicaid, the health insurance plan for low income earners and disabled people.1

They found that 82.5% of the cohort had received one or more prescription drugs during pregnancy. The most commonly dispensed drug classes were antibacterials, dispensed to 49.7% of the women; analgesics and antipyretics (29.6%); skin and mucous membrane anti-infectives (28.7%); urinary anti-infectives (21.7%); and first generation antihistamines (18.6%). The most commonly dispensed drugs were nitrofurantoin, metronidazole, amoxicillin, azithromycin, and promethazine. (…)

The researchers noted that, of the 20 most commonly dispensed drugs, nine were rated by the Teratogen Information System as having limited to fair data quality and quantity to inform human teratogenic risk assessments, and the other 11 received fair to good ratings. “Lack of unambiguous safety information may lead to the use of medications with potential to cause adverse pregnancy outcomes, whereas beneficial medications may be avoided,” the researchers concluded. (...)

- Legemidler og svangerskap

Legemidler og svangerskap
nhi.no 7.10.2010
Selv om man skal være forsiktig med å bruke legemidler under svangerskap og i ammeperioden, så er det sjelden at legemidler er skadelige for fosteret.

Som en hovedregel bør man forsøke å bruke minst mulig medisiner når man er gravid. Medisiner kan skade fosteret, og det tryggeste er å avstå fra bruken dersom medisinene ikke er nødvendige. Noen sykdommer krever imidlertid medikamentell behandling også hos gravide. Bruk av medisiner under svangerskap bør alltid diskuteres med lege. Dette gjelder også kosttilskudd. (...)

- Gravide tester medicin uden at vide det

Gravide tester medicin uden at vide det
b.dk 7.3.2011
Medicinalbranchen sniger forsøg med medicin til gravide ind ad bagdøren, mener en professor.

Ny medicin bliver aldrig testet på gravide og ammende før godkendelse, fordi læger og producenter er bange for, at den nyudviklede medicin kan skade fostre og de nyfødte børn.

Derfor er de gravide og deres børn i realiteten forsøgspersoner i virkelighedens verden, når først medicinen godkendes, og lægerne begynder at udskrive den også til gravide og ammende. Det skriver Morgenavisen Jyllands-Posten.

- Med lægernes og myndighedernes stiltiende accept sniger medicinalbranchen forsøgene ind ad bagdøren og venter efter markedsføringen på, at nogle kvinder bliver gravide, mens de får medicinen, så man kan se, om den giver fosterskader.

Det påpeger dr.med. Kim Brøsen, professor i klinisk farmakologi, Syddansk Universitet.

Han mener, at producenterne skubber ansvaret for eventuelle fosterskader over på de ordinerende læger.

- Ingen virksomhed, etisk komité eller myndighed kan holde til at tage ansvaret, hvis noget går galt, siger Kim Brøsen til Jyllands-Posten.

- I stedet lukker vi alle øjnene, godkender præparaterne og skubber det over til lægerne at tage beslutningen om at give usikker medicin til de gravide, som intet får at vide om eksperimentet.

Hos Lundbeck afviser udviklingsdirektør Anders Gersel Pedersen kritikken.

- Det er nu engang lægers opgave at træffe vanskelige beslutninger. Alternativet er, at vi skriver på al ny medicin, at den ikke må gives til gravide.

- Men så risikerer lægerne at stå over for en meget syg gravid kvinde, som, de ved, kunne have været hjulpet med medicinen,« siger han.

Mere end halvdelen af alle gravide får mindst én type receptmedicin i løbet af graviditeten, viser en ny undersøgelse fra Bispebjerg Hospital. (...)

(Anm: Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. Objective To follow up on previously reported associations between periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and specific birth defects using an expanded dataset from the National Birth Defects Prevention Study. (…) Conclusions These data provide reassuring evidence for some SSRIs but suggest that some birth defects occur 2-3.5 times more frequently among the infants of women treated with paroxetine or fluoxetine early in pregnancy. BMJ 2015;351:h3190 (Published 08 July 2015).)

(Anm: New Study Reveals Benefits, Risks of Antidepressants During Pregnancy. NEW YORK -- August 4, 2015 -- Treating maternal psychiatric disorder with selective serotonin reuptake inhibitors (SSRIs) is associated with a lower risk of certain pregnancy complications including preterm birth and delivery by Caesarean section; however, SSRIs resulted in an increased risk of neonatal problems, according to a study published online in the American Journal of Psychiatry. (dgnews.docguide.com 4.8.2015).)

(Anm: Study links outdoor air pollution with millions of preterm births. Scientists have published a major study which links outdoor air pollution with 2.7 million preterm births per year. The study, which was led by a team from The Stockholm Environment Institute (SEI) at the University of York, found that in 2010, about 2.7 million preterm births globally - or 18 per cent of all preterm births - were associated with outdoor exposure to fine particulate matter (PM2.5). (medicalnewstoday.com 20.2.2017).)

(Anm: Air Pollution May Directly Cause Those Year-Round Runny Noses, According to a Mouse Study (hopkinsmedicine.com 18.4.2017).)

- Paracetamol under graviditeten kan gi risiko for uheldige effekter på barnets utvikling

Ny studie om langvarig bruk av paracetamol i svangerskapet
fhi.no 25.10.2013
Paracetamol er det mest brukte legemiddelet i svangerskapet. Likevel er det svært få studier som har sett på mulige langtidskonsekvenser for barnet. En ny studie der Folkehelseinstituttet bidrar antyder at langtidsbruk av paracetamol under graviditeten kan gi risiko for uheldige effekter på barnets utvikling.

Studien bruker data fra den norske Mor-og-barn undersøkelsen ved Folkehelseinstituttet for å undersøke effekten av paracetamol i svangerskapet på psykomotorisk utvikling, adferd og temperament ved 3-års alder. Nær 3 000 søskenpar er inkludert i studien.

Studien er et samarbeid mellom Universitetet i Oslo, Nasjonalt folkehelseinstitutt og Hospital for Sick Children i Toronto, Canada, og er publisert i tidsskriftet International Journal of Epidemiology 25. oktober 2013. (...)

(Anm: Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study. Int. J. Epidemiol. 2013 (First published online: October 24, 2013).)

- Paracetamol kan skade guttefostre

- Paracetamol kan skade guttefostre
vg.no 8.11.2010
Kvinner som spiser hodepinetabletter med paracetamol under graviditet, risikerer å føde gutter med misdannet kjønnsorgan.

47.000 danske kvinner har deltatt i en undersøkelse i regi av universitetet i Aarhus. Resultatet presenteres i siste utgave av tidsskriftet Epidemiology. (...)

- Guttene vil sannsynligvis ha nedsatt sædkvalitet resten av livet. I tillegg kommer de guttene som ikke har medfødte misdannelser, men som vi likevel mistenker vil få nedsatt sædkvalitet på grunn av paracetamol, sier Morten Søndergaard Jensen ved universitetet i Aarhus.

Rundt halvparten av kvinnene som deltok i undersøkelsen tok piller med paracetamol under graviditeten. (...)

(Anm: Maternal Use of Acetaminophen, Ibuprofen, and Acetylsalicylic Acid During Pregnancy and Risk of Cryptorchidism. Epidemiology2010;21(6):779-785 (November).)

(Anm: Bivirkningskomité advarer mod højdosis ibuprofen (dagenspharma.dk 14.4.2015).)

- Antidepressiva, angstdempende legemidler, og antipsykotika, visse smertestillende legemidler og en rekke legemidler for røykeavvenning og substansavhengighet og behandling av alkoholavhengighet er usikre

Most drugs are safe to use during breastfeeding, says report (De fleste legemidler er trygge å bruke under amming, ifølge rapport)
BMJ 2013;347:f5332 (28 August 2013)
Only a small proportion of medications need to be avoided by breastfeeding mothers, an American Academy of Pediatrics committee has concluded in a report.

“Many mothers are inappropriately advised to discontinue breastfeeding or avoid taking essential medications because of fears of adverse effects on their infants,” the academy’s Committee on Drugs said in the report, which was published online in the journal Pediatrics on 26 August.1 (...)

The lead author is Hari Cheryl Sachs, lead medical officer for the pediatric and maternal health staff at the US Food and Drug Administration’s Center for Drug Evaluation and Research.(...)

I rapporten fokuserte komiteen sin diskusjon om visse legemidler som skal brukes med forsiktighet eller i noen tilfeller ikke mens du ammer på grunn av kjente risikoer eller mangel på informasjon om deres sikkerhet, inkludert visse antidepressiva, angstdempende legemidler, og antipsykotika, visse smertestillende legemidler og en rekke legemidler for røykeavvenning og substansavhengighet og behandling av alkoholavhengighet. (In the report, the committee focused its discussion on certain drugs that should be used with caution or in some cases not at all while breastfeeding, because of either known risks or lack of information about their safety, including certain antidepressants, anxiolytics, and antipsychotics, certain pain medications, and a number of drugs for smoking cessation and substance and alcohol dependence treatment.)

(Anm: The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics 2013;132:e796–e809 (Published online August 26, 2013).)

- Sammenlignet med de som tok lamotrigin hadde de som tok litium mer enn doblet risiko for hjertesvikt.

(Anm: Mors litiumbruk utgjør liten risiko for fetus (foster). Mom's Lithium Use Poses Modest Risk to Fetus. Risk in early pregnancy lower than reported in 1970s study. Infants exposed to lithium in utero in the first trimester had a modest increased risk of cardiac malformations compared with both unexposed infants and those exposed to another common mood stabilizer, a large retrospective cohort study found. Compared with unexposed infants, those who were exposed to lithium had a 65% increased risk of cardiac malformations (adjusted RR 1.65, 95% CI 1.02-2.68), albeit with a wide confidence interval, reported Elisabetta Patorno, MD, of Brigham and Women's Hospital, and colleagues. When compared with exposure to lamotrigine, those exposed to lithium had more than twofold increased risk of cardiac malformations (adjusted RR 2.25, 95% CI 1.17-4.34), the authors wrote in the New England Journal of Medicine. (medpagetoday.com 7.6.2017).)

- Litiumbruk ved graviditet og risiko for hjertesvikt.

(Anm: Lithium Use in Pregnancy and the Risk of Cardiac Malformations. Conclusions Maternal use of lithium during the first trimester was associated with an increased risk of cardiac malformations, including Ebstein’s anomaly; the magnitude of this effect was smaller than had been previously postulated. N Engl J Med 2017; 376:2245-2254 (June 8, 2017).)

- FDA skal granske sikkerhet for legemidler tatt under svangeskap

FDA to study safety of drugs taken during pregnancy (FDA skal granske sikkerhet for legemidler tatt under svangeskap)
reuters.com 30.12.2009
WASHINGTON (Reuters) - U.S. health officials plan to study the safety of medications taken during pregnancy with an eye toward using the data in future regulations and medical practice, the U.S. Food and Drug Administration said on Wednesday.

Citing a lack of clinical trials to determine how medications affect mothers and unborn children, the FDA said it will collaborate with other researchers in the new study, called the Medication Exposure in Pregnancy Risk Evaluation Program.
The agency said data shows that about two-thirds of women who deliver a baby have taken at least one prescription medication during pregnancy.

"Results of these studies will provide valuable information for patients and physicians when making decisions about medication during pregnancy," Gerald Dal Pan, a director at the FDA's Center for Drug Evaluation and Research, said in a statement.

The program will work off of data from 11 health plan-affiliated research sites that have healthcare information for about 1 million births over a seven-year period started in 2001.

The FDA did not give a timeline for when the program will complete the safety study. (...)

FDA, Health Plans Begin Study of Drug Effects in Pregnancy
medpagetoday.com 31.12.2009
A massive new database-driven study of effects of prescription drugs during pregnancy, called the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP), is getting under way under FDA sponsorship, the agency announced.
The FDA will collaborate with the HMO Research Network's Center for Education and Research in Therapeutics, based at Harvard Medical School in Boston and Vanderbilt University in Nashville, to collate data from 11 health plan-affiliated research sites.

About half of these sites are part of the Kaiser Permanente system. Others include the research arms of the Harvard Pilgrim and Fallon Community health plans in Massachusetts, the Lovelace Clinic Foundation in New Mexico, the Group Health Research Institute of Seattle, the HealthPartners system in Minnesota, and the Tennessee Medicaid program. (...)

- Sjelden fødseldefekt øker

Rare birth defect on the rise (Sjelden fødseldefekt øker)
reuters.com 20.7.2013
(Reuters Health) - Andelen av barn som fødes med en defekt kalt gastroskise (gastroschisis) har nesten doblet siden 1995, ifølge en ny stor studie. (The proportion of babies born with a defect called gastroschisis has nearly doubled since 1995, according to a large new study.)

The cause of gastroschisis - which is a hole in the baby's abdomen - is unclear, although it's known to be more likely in the children of teen mothers. A mother's exposure to certain chemicals has also been tied to the malformation, though not conclusively.

In the new study, researchers looked at rates of gastroschisis in millions of live births over an 11-year period in the U.S.

"We have a pattern where the prevalence is very much highest among young women and it's growing more rapidly among that group than any other group," said Russell Kirby, a professor at the University of South Florida and the lead author of the study.

Kirby's study could not explain why the birth defect is becoming more common, and gastroschisis itself is not well understood.

The malformation involves an opening next to the belly button, through which the baby's intestines protrude.

Newborns with gastroschisis require immediate surgery to close the hole and put the organs back in place.

Most babies with gastroschisis survive, but Kirby said some children have problems with growth and development and there is not a lot of research about the long term outcomes for these kids.

By general estimates, the condition is relatively rare, with a rate of 2 to 3 cases per 10,000 live births in the U.S. But in recent years, studies have suggested the defect is being seen more often.

To get a better sense of how the numbers have changed over time, Kirby and his colleagues gathered birth defect monitoring data from 15 states.

They found that among 13.2 million births between 1995 and 2005, there were 4,713 babies born with gastroschisis, which translates to about 3.5 out of every 10,000 babies.

This number grew steadily over the study period, however, starting out at 2.3 out of every 10,000 babies in 1995 and climbing to 4.4 out of every 10,000 infants in 2005. (...)

(Anm: Prevalence and Correlates of Gastroschisis in 15 States, 1995 to 2005. Obstetrics & Gynecology 2013 (8 July).)

(Anm: Gastroschisis (en.wikipedia.org).)

(Anm: Bukveggsdefekter - Gastroskise; Defekt i rektusmuskulaturen, slik at tarmer, ventrikkel og lever blottes ved fødselen. Ofte ledsaget av tarmatresi. Kirurgisk beh., god prognose. - Omfalocele; Defekt i navlestrengen. Tarmene dekket til av en hinne. Sterkt genetisk bestemt, assosiert til syndromer og kromosomdefekter; høy mortalitet. (manan.dk 2009).)

(Anm: (...) I en studie fra Broussard (2011) ble det funnet en høyere forekomst av forskjellige typer fosterskade (inkl. hjertefeil, nevralrørsdefekter og gastroskise) hos barn av mødre som hadde brukt opioider (62). (Vanedannende legemidler – forskrivning og forsvarlighet (helsedirektoratet.no 2013).)

(Anm: FDA Tightens Opioid Labeling (medpagetoday.com 10.9.2013).)

(Anm: Exposure to prescribed drugs in pregnancy and association with congenital malformations. Obstet Gynecol. 1981 Sep;58(3):336-44.)

- Eksponering for forskrevne legemidler i svangerskapet og tilknytning til medfødte misdannelser

Exposure to prescribed drugs in pregnancy and association with congenital malformations (Eksponering for forskrevne legemidler i svangerskapet og tilknytning til medfødte misdannelser)
Obstet Gynecol. 1981 Sep;58(3):336-44
Abstrakt I en case-kontrollstudie (N = henholdsvis 1 427 og 3 001, ) på fødsler i Connecticut var forekomsten av medfødte misdannelser 52 per 1 000 hos levendefødte. Av alle mødre brukte 44,5 % minst ett foreskrevet legemiddel under graviditet. Case-mødre var mer sannsynlig enn kontroll-mødre å ha brukt et reseptbelagt legemiddel (odds ratio [o] = 13, P mindre enn .0001), spesielt et antidepressiva (o = 7.6), narkotiske smertestillende (o = 3.6), eller beroligende legemidler (o = 23); P mindre enn .01 for alle assosiasjoner. Det var en relasjon mellom bruk av beroligende legemidler og røyking i svangerskapet, noe som resulterer i en o = 3.7 (P mindre enn .01) risiko for de eksponerte for begge. De samvirkende forbindelser mellom beroligende midler-sigaretter med misdannelser støtter eksisterende pharmakologisk forskning og antyder at epidemiologiske studier av virkningen av samtidige maternofetal eksponering for miljømessige substanser kan videre forklare etiologien for noen medfødte misdannelser. (...) (Abstract In a case-control (N = 1427 and 3001, respectively) study of deliveries in Connecticut the incidence of congenital malformations was 52 per 1000 live births. Of all mothers, 44.5% used at least 1 prescribed drug during pregnancy. Case mothers were more likely than controls to have used a prescription drug (odds ratio [o] = 13, P less than .0001), particularly an antidepressant (o = 7.6), narcotic analgesic (o = 3.6), or tranquilizer (o = 23); P less than .01 for all associations. There was a synergistic relationship with tranquilizer use and smoking in pregnancy, resulting in a o = 3.7 (P less than .01) risk for those exposed to both. The synergistic relationship of tranquilizers-cigarettes with malformations supports existing pharmacologic research and suggests that epidemiologic study of the impact of simultaneous maternofetal exposure to environmental agents may further explain the etiology of some congenital malformations.)

More Newborns Suffering Drug Withdrawal at Birth (Flere nyfødte lider av seponering av legemidler ved fødsel)
health.yahoo.com 31.1.2012
MONDAY, Jan. 30 (HealthDay News) -- A dramatic rise in newborns experiencing drug withdrawal after being exposed in the womb poses challenges for clinicians on how to detox these tiny victims, a new report indicates.

The American Academy of Pediatrics (AAP) has released its first updated guidelines on neonatal drug withdrawal since 1998, partly in response to the escalating abuse of both illicit and prescription drugs by pregnant women and partly in recognition of better pain management techniques for babies who are critically ill.

"There have been pockets of the country where up to 25 percent of all NICU [neonatal intensive care unit] babies at any given time are being treated for withdrawal," said report co-author Dr. Mark Hudak, a professor of pediatrics at the University of Florida College of Medicine in Jacksonville. "The problem has percolated up and reached the attention of government and medical officials."

The report is published online Jan. 30 in advance of appearing in the February issue of the journal Pediatrics. (...)

(Anm: Neonatal Drug Withdrawal. Pediatrics 2012 (Published online January 30).)

(Anm: seponere; innstille, holde opp med (om medisinsk behandling). Kilde: Store norske leksikon.)

(Anm: seponering; det å stansa ei behandling, slutta med eit legemiddel, vanleg forkorting: sep. EN cessation of medication; withdrawal. ET [lat. seponere setja til side] Kilde: Norsk medisinsk ordbok.)

(Anm: Babies with drug withdrawal syndrome more likely to be readmitted (medicalnewstoday.com 1.10.2015).)

(Anm: Vedvarende sponeringslidelser (bivirkninger) indusert av paroxetine (Seroxat; paroksetin), en selektiv serotonin reopptakshemmer (SSRI), og behandlet med spesifikk kognitiv atferdsterapi (Persistent Postwithdrawal Disorders Induced by Paroxetine, a Selective Serotonin Reuptake Inhibitor, and Treated with Specific Cognitive Behavioral Therapy.) De første månedene av paroksetinavbrudd, inkludert nedtrapping og 1 måned med fullstendig seponering, var kjennetegnet av vedvarende post-abstinensforstyrrelser som består av kontinuerlig agitasjon, depersonalisering, generalisert angst, fysisk svakhet, humørsvingninger og søvnproblemer. (The first months of paroxetine withdrawal, including tapering and 1 month of complete discontinuation, were characterized by persistent postwithdrawal disorders consisting of continuous agitation, depersonalization, generalized anxiety, physical weakness, mood swings and sleep difficulties.) Psychother Psychosom 2014;83:247-248).)

Link Between SSRIs and Rare Newborn Condition Still Unclear
medscape.com 14.12.2011
December 14, 2011 — The link between the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and persistent pulmonary hypertension of the newborn (PPHN) remains unclear, says the US Food and Drug Administration (FDA).

In a drug and safety communication released December 14, the agency says it is uncertain whether SSRIs cause PPHN because the data are conflicting.

"Two studies suggest an increased risk for PPHN with SSRI use in pregnancy. Three other studies do not support this association and the potential risk with SSRI use during pregnancy remains unknown," the FDA release notes.

As a result, the agency recommends that pregnant women who are taking antidepressants do not stop treatment.

The update follows an FDA advisory released in July 2006 and reported by Medscape Medical News at that time regarding the potential risk for PPHN associated with gestational exposure to SSRIs. (...)

(Anm: Does SSRI Use During Pregnancy Increase the Risk for PPHN? Yes, though perhaps more modestly than previously suggested. (…) Comment This is the most comprehensive analysis to date of the relationship between SSRI use and PPHN in the U.S. Although questions remain about whether SSRI use is associated with milder versus severe PPHN, this is the first study to rigorously control for maternal depression and provides important data indicating that the overall risk for PPHN following maternal SSRI use might be more modest than previously described. NEJM 2015 (July 13, 2015).)

Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: Drug Safety Communication - Use During Pregnancy and Potential Risk of Persistent Pulmonary Hypertension of the Newborn
fda.gov 12.12.2011
Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); Viibryd (vilazodone) (...)

ISSUE: FDA notified healthcare professionals and the public on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women during pregnancy and the potential risk of a rare heart and lung condition known as P ersistent Pulmonary Hypertension of the Newborn (PPHN). The initial Public Health Advisory in July 2006 on this potential risk was based on a single published study. Since then, there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.
FDA has reviewed the additional new study results and has concluded that, given the conflicting results from different studies, it is premature to reach any conclusion about a possible link between SSRI use in pregnancy and PPHN. FDA will update the SSRI drug labels to reflect the new data and the conflicting results.

BACKGROUND: SSRIs are marketed under various brand and generic drug names, and are used to treat depression and other psychiatric disorders. There are no adequate and well-controlled studies of SSRIs in pregnant women.

PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with PPHN may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage, and even death.

RECOMMENDATION: FDA advises health care professionals not to alter their current clinical practice of treating depression during pregnancy. See the Data Summary in the FDA Drug Safety Communication for additional information. (...)

(Anm: FDA Drug Safety Communication: Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies. (fda.gov 12.12.2011).)

- Kvinner advares ofte ikke om mulige SSRI-relaterte fødselsdefekter

Sent språk kan skyldes mors antidepressiva
dagensmedisin.no 16.4.2014
Barn av mødre som bruker antidepressiva i svangerskapet, kan ha økt risiko for forsinket språkutvikling.
Forsinket språkutvikling ved treårsalder kan ha sammenheng med mors bruk av den vanligste typen antidepressiva (SSRI) i svangerskapet, viser en studie fra Folkehelseinstituttet.

Studien er en av få i verden som har sett på langtidseffekter hos barn etter mors bruk av antidepressiva i svangerskapet, og som har kunnet følge så mange barn over lang tid. Studien inkluderer 50. 000 barn fra Den norske mor og barn-undersøkelsen (MoBa).

Angstsymptomer gir større risiko
- Siden studien er blant de første av sitt slag, er det viktig at resultatene blir etterprøvd av andre forskere før det legges alt for stor vekt på dem, sier Svetlana Skurtveit, seniorforsker og professor på Folkehelseinstituttet og Universitet i Oslo, til FHIs nettsider.

FHI har gjort studien i samarbeid med SERAF ved Universitetet i Oslo og Harvard School of Public Health. Studien er publisert i BJOG: An International Journal of Obstetrics and Gynaecology. (...)

(Anm: Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay. Pediatrics 2014 (Published online April 14, 2014).)

(Anm: Antidepressants during pregnancy linked to autism. Prof. Bérard says: (…) Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." The use of selective serotonin reuptake inhibitors (SSRIs) - a common class of antidepressants - during the second and/or third trimester was significantly associated with an increased risk of ASD. (medicalnewstoday.com 14.12.2015).)

(Anm: Flere unge bruker antidepressiva enn for ti år siden. Dette viser en ny studie fra Folkehelseinstituttet gjort i samarbeid med Høgskolen i Hedmark. Studien viser også at færre barn i 1-2-årsalderen får sovemidler. (…) Bruk av et psykofarmaka er i denne studien definert som uttak av minst én resept i løpet av et år på følgende legemidler: •sovemiddel inkludert alimemazin (Vallergan) •midler mot depresjon (antidepressiva) •midler mot psykose (antipsykotika) •angstdempende midler (anxiolytika) •midler i behandling av ADHD (fhi.no 2.2.2016).)

(Anm: Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children.  Conclusions and Relevance  Use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester increases the risk of ASD in children, even after considering maternal depression. Further research is needed to specifically assess the risk of ASD associated with antidepressant types and dosages during pregnancy. JAMA Pediatr. 2015 (Published online December 14, 2015).)

(Anm: Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway. BJOG. 2014 Apr 14. doi: 10.1111/1471-0528.12821. [Epub ahead of print].)

(Anm: Altered dopamine signaling a clue to autism (medicalnewstoday.com 4.2.2015).)

Forsinket språkutvikling hos barnet kan ha sammenheng med mors bruk av antidepressiva
fhi.no 15.4.2014
Barn av mødre som brukte den vanligste typen antidepressiva (SSRI) i svangerskapet, kan ha økt risiko for forsinket språkutvikling ved treårsalder sammenlignet med barn av mødre som ikke brukte antidepressiva mens de var gravide. Det viser resultater i en studie fra Den norske mor og barn-undersøkelsen på Folkehelseinstituttet.

Resultatene fra studien viser at gravides bruk av antidepressiva kan ha innvirkning på språkutvikling. Funnene viser også at dersom den gravide hadde symptomer på angst og depresjon, økte risikoen for at barnet fikk forsinket språkutvikling. Forskerne understreker at svært få barn kom i kategorien som tilsvarer alvorlig forsinket språkutvikling.

Dette er en av få studier i verden som har sett på langtidseffekter hos barn etter mors bruk av antidepressiva i svangerskapet, og som har kunnet følge så mange barn over lang tid. (...)

Om studien
Studien inkluderer i overkant av 50 000 barn fra Den norske mor og barn-undersøkelsen (MoBa). Alle foreldre som har deltatt i MoBa har bidratt med viktig informasjon om sin livsstil, sine plager og sykdommer før, under og etter svangerskapet. Dette har gjort det mulig å kontrollere for andre risikofaktorer for forsinket språkutvikling som kunne ha påvirket forskernes resultater. Et eksempel på en slik faktor er depresjon, som forskerne allerede vet at i seg selv kan påvirke barns utvikling. Forskerne er imidlertid også åpne for at det kan være andre faktorer som kan påvirke språkutviklingen.

Folkehelseinstituttet har gjort studien i samarbeid med SERAF ved Universitetet i Oslo og Harvard School of Public Health. (...)

(Anm: Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway. BJOG. 2014 Apr 14. doi: 10.1111/1471-0528.12821. [Epub ahead of print].)

Neonatal seizures after antenatal venlafaxine exposure (Neonatale (før fødselen) anfall (slag) etter antenatal (under svangerskapet) venlafaxine eksponering )
Acta Paediatr. 2013 Aug 2. doi: 10.1111/apa.12375. [Epub ahead of print]
Abstract Functional and behavioural deficits in neonates following the use of selective serotonin and norepinephrine reuptake inhibitors (SNRI) in the third trimester of pregnancy is well documented.1,2,3 Venlafaxine and its active metabolite, O-desmethylvenlafaxine are recognized as potent SNRIs. Up to 63% of neonates exposed to venlafaxine may develop symptoms, which are usually transient and self-limited.4,5 (...)

(Anm: Venlafaxine-Induced Cytotoxicity Towards Isolated Rat Hepatocytes Involves Oxidative Stress and Mitochondrial/Lysosomal Dysfunction. Purpose: Depression is a public disorder worldwide. Despite the widespread use of venlafaxine in the treatment of depression, it has been associated with the incidence of toxicities. Hence, the goal of the current investigation was to evaluate the mechanisms of venlafaxine-induced cell death in the model of the freshly isolated rat hepatocytes. (…) Conclusion: Therefore, our data indicate that venlafaxine induces oxidative stress towards hepatocytes and our findings provide evidence to propose that mitochondria and lysosomes are of the primary targets in venlafaxine-mediated cell damage. Adv Pharm Bull. 2016 Dec;6(4):521-530.)

(Anm: Akutt toksisitet for 8 antidepressiva: hva er deres virkningsmekanismer? (Acute toxicity of 8 antidepressants: what are their modes of action? Currently, the hazard posed by pharmaceutical residues is a major concern of ecotoxicology. Most of the antidepressants belong to a family named the Cationic Amphipathic Drugs known to have specific interactions with cell membranes. The present study assessed the impact of eight antidepressants belonging to selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors.) Chemosphere. 2014 Aug;108:314-9. Epub 2014 Feb 14. (PDF).)

(Anm: Cytotoxic immune cell in sick and healthy skin a key to understanding vitiligo. With the aid of thousands of skin biopsies and over a hundred kilograms of skin, researchers at Karolinska Institutet have observed how two subgroups of immune cell behave in healthy skin. This functional dichotomy is preserved in the inflammatory diseases psoriasis and vitiligo. The study, which is published in the journal Immunity, opens the way for more targeted local treatments for patchy inflammatory skin disorders. (medicalnewstoday.com 22.2.2017).)

Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study (Foreldres depresjon, mors antidepressant bruk under svangerskapet, og risikoen forautismespekterforstyrrelser: befolkningsbasert kasus kontrollstudie (case-control study))
BMJ 2013;346:f2059 (19 April 2013)
(...) Objective To study the association between parental depression and maternal antidepressant use during pregnancy with autism spectrum disorders in offspring.
Design Population based nested case-control study.

Conclusions In utero exposure to both SSRIs and non-selective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability. Whether this association is causal or reflects the risk of autism with severe depression during pregnancy requires further research. However, assuming causality, antidepressant use during pregnancy is unlikely to have contributed significantly towards the dramatic increase in observed prevalence of autism spectrum disorders as it explained less than 1% of cases. (...)

Zoloft Use By Pregnant Women Connected to Clubfoot (Gravide kvinners bruk av Zoloft knyttet til klumpfot)
injurylawyer-news.com 20.12.2012
Zoloft (generic name: sertraline), manufactured by Pfizer, has been associated with birth defects in infants born to mothers who took the antidepressant medication. The problem has been more common to women who took the medication in the first trimester of their pregnancy. Many women who have had children with a birth defect after using Zoloft have chosen to file a Zoloft lawsuit to recover compensation. (...)

Craniosynostosis: A Serious Zoloft Birth Defect (Kraniosynostose: en alvorlig Zoloft-fødselsdefekt)
injurylawyer-news.com 13.12.2012
The New England Journal of Medicine recently published a study that showed that infants exposed to SSRI drugs such as Zoloft while in the womb are twice as likely as other infants to experience a birth defect known as craniosynostosis. Craniosynostosis is a condition marked by the premature closing of an infant’s skull, which can inhibit brain growth. This condition can be associated with genetic disorders such as Apert, Carpenter, Crouzon, Chotzen, and Pfeiffer syndromes as well as the use of SSRI drugs during a woman’s pregnancy.

Risks of Zoloft use
Craniosynostosis signs include misshapen head, developmental delays, seizures, and blindness. There are two different treatments for craniosynostosis–one involves a cranial mold being used to reshape the skull, which can be effective in less severe cases. If the birth defect is more severe, however, surgery may be necessary in order to relieve pressure on the brain and cranial nerves and help improve the symmetry of the infant’s skull.

Zoloft increases the likelihood of infants developing craniosynostosis, but this isn’t the only reason women are worried about taking the drug during their pregnancies. Multiple studies have shown that taking Zoloft and similar SSRI drugs, which can help treat depression, general anxiety disorder, obsessive-compulsive disorder, and post traumatic stress disorder, can contribute to several serious birth defects in infants, including omphalocele, atrial septal defects, and ventricular septal defects.

Persistent pulmonary hypertension of the newborn is one potential side effect resulting from Zoloft use that particularly concerns expectant mothers. It is a condition that restricts blood flow to the lungs and can be very serious in an infant. (...)

(Anm: Craniosynostosis; (en.wikipedia.org).)

(Anm: Hva er kraniosynostose? Hjerneskallen, kraniet, dannes i fosterstadiet av flere flate bein som vokser mot hverandre. Ved fødselen er disse ulike beinene ikke vokset sammen, og de er atskilt med en søm (sutur). (nhi.no).)

Zoloft MDL Adds Lawsuit From Mother of Child With Autism and Birth Defects (Zoloft MDL møter søksmål fra mor barn med autisme og fødselsskader)
injurylawyer-news.com 19.11.2012
On November 19, 2012, the Zoloft MDL in the Eastern District of Pennsylvania added a new lawsuit filed by a mother whose child was born with autism as well as life-threatening physical birth defects after Zoloft use during pregnancy.

Pfizer did not warn of drug’s risks, lawsuit alleges
The lawsuit alleges that although Zoloft manufacturer Pfizer had gotten reports linking Zoloft to birth defects as far back as the 1990s, the company “failed and continues to fail to warn and disclose” to the public and the medical community the risk of side effects resulting from Zoloft use during pregnancy.

As a result, the lawsuit claims, the plaintiff and her physician were not aware of the risk of birth defects when she took Zoloft during her pregnancy in 2004. (...)

Antidepressiv medicin forbundet med komplikationer hos gravide
dagenspharma.dk 8.11.2012
Brug af de antidepressive ssri-præparater under graviditeten kan øge risikoen for svangerskabsforgiftning, for tidlig fødsel, abortering eller neurologiske skader på fosteret. (...)

Paxil During Pregnancy Increases Risk of Reduced Infant Head Size (Bruk av Seroxat (Paxil) i svangerskapet øker risikoen for redusert hodestørrelse hos spedbarn)
prweb.com 27.9.2012
A new study, published in the July 2012 issue of Archives of General Psychiatry, reveals that serotonin reuptake inhibitors use (including Paxil) during pregnancy increases risk of reduced infant head size and preterm birth. Paxil is an antidepressant drug belonging to a group called selective serotonin reuptake inhibitors (SSRIs). In January 2012, the British Medical Journal published a study revealing that selective SSRIs, including Paxil, are linked to pulmonary hypertension in newborns (PPHN) of mothers who took them during pregnancy. Now, AttorneyOne.com, a recognized authority on law, can provide helpful, proven advice and simple solutions including how to get in contact with legal counsel so anyone can easily and inexpensively deal with cases of Paxil severe adverse events. [http://www.attorneyone.com/paxil-birth-defect-lawsuit/ (...)

A new study, published in the July 2012 issue of Archives of General Psychiatry, reveals that serotonin reuptake inhibitors use (including Paxil) during pregnancy increases risk of reduced infant head size and preterm birth. Paxil is an antidepressant drug belonging to a group called selective serotonin reuptake inhibitors (SSRIs). 7,696 pregnant women were included in the study and the objective of the researchers was to examine the effects of maternal SSRI use during pregnancy on fetal growth and birth outcomes.

In January 2012, the British Medical Journal published a study revealing that selective SSRIs, including Paxil, are linked to pulmonary hypertension in newborns (PPHN) of mothers who took them during pregnancy. (...)

(Anm: Maternal Use of Selective Serotonin Reuptake Inhibitors, Fetal Growth, and Risk of Adverse Birth Outcomes. Arch Gen Psychiatry. 2012 (Published online March 5).)

Depression and Serotonin Reuptake Inhibitor Treatment as Risk Factors for Preterm Birth (Depresjon og behandling med serotoninreopptakshemmer som risikofaktorer for tidlig fødsel)
Epidemiology. 2012 Sep;23(5):677-685.
BACKGROUND: Major depressive disorder and the use of serotonin reuptake inhibitors (SRIs) in pregnancy have been associated with preterm birth. Studies that have attempted to separate effects of illness from treatment have been inconclusive. We sought to explore the separate effects of SRI use and major depressive episodes in pregnancy on risk of preterm birth.

METHODS: We conducted a prospective cohort study of 2793 pregnant women, oversampled for a recent episode of major depression or use of an SRI. We extracted data on birth outcomes from hospital charts and used binary logistic regression to model preterm birth (<37 weeks' gestation). We used ordered logistic regression to model early (<34 weeks' gestation) or late (34-36 weeks) preterm birth, and we used nominal logistic regression to model preterm birth antecedents (spontaneous preterm labor/preterm premature rupture of membranes/preterm for medical indications/term).

RESULTS: Use of an SRI, both with (odds ratio = 2.1 [95% confidence interval = 1.0-4.6]) and without (1.6 [1.0-2.5]) a major depressive episode, was associated with preterm birth. A major depressive episode without SRI use (1.2 [0.68-2.1]) had no clear effect on preterm birth risk. None of these exposures was associated with early preterm birth. Use of SRIs in pregnancy was associated with increases in spontaneous but not medically indicated preterm birth.

Konklusjoner: SRI-bruk økte risiko for prematur fødsel. Selv om effekten av en depressiv episode alene var uklar hadde symptomatiske kvinner, som gjennomgår antidepressiv behandling, forhøyet risiko. (...) (CONCLUSIONS: SRI use increased risk of preterm birth. Although the effect of a major depressive episode alone was unclear, symptomatic women undergoing antidepressant treatment had elevated risk.)

Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies (Uheldige resultater av mors bruk av antidepressiva og: en kohortstudie av 228,876 svangerskap)
American Journal of Obstetrics & Gynecology 2012 (published online 02 May 2012)
(...) Objective Describe antidepressant medication use patterns during pregnancy and pregnancy outcomes.

Study Design Cohort of 228,876 singleton pregnancies covered by Tennessee Medicaid, 1995-2007.

Results Of 23,280 pregnant women with antidepressant prescriptions prior to pregnancy, 75% filled none in the second or third trimesters of pregnancy and 10.7% used antidepressants throughout pregnancy. Filling 1, 2, and 3+ antidepressants during second trimester was associated with shortened gestational age by 1.7 (1.2- 2.3), 3.7 (2.8- 4.6), and 4.9 (3.9- 5.8) days, controlling for measured confounders. Third trimester selective serotonin reuptake inhibitor (SSRI) use was associated with infant convulsions; adjusted odds ratios were 1.4 (0.7-2.8); 2.8 (1.9- 5.5); and 4.9 (2.6-9.5) for filling 1, 2, and 3 prescriptions respectively.

Konklusjoner De fleste kvinner slutter med antidepressiva før eller i løpet av første trimester av svangerskapet. Bruk av antidepressiva i andre trimester er forbundet med tidlig fødsel, og SSRI-bruk i tredje trimester er forbundet med kramper hos spedbarn. (...) (Conclusions Most women discontinue antidepressant medications prior or during the first trimester of pregnancy. Second trimester antidepressant use is associated with preterm birth, and third trimester SSRI use is associated with infant convulsions.)

(Anm: Konfunder – ikke confounder – på norsk. Et av de viktigste begrepene i epidemiologi er «confounder». På norsk bør det skrives «konfunder». Når noen påstår at en faktor A er årsak til en effekt B, lurer vi på om det finnes en faktor som kan påvirke både A og B og derved tilsløre en reell årsakssammenheng (1). Denne faktoren kalles på engelsk «confounder» eller «confounding factor». Det dreier seg om kjente eller ukjente bakenforliggende forhold som kan påvirke utfallet og som er ulikt fordelt mellom eksponerte og ikke-eksponerte (2). Eksempel: Er vindrikking (faktor A) årsak til bedre helse (effekt B)? Kanskje, men det finnes selvsagt en rekke bakenforliggende variabler, f.eks. sosial klasse, som kan være den egentlige forklaringen. Vi kan også snakke om spuriøs sammenheng. Det er betegnelsen på en skinnsammenheng som fremstår som ekte årsakvirkning-forhold, men ikke er det. Det er en bakenforliggende variabel, en «confounder», som er den egentlige årsaken til sammenhengen (3, 4). Tidsskr Nor Legeforen 2013; 133:2280  (12.11.2013).)

Baby II: Unngå antidepressiva
aftenposten.no 8.6.2012
Medisiner mot depresjon bør erstattes med terapi mot slutten av graviditeten, skriver en gruppe nordiske forskere i British Medical Journal. Å anvende antidepressiva av typen SSRI i denne fasen dobler risikoen for at barnet blir født med en alvorlig lungesykdom.

Ved forløsningen tar barnet lungene i bruk, og blodomløpet skifter retning. Antidepressiva kan medvirke til å forstyrre denne endringen. Dermed kan blodtrykket i lungene bli for høyt, noe som skader dem og i verste fall fører til at barnet dør. (...)

More questions on antidepressants during pregnancy (Flere spørsmål om antidepressiva i svangerskapet )
reuters.com 30.5.2012
(Reuters Health) - When moms-to-be use antidepressants, their babies may be more likely to be born early or have a seizure soon after birth, a large U.S. study suggests.

The findings, reported in the American Journal of Obstetrics & Gynecology, add to evidence linking antidepressants to certain pregnancy risks -- including preterm birth and smaller size at birth. (...)

When mothers filled two or three antidepressant prescriptions during the second trimester, their babies stayed in the womb for four to five days less, on average, than other babies.

In addition, newborns were more likely to have a seizure if their mother used a selective serotonin reuptake inhibitor (SSRI) during the third trimester.
SSRIs include commonly used antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and paroxetine (Paxil). (...)

(Anm: American Journal of Obstetrics & Gynecology 2012 (published online 02 May 2012).)

New Antidepressants Research Suggests Use During Pregnancy Could Lead to Early Labor, Infant Seizures
digitaljournal.com 5.6.2012
New research published in the American Journal of Obstetrics and Gynecology suggests that women who use antidepressants while pregnant higher risks of early labor and infant seizures.
HEWLETT, NY, June 05, 2012 /24-7PressRelease/ -- The Rottenstein Law Group, which represents clients with claims stemming from injuries and birth defects caused by Selective Serotonin Reuptake Inhibitors (SSRIs) Zoloft and Paxil, has learned of research suggesting that pregnant women who take SSRIs to treat depression might be putting themselves at risk of going into earlier labor, or the rare occurrence of their newborn infants experiencing seizures.

According to a May 30 Reuters article, new findings published in the May 2, 2012 online edition of the American Journal of Obstetrics and Gynecology taken from a study conducted at Vanderbilt University School of Medicine in Nashville, TN, show that women who took an antidepressant like Zoloft or Paxil during the second or third trimester were more likely to give birth earlier than their estimated due dates, and newborns born to mothers who took the medication were at greater risk of having seizures. (...)

(Anm: American Journal of Obstetrics & Gynecology 2012 (published online 02 May 2012).)

Antidepressant Use During Pregnancy and the Risk of Pregnancy Induced Hypertension (Bruk av antidepressiva under svangerskapet og svangerskapindusert forhøyet blodtrykk)
British Journal of Clinical Pharmacology 2012 (Accepted, unedited articles published online for future issues)
(...) Aims: Due to their effect on altering physiological interactions between vasodilator and vasoconstrictor autacoids in normal pregnancies, antidepressants may be associated with the risk of pregnancy-induced hypertension. We evaluated the impact of antidepressant use during pregnancy on the risk of pregnancy-induced hypertension. (...)

Results: Among cases, 45 (3.7%) had used antidepressants during pregnancy compared with 300 (2.5%) in the control group (OR 1.52; 95% CI 1.10-2.09). After adjusting for potential confounders, use of antidepressants during pregnancy was significantly associated with increased risk of pregnancy-induced hypertension (OR 1.53; 95% CI 1.01-2.33). In stratified analyses, use of selective serotonin reuptake inhibitors (OR 1.60; 95% CI 1.00, 2.55), and more specifically, paroxetine (OR 1.81; 95% CI 1.02, 3.23) were associated with risk of pregnancy-induced hypertension.

Conclusions: Women who use antidepressants during pregnancy are at increased risk of pregnancy induced hypertension with or without pre-eclampsia above and beyond the risk that could be attributed to their depression or anxiety disorders. (...)

Antidepressant Use During Pregnancy Linked to Hypertension (Bruk av antidepressiva under svangerskapet linket til forhøyet blodtrykk)
medscape.com 22.3.2012
March 21, 2012 — Women who use antidepressants while pregnant have an increased risk of developing pregnancy-induced hypertension, new research shows.

The increased risk is beyond the risk that could be attributed to their depression or anxiety disorders, Mary A. De Vera, PhD, from the University of Montreal, and Anick Bérard, PhD, from Sainte Justine Research Center, Montreal, Quebec, Canada, write. (...)

Antidepressant use during pregnancy was associated with a 53% increased risk for pregnancy-induced hypertension (OR, 1.53; 95% CI, 1.01 - 2.33). Use of SSRIs was associated with a 60% increased risk (OR, 1.60; 95% CI, 1.00 - 2.55); of the SSRIs, paroxetine was associated with the greatest risk for pregnancy-induced hypertension (OR, 1.81; 95% CI, 1.02 - 3.23).

"It is very important for physicians and women to discuss the risks and benefits of antidepressants before prescribing," said Dr. Bérard.
"Close monitoring needs to be done, because there could be benefits, and there can also be risks. The message isn't as simple as telling pregnant women to stop taking antidepressants. (...)

Potential Link Between Antidepressant Use During Pregnancy And Hypertension
medicalnewstoday.com 22.4.2012
Use of selective serotonin re-uptake inhibitor (SSRI) antidepressants during pregnancy appears to be linked with increased risk of pregnancy induced high blood pressure ("hypertension"), but a causal link has not been established.

Pregnancy hypertension is sometimes linked with pre-eclampsia, a serious condition that can harm pregnant women and their unborn babies. But the authors stress that pregnant women should not stop taking their prescribed medication; instead they should seek a consultation with their doctor if they are concerned.

Out of 1,216 women, the overall incidence of hypertension in women taking SSRIs appeared to increase from about 2% to about 3.2% (a relative risk increase of 60%). One specific SSRI, paroxetine, was associated with an increase in incidence of hypertension to about 3.6% (an 81% increase).

"These results are an early indicator of risk attributable to antidepressant drug treatment above that which may be attributed to depression or anxiety disorders in the absence of drug treatment," says senior researcher, Dr Anick Bérard who is Director of the research unit of medications and pregnancy at CHU Ste-Justine's Research Center, and professor at the Faculty of Pharmacy at the University of Montreal, Quebec, Canada. The research has just been published in the British Journal of Clinical Pharmacology.

The issue is particularly important given that antidepressants are one of the most commonly used medications during pregnancy. Up to 20% of pregnant women are affected by depression and anywhere between 4% and 14% of pregnant women frequently use anti-depressants.

The study drew data from the Quebec Pregnancy Registry and compared 1,216 women who had been diagnosed with pregnancy-induced hypertension with or without pre-eclampsia and with no history of hypertension before pregnancy, with 12,160 matched controls.

"Pregnancy induced hypertension is a serious condition that can directly affect the mother and her unborn baby. Although a few other studies on the same topic have been performed before, our study is the only one that looks at the class and type of antidepressant and the risk of pregnancy induced hypertension," says Bérard. (...)

Antidepressiv medicin kan svække hjernens vækst hos fostre
dagenspharma.dk 13.3.2012
Hos gravide kvinder, der tager SSRI-præparater, vokser fostrenes hoveder langsommere, mens deres kroppe udviklede sig i et normalt tempo. (...)

Moms' Antidepressants May Affect Babies' Head Size: Study (Mors antidepressiva kan ifølge studie påvirke babyers hodestørrelse)
health.msn.com 5.3.2012
Pregnant women may want to try alternatives to treat depression, experts say

MONDAY, March 5 (HealthDay News) -- Pregnant women taking certain antidepressants may be more likely to deliver infants with reduced head growth, a new study suggests.

The researchers also found that although selective serotonin reuptake inhibitors (SSRIs) such as Paxil and Prozac relieved depression in these women, they appeared to be associated with a higher risk of preterm birth.

"Fetal body growth is a marker of fetal health and fetal head growth is a marker for brain development," said lead researcher Hanan El Marroun, a postdoctorate fellow in the department of child and adolescent psychiatry at Sophia Children's Hospital and Erasmus Medical Center in Rotterdam, the Netherlands. "We found prenatal exposure to SSRIs was associated with decreased growth of the head, but not decreased growth of the body."

In mothers with untreated depression, the babies had smaller growth in both the body and head, the investigators found.

"If the depression is untreated, it affected the whole body; but if the mother used SSRIs, the head growth of the fetus was affected," El Marroun noted. "This may mean that smaller head growth is not explained by depression, but by the SSRIs."

Dette tyder på at ubalanse i hjernens serotonin -- etn kjemikalie som hjelper hjernen å sende signaler fra et område til et annet -- ikke er bra for spedbarns hjerneutvikling, uttalte hun. SSRI-er er spesielt målrettet serotonin. (...) (This suggests that imbalance in the brain's serotonin -- a chemical that helps the brain send signals from one area to another -- is not good for infants' developing brains, she said. SSRIs specifically target serotonin.)

(Anm: SSRIs During Pregnancy Linked to Reduced Fetal Head Growth (Video) (insidermedicine.ca 5.3.2012).)

Antidepressants in pregnancy: weighing benefits and risks
news-medical.net 5.3.2012
(...) Most of the mothers (7,027, or 91.3%), who had few depressive symptoms and did not use SSRIs, formed the control group. Another 570 mothers (7.4%) had clinically relevant depressive symptoms but did not use SSRIs, while the remaining 99 mothers (1.3%) used SSRIs during pregnancy. Mean depression scores on the depression scale of the Brief Symptom Inventory were 0.10 in the control group, 1.45 in the women with depressive symptoms but no SSRIs, and 0.74 for the women taking SSRIs.

They found that the untreated, depressed women were more likely to have babies with reduced body growth, including reduced fetal head size, while depressed women taking SSRIs were more likely to have babies with reduced fetal head size but a normal fetal body growth. It's unclear how significant reduced fetal head growth is. It has been linked to later behavioral and psychiatric problems in other studies.

Fetal head growth is “one of the best prenatal markers of brain volume,” and reduced head growth has been linked to poor cognitive performance, behavioral problems, and psychiatric disorders later in life. “Nonetheless, we must be careful not to infer an association of SSRI use in pregnancy with future developmental problems. ... [M]ore long-term drug safety studies are needed before evidence-based recommendations can be derived,” the investigators noted. (...)

Antidepressants in pregnancy: weighing benefits and risks
news-medical.net 5.3.2012
(...) Most of the mothers (7,027, or 91.3%), who had few depressive symptoms and did not use SSRIs, formed the control group. Another 570 mothers (7.4%) had clinically relevant depressive symptoms but did not use SSRIs, while the remaining 99 mothers (1.3%) used SSRIs during pregnancy. Mean depression scores on the depression scale of the Brief Symptom Inventory were 0.10 in the control group, 1.45 in the women with depressive symptoms but no SSRIs, and 0.74 for the women taking SSRIs.

They found that the untreated, depressed women were more likely to have babies with reduced body growth, including reduced fetal head size, while depressed women taking SSRIs were more likely to have babies with reduced fetal head size but a normal fetal body growth. It's unclear how significant reduced fetal head growth is. It has been linked to later behavioral and psychiatric problems in other studies.

Fetal head growth is “one of the best prenatal markers of brain volume,” and reduced head growth has been linked to poor cognitive performance, behavioral problems, and psychiatric disorders later in life. “Nonetheless, we must be careful not to infer an association of SSRI use in pregnancy with future developmental problems. ... [M]ore long-term drug safety studies are needed before evidence-based recommendations can be derived,” the investigators noted. (...)

Maternal Use of Selective Serotonin Reuptake Inhibitors, Fetal Growth, and Risk of Adverse Birth Outcomes
Arch Gen Psychiatry. 2012 (Published online March 5)
(...) Context Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed to pregnant women, but knowledge about their unintended effects on child health is scarce. (...)

Conclusions Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed. (...)

SSRI-antidepressiva til gravide øker risikoen for høyt blodtrykk i lungene hos barnet
fhi.no 13.1.2012
Kvinner som behandles med antidepressive legemidler av typen SSRI under siste del av graviditeten har en økt risiko for å føde barn med vedvarende høyt blodtrykk i lungene. Det viser en ny studie utført av forskere fra de fem nordiske landene. Fra Norge har forskere ved Folkehelseinstituttet deltatt.
Studien er en såkalt kohortstudie og har vært koordinert av Karolinska Institutet i Stockholm med aktivt bidrag fra forskere ved Folkehelseinstituttet i Oslo. Artikkelen publiseres i det vitenskapelige tidsskriftet British Medical Journal (BMJ). (...)

(Anm: Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ 2012;344:d8012 (12 January).)

Nordisk studie bekräftar tidigare känt samband mellan SSRI-behandling och ökad risk för högt blodtryck i lungorna hos det nyfödda barnet
lakemedelsverket.se 13.1.2012
En ny nordisk studie omfattande 11 000 barn bekräftar tidigare studieresultat att behandling av kvinnor med depression med SSRI-läkemedel i senare delen av graviditeten kan leda till ökad risk att föda barn som drabbas av högt blodtryck i lungornas blodkärl. (...)

SSRI till gravid ökar risken för högt blodtryck i lungorna hos barnet
ki.se 13.1.2012
[PRESSMEDDELANDE 2012-01-13] Nyfödda barn till kvinnor som behandlas med antidepressiva SSRI-läkemedel under senare delen av graviditeten har en ökad risk att drabbas av kvarstående högt blodtryck i lungornas blodkärl, så kallad persisterande pulmonell hypertension. Det visar en ny samnordisk studie som letts från Karolinska Institutet och som publiceras i den vetenskapliga tidskriften British Medical Journal (BMJ). (...)

Mødre kræver depressionspille-erstatning
politiken.dk 23.12.2011
ANTIDEPRESSIVT. Præparatet Cipramil har været i søgelyset flere gange på grund af uheldige bivirkninger.

Sager om mødres brug af antidepressions-piller under graviditeten strømmer ind.

Nye sager i forbindelse med mødres brug af piller mod depression under graviditeten er det seneste år strømmet ind hos Patientforsikringen.

Alene i 2011 har Patientforsikringen fået syv nye sager om aborter, misdannelser, problemer i udviklingen og andre alvorlige symptomer. Det skriver Ekstra Bladet.

Sagerne er kommet ind efter avisens afsløringer af, at myndighederne har reageret alt for langsomt i forhold til at advare gravide om depresisonspiller, hvilket har fået kvinderne og deres familier til at søge forsikringen om kompensation for skader på deres børn. (...)

Nye alvorlige lykkepiller-sager: Baby uden kranium
ekstrabladet.dk 23.11.2011
Nye choktal fra Lægemiddelstyrelsen: Dødfødt baby, stribevis af aborter og foster uden kranium (...)

Før Ekstra Bladet i foråret satte fokus på sagen havde Styrelsen modtaget 51 indberetninger over en periode på over 10 år. Nu her fem måneder efter Ekstra Bladets første artikler har Lægemiddelstyrelsen pr. 28. september modtaget 35 nye indberetninger om alvorlige bivirkninger, så man i alt er oppe på 86.

Læs også: Gravide proppet med livsfarlige lykkepiller

- De nye tal bestyrker mistanken om, at antidepressiv medicin under graviditeten kan give alvorlige bivirkninger, siger Lektor Lise Aagaard fra Institut for Farmakologi og Farmakoterapi på Københavns Universitet

Bivirkninger kan ramme børn senere i livet
Hos Lægemiddelstyrelsen har man særligt fokus på de bivirkninger, der rammer børn senere i livet:

- Det som vi lægger ekstra mærke til, er rapporterne om forsinket psykomotorisk udvikling. Altså det, at børn flere år efter de har været eksponeret for den her medicin under graviditeten, måske udvikler sig unormalt.

- Det emne vil vi se nærmere på og blandt andet undersøge om andre lande har set det samme og tage kontakt til danske læger, der arbejder med disse patienter, siger overlæge Doris Stenver. (...)

Antidepressiv medicin øger risiko for autisme hos rotter
dagensmedicin.dk 18.11.2011
Rotter, der lige efter fødslen fik ssri-præparater, udviklede velkendte autistiske lidelser som anormaliteter i hjernen og adfærdsforstyrrelser.

Det viser en ny undersøgelse i tidsskriftet Proceedings of the National Academy of Sciences.

Opdagelsen bekræfter et tidligere befolkningsstudie i år, der viste, at kvinder, der tog ssri-midler under graviditeten, fik børn, der havde dobbelt så stor risiko for at udvikle autisme. Begge studier antyder, at indtagelse af de meget udbredte form for antidepressiv medicin under graviditeten kan være en medvirkende forklaring på den dramatiske stigning i udviklingshæmmede børn.

Antallet af gravide kvinder, der tager ssri-midler, er steget fra 0,5 pct. i 1985 til næsten 10 pct. i dag. Samtidig er forekomsten af autisme steget fra 1 ud af 1.000 fødsler i 1996 til 1 ud af 100 i dag. Den større opmærksomhed og forbedrede diagnosticering af autismelidelserne kan ikke forklare stigningen alene.

Forskerne behandlede mere end 200 rotter med ssri-midlet citalopram på vigtige tidspunkter i rotternes hjerneudvikling. Rotter fødes på et tidligere udviklingstrin, svarende til slutningen af 6. måned hos et menneskefoster. Behandlingen blev givet i to uger fra 8. dag efter fødslen, en periode, der svarer til hjernens udviklingsperiode hos menneskefostre i 3. trimester.

I modsætning til kontrolgruppen var de behandlede rotter uinteresserede i at udforske og lege som små og viste tegn på dårlige sociale kompetencer som voksne. Rotternes adfærd og neurologiske problemer pegede på, at deres hjerner ikke i tilstrækkelig grad kunne udføre og forarbejde informationer. Den adfærd var mere udtalt blandt hanrotter end hunrotter – en kønsforskel, der også findes for autisme, der oftere diagnosticeres hos drenge og mænd.

Forskerne udførte eksperimenter, der viste, at behandling med antidepressiv medicin havde stor indflydelse på tindingelappen – den del af hjernen, der tager sig af bearbejdning af lyde og tale. Forsøgsrotternes hjerner modnedes ikke normalt, og udviklingen af tindingelappen var meget forsinket og funktionerne nedsat. Forsinket udvikling af tindingelappen er også et kendetegn hos autistiske børn, der kæmper med sprog- og læsevanskeligheder. (...)

(Anm: Perinatal antidepressant exposure alters cortical network function in rodents. PNAS (Proceedings of the National Academy of Sciences) 2011 (Published online before print October 24).)

(Anm: - Antikolinerge effekter av vanlige legemidler knyttet til økt dødelighet (BMJ 2011; 342:d4037 (28 June).)

Antidepressants linked to cardiac death (Antidepressiva linket til hjertedød)
hospitalpharmacyeurope.com 16.11.2011
People taking anti-psychotic drugs and anti-depressant drugs have a much higher risk of dying during an acute coronary event of a fatal arrhythmia than the rest of the population, according to research published in the European Heart Journal.

The study showed that the combined use of both antipsychotic and antidepressant drugs was associated with an even greater risk of sudden cardiac death (SCD) during a coronary event. (...)

(Anm: Antidepressant medication use and future risk of cardiovascular disease: the Scottish Health Survey. Eur Heart J (2011) 32 (4): 437-442 (November 30).)

Høye doser citalopram kan gi hjertebivirkninger
legemiddelverket.no 8.11.2011
Det er påvist sammenheng mellom høye doser citalopram og hjertebivirkninger. Ny maksimaldose for citalopram er 40 mg.

Citalopram brukes for å behandle depresjoner, panikkangst og tvangslidelse. En gjennomgang av studier og spontanrapporter viser er en sammenheng mellom bruk av høye doser citalopram og forlenget QT-intervall ved EKG. (...)

Bivirkninger om lykkepiller blev skjult
b.dk 27.10.2011
Medicinalfirmaer politianmeldes for at tie om døde babyer

Medicinalfirmaer har skjult, at kvinder risikerer aborter, dødfødte babyer og misdannede børn, hvis de spiser lykkepiller under graviditeten. (...)

Producenterne blev i juni pålagt at advare om bivirkningerne efter, at det var kommet frem, at myndighederne havde fået 51 indberetninger om alvorlige bivirkninger ved lykkepiller fra danske gravide. Herunder 12 indberetninger om aborter og fosterdød og fire om døde babyer. (...)

Det er jo ganske alvorlige bivirkninger, som de skulle fortælle om - bl.a. at gravide risikerede misdannede babyer og at abortere?

- Ja, når vi advarer er det jo alvorligt. Derfor har vi krævet, at de trækker de pakninger tilbage, hvor advarslen ikke står på indlægssedlen, siger afdelingschef Anne-Marie Vangsted til B.T.

Foreningen for den danske medicinalbranche LIF er særdeles fåmælte om sagen.

- Ingen kommentarer, skriver kommunikationschef Lars Bech Pedersen i en sms. (...)

(Anm: Antidepressiva (nytteverdi) (mintankesmie.no).)

(Anm: Ny forskning: Lykkepiller gør mere skade end gavn. Folk med depression får intet ud af at tage antidepressivet SSRI, bedre kendt som lykkepiller, viser nyt dansk studie. (jyllands-posten.dk 13.2.2017).)

(Anm: Forskere finner link mellom bruk av antidepressiva, medfødte misdannelser eller dødfødsler. (Researchers Find Link Between Antidepressant Use, Congenital Anomalies or Stillbirths) (…) "Mens denne ekstra risikoen kan virke liten er resultatene etter mitt syn så alvorlig som de kan være." (“While this extra risk may seem small, in my view, the outcomes are as serious as they can be.”) (dgnews.docguide.com 5.12.2016).)

(Anm: Eksponering av foster for antidepressiva kan endre Corpus Callosums mikrostruktur: Presentert ved PAS / ASPN. (…) Fordi "den neonate (nyfødtes) corpus callosum mikrostruktur er assosiert med utero (livmor) SSRI-eksponering og prenatal (før fødsel) mødredepresjon, er tidlige modningsprosesser i denne regionen følsomme for endret 5-hydroksytryptamin (5-HT) signalering under tiden i utero (livmor)," bemerket Campbell. "Disse resultatene - sammen med forstyrret hvit substans’ mikrostruktur i genu hos premature spedbarn - tyder dette på at utviklingen av [corpus callosum] kan være følsom for tidlige uheldige påvirkninger. (Fetal Exposure to Antidepressants May Alter Corpus Callosum Microstructure.) (dgnews.docguide.com 10.5.2017).)

(Anm: Unormal sæd med SSRI antidepressiva. Flere studier har funnet endrede sædparametere etter eksponering for SSRI-antidepressiva. Selv om SSRIs rolle er usikker, er det berettiget å ta hensyn til de observerte effektene på sædkvalitet og informere eksponerte pasienter. (Semen abnormalities with SSRI antidepressants. Several studies have found altered semen parameters after exposure to SSRI antidepressants. Although the role of SSRIs is uncertain, it is justified to take into account the observed effects on sperm quality and to inform exposed patients.) Prescrire Int 2015; 24 (156): 16-17.)

(Anm: Gravide kvinner som tar antidepressiva er mer sannsynlig å få barn med autisme, ifølge studie. Pregnant women who take antidepressants more likely to have a child with autism, study finds. Research data published in the BMJ reveal that antidepressant use during pregnancy increases the risk of autism in children, as reported The Independent Thursday. (firstwordpharma.com 20.7.2017).)

(Anm: - Nye data viser økt risiko for misdannelser når antidepressiva brukes under graviditet. (…) En studie publisert i British Medical Journal (BMJ) avslører at antidepressiva forskrevet til gravide kan øke sjansen for å få en baby med misdannelser.) (New Data Show Heightened Risk of Birth Defects When Antidepressants Are Used During Pregnancy.) (dgnews.docguide.com 19.1.2017).)

(Anm: - Utviklingen av et potensielt livstruende serotonergt syndrom eller nevroleptisk malignt syndrom (NMS)-lignende reaksjoner er rapportert for SNRI-er og SSRI-er alene, inkludert Celexa-behandling, men spesielt ved samtidig bruk av serotonerge legemidler (inklusive triptaner) og legemidler som svekker metabolisme av serotonin (inklusive MAO-hemmere), eller med antipsykotika eller andre dopaminantagonister (fda.gov 6.3.2009).)

(Anm: Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. (…) Conclusions Antidepressants with effects on serotonin reuptake during embryogenesis increased the risk of some organ-specific malformations in a cohort of pregnant women with depression. BMJ Open 2017;7:e013372.)

(Anm: Bruk av antipsykotika er assosiert med en 60 % økt risiko for dødelighet hos pasienter med Alzheimers sykdom. (…) Bruk av to eller flere antipsykotika samtidig ble knyttet til nesten doblet dødsrisiko (200 %) enn ved monoterapi.) (Antipsychotic Drug Use Increases Risk of Mortality Among Patients With Alzheimer’s Disease. JOENSUU, Finland -- December 12, 2016 -- Antipsychotic drug use is associated with a 60% increased risk of mortality among patients with Alzheimer's disease, according to a study published in the Journal of Alzheimer’s Disease. The risk was highest at the beginning of drug use and remained increased in long-term use. Use of 2 or more antipsychotic drugs concomitantly was associated with almost 2 times higher risk of mortality than monotherapy.) (dgnews.docguide.com 12.12.2016).)

(Anm: Antipsykotika dobler dødsrisiko allerede etter 180 dagers bruk. Greater Mortality Risk With Antipsychotics in Parkinson's (Større dødsrisiko med antipsykotika ved Parkinsons) (medicalnewstoday.com 21.6.2015).)

(Anm: (...) For ytterligere å illustrere problemet kan nevnes at antipsykotika forårsaker parkinsonisme (5), og en studie fant at mennesker med Parkinsons sykdom og psykose hadde fire ganger større sannsynlighet for å dø etter tre til seks måneders behandling enn de som ikke fikk antipsykotika. (6) De var også mer utsatt for kognitiv svikt, forverring av parkinsonsymptomer, hjerneslag, infeksjoner og fall. RE: Psykisk syke lever kortere. Tidsskr Nor Legeforen 10.11.2015.)

(Anm: Legemidler som kan gi delirium hos eldre. Delirium ses særlig hos eldre ved akutte sykdommer og skader eller som følge av toksisk eller farmakologisk påvirkning. Eldre personer har mange sykdommer og bruken av legemidler er høy. Mange legemidler, og særlig de med antikolinerg eller dopaminerg effekt, kan gi delirium. Kjennskap til legemidler og kombinasjoner av legemidler som kan gi delirium, er viktig for å kunne forebygge og behandle tilstanden. Tidsskr Nor Legeforen 2005; 125:2366-7 (8.9.2005).)

(Anm: Delirium in hospitalized patients: Risks and benefits of antipsychotics. ABSTRACT Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. Here, we review the use of haloperidol, olanzapine, quetiapine, risperidone, and aripiprazole for this purpose. Cleveland Clinic Journal of Medicine. 2017 August;84(8):616-622.)

(Anm: Post injektionssyndrom. (…) De fleste af disse patienter udviklede symptomer på sedation (fra mild sedation til koma) og/eller delirium (herunder forvirring, desorientering, ophidselse/ uro, angst og anden kognitiv svækkelse). Andre symptomer inkluderede ekstrapyramidale symptomer, dysartri, ataksi, aggression, svimmelhed, svaghed, hypertension eller krampe.) (sundhedsstyrelsen.dk 29.6.2014).)

(Anm: Mødre til børn med misdannelser har øget dødelighed. (…) Bivirkninger har ført til to dødsfald. Den største del af bivirkningerne (42 procent) af de 429 blev indberettet for såkaldte psykostimulerende lægemidler - eksempelvis til behandling af ADHD - efterfulgt af 31 procent for antidepressiver og 24 procent for antipsykotiske lægemidler. (videnskab.dk 20.12.2016).)

(Anm: Antikolinerge effekter av vanlige legemidler knyttet til økt dødelighet hos mennesker over 65. De kombinerte antikolinerge effektene av mange vanlige legemidler øker risikoen for kognitiv svekkelse og død hos personer over 65 år, ifølge resultater fra en storskala studie på den langsiktige helseeffekten av legemidler.(Anticholinergic effects of common drugs are associated with increased mortality in over 65s. The combined anticholinergic effects of many common drugs increase the risk of cognitive impairment and death in people aged over 65, a large scale study of the long term effect of drugs on health has found.) BMJ 2011; 342:d4037 (28 June).)

(Anm: Men experience greater cognitive impairment and increased risk of death following hip surgery. In a study of hip fracture patients, men displayed greater levels of cognitive impairment within the first 22 days of fracture than women, and cognitive limitations increased the risk of dying within six months in both men and women. "While men make up only about 25 percent of all hip fractures, the number of men who fracture their hip is increasing and we know men are more likely to die than women after a hip fracture," said Dr. Ann Gruber-Baldini, lead author of the Journal of the American Geriatrics Society study. (medicalnewstoday.com 10.2.2017).)

(Anm: Det autonome nervesystemet. Det autonome nervesystemets hovedoppgave er å bidra til likevekt i kroppens basale funksjoner. Det vil blant annet si kroppstemperatur, blodtrykk, åndedrett og fordøyelse. (nhi.no 4.3.2015).)

(Anm: Ulike selektive serotonin reopptakshemmeres (SSRI-er) cytotoksisitet mot kreftceller. (Cytotoxicity of different selective serotonin reuptake inhibitors (SSRIs) against cancer cells.) (…) Vi har funnet at paroxetine (paroksetin; Seroxat; Paxil etc.) har cytotoksisk aktivitet mot tumorceller. J Exp Ther Oncol. 2006;6(1):23-9.)

(Anm: Could antidepressants stop prostate cancer from spreading? In almost all cases where prostate cancer spreads to other areas of the body, the disease spreads to the bone first. In a new study, researchers reveal the discovery of an enzyme that helps prostate cancer cells to invade bone. Furthermore, certain antidepressant medications may have the potential to block this enzyme. Study co-author Jason Wu, of Washington State University-Spokane, and colleagues recently reported their findings in the journal Cancer Cell. (medicalnewstoday.com 13.3.2017).)

(Anm: Classic cytotoxic drugs: a narrow path for regulatory approval. Several classic cytotoxic drugs have shown encouraging activity in the treatment of metastatic breast cancer.1–3 However, only a few have received an overwhelming welcome from regulatory authorities and succeeded in obtaining widespread regulatory approval for routine use. For example eribulin was approved for treatment of metastatic breast cancer in several countries including Japan, USA, and Europe, based on data that showed longer overall survival in patients treated with eribulin compared with patients treated with physician's choice of treatment. In contrast ixabcpilone with capecitabine gained approval from the US Food and Drug Agency based on data showing longer progression-free survival compared with capccitabine alone, but did not obtain rcgulatory authorisation in Europc because it is associated with a high incidence of nevropathy.5 Lancet Oncol. 2017 Feb 10. pii: S1470-2045(17)30089-X. [Epub ahead of print].)

(Anm: Ødelagt cellulær "klokke" linket til hjerneskade (Broken Cellular 'Clock' Linked to Brain Damage) (sciencedaily.com 25.11.2013).)

(Anm: Signaling Pathways Linked to Serotonin-Induced Superoxide Anion Production: A Physiological Role for Mitochondria in Pulmonary Arteries. Abstract. Serotonin (5-HT) is a potent vasoconstrictor agonist and contributes to several vascular diseases including systemic or pulmonary hypertension and atherosclerosis. Although superoxide anion ([Formula: see text]) is commonly associated to cellular damages due to [Formula: see text] overproduction, we previously demonstrated that, in physiological conditions, [Formula: see text] also participates to the 5-HT contraction in intrapulmonary arteries (IPA). Front Physiol. 2017 Feb 9;8:76. eCollection 2017.)

(Anm: Bruk av antidepressiva ble assosiert med et betydelig eldre utseende og forskere fant også ut at vekten spilte en viktig faktor. I de sett med tvillinger som var yngre enn 40 år ble tyngre tvillinger oppfattet som eldre. (…) I tillegg mistenker forskerne at den vedvarende avslapping av ansiktsmuskler som antidepressiva forårsaker kan forklare årsaken til at ansiktet faller sammen (henger). (mintankesmie.no).)

(Anm: Minislag (ministroke: transient ischemic attack (TIA)) linket til lavere forventet levetid. (- Minislag kan forårsake demens.) (- Enkelte psykofarmaka kan øke risiko for minislag / demens.) (mintankesmie.no).)

(Anm: Stumme infarkt rammer oftere folk med høy smertetoleranse. Stumme hjerteinfarkt gir ikke de klassiske brystsmertene som ved vanlige infarkt. - Denne pasientgruppen tar enten ikke kontakt med lege, eller de har ikke fått riktig diagnose, sier lege og forsker Andrea Milde Øhrn. (…) Det er vanlig å tenke sterke brystsmerter og akutt behandling når det er snakk om hjerteinfarkt. Det mange kanskje ikke vet, er at man kan ha hatt et hjerteinfarkt uten å vite det. Dette kalles et stumt infarkt, et hjerteinfarkt med få eller ingen symptomer. - Et stumt hjerteinfarkt er et hjerteinfarkt som ikke er erkjent. (nhi.no 3.2.2017).)

(Anm: Sannsynlig karotidyni forårsaket av fluoxetine (Prozac; SSRI-er). (Probable fluoxetine-induced carotidynia.)  Karotidyni er en fokal nakkesmerte (bestemt, avgrenset område), som involverer anatomiske områder til den berørte arteria carotis, og stråler ofte ut i den ipsilateral side (samme side) av ansiktet eller øret. På grunnlag av medisinsk historie og alder har karotidyni konvensjonelt vært klassifisert i klassisk (ikke-migrenøs), migrenøs, og vaskulære varianter. The Lancet 2009;374(9695):1061-1062 (26 September).)

(Anm: Nakkesmerter sætter forskerne skakmat. Kroniske nakkesmerter koster samfundet milliarder og er en af de hyppigste årsager til, at danskere melder sig syge fra job. Forskerne er i vildrede: Ingen behandling er effektiv. (videnskab.dk 22.12.2016).)

(Anm: Antidepressiva linket til hjerterisiko: tvillingstudie. (Antidepressants linked to heart risk: twins study) - Middelaldrende menn som bruker antidepressiva er mer sannsynlig å ha en innsnevring av blodårer, noe som øker risikoen for hjerteinfarkt og slag, enn de som ikke bruker legemidlene, ifølge en studie presentert på lørdag. (Reuters) - Middle-age men who use antidepressants are more likely to have a narrowing of blood vessels, increasing the risk of heart attacks and strokes, than those who do not use the medications, according to a study presented on Saturday.) (reuters.com 2.4.2011).)

(Anm: - Pfizers Zyvoxid (Zyvox) og antidepressiva kan være en dødelig kombinasjon. (- Det antas at når linezolid gis til pasienter, som behandles med serotonerge psykofarmaka, kan forhøyede nivåer av serotonin bygge seg opp i hjernen og forårsake toksisitet (giftighet). Dette er referert til som Serotonin syndrom - tegn og symptomer inkluderer mentale endringer (forvirring, hyperaktivitet, minneproblemer), muskelrykninger, overdreven svetting, skjelving eller risting, diaré, problemer med koordinasjon og / eller feber.) (fda.gov 21.10.2011).)

(Anm: Hva er det forskrivere og pasienter ikke vet om bivirkninger av antidepressiva? (What do prescribers and patients not know about the side effects of antidepressant drugs?) (medicalnewstoday.com 15.9.2016).)

(Anm: Forskere: Alvorlige bivirkninger, når antidepressiver droppes. Angst, depression og selvmordstanker er nogle af de bivirkninger, som tit forekommer, når man holder op med at tage antidepressiv medicin. Bivirkningerne kan i nogle tilfælde være langvarige og kroniske, viser et nyt studie. (videnskab.dk 16.3.2015).)

(Anm: Bruk av visse smertestillende midler (og antidepressiva (+ 31 %)) forbundet med økt risiko for drap (Use of certain painkillers linked with increased risk of homicide) Enkelte legemidler som påvirker sentralnervesystemet - som smertestillende og beroligende benzodiazepiner - er assosiert med økt risiko for å begå et drap, finner en ny studie publisert i tidsskriftet World Psychiatry. (medicalnewstoday.com 1.6.2015).)

(Anm: Psykiatriske patienter ender i private botilbud. Drab og vold har de seneste år fyldt debatten om de danske bosteder for patienter med psykiske problemer. (…) Psykiatriske patienter ender i private botilbud. (…) Mens Folketinget kæmper for en løsning på problemet med vold på offentlige bosteder, vælger flere kommuner at sende tunge patienter til private tilbud. (politiken.dk 18.3.2017.)

(Anm: Aggresjon knyttet til økt risiko for substansmisbruk. Aggression disorder linked to greater risk of substance abuse. (…) In the study, published in the Journal of Clinical Psychiatry, Emil Coccaro, MD, and colleagues analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States. They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use. The findings suggest that a history of frequent, aggressive behavior is a risk factor for later substance abuse, and effective treatment of aggression could delay or even prevent substance abuse in young people. (medicalnewstoday.com 2.3.2017).)

(Anm: Halvparten av norske drap begått av rusede. (…) I 125 av drapene – eller 54 prosent – er det beskrevet i dommen at gjerningspersonen var påvirket av rusmidler under drapet. (nrk.no 13.12.2016).)

- En pasient på UNN døde av blodforgiftning som følge av et legemiddel mot psykiske lidelser, opplyser Statens helsetilsyn.

(Anm: En pasient på UNN døde av blodforgiftning som følge av et legemiddel mot psykiske lidelser, opplyser Statens helsetilsyn. (- Pasienten døde etter kort tid, og dødsårsaken var nøytropen sepsis (blodforgiftning), heter det i tilsynets rapport. (nrk.no 12.10.2016).)

(Anm: Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body, frequently a response of the immune system to infection. (en.wikipedia.org).)

(Anm: Sepsis. Definisjon: SIRS + påvist/mistenkt infeksjon (f. eks. positiv blodkultur). SIRS- kriteriene er: - Feber > 38 ºC eller hypotermi < 36 ºC - Puls > 90/minutt - Respirasjonsfrekvens > 20/minutt eller hypokapni med pCO2 < 4,3 kPa i blodgass - Leukocytose ≥ 12 × 109/l eller leukopeni < 4 × 109/l eller > 10 % umodne leukocytter. (helsebiblioteket.no - Metodebok for indremedisinere, 2012).)

(Anm: Rollen til mitokondriell dysfunksjon (mitokondriedysfunksjon) ved sepsis (blodforgiftning)-indusert multiorgansvikt. (The role of mitochondrial dysfunction in sepsis-induced multi-organ failure). (Virulence. 2013 Nov 1;5(1).)

- Diagnostisering av sepsis. Sepsis, også kjent som blodforgiftning, er kroppens hyperaktive respons på en infeksjon som kan føre til betennelse, vevskader, organsvikt etc.

(Anm: Diagnosing Sepsis. Sepsis, also known as blood poisoning, is the body’s hyperactive response to an infection that can lead to inflammation, tissue damage, organ failure etc. It is a very dangerous state in which the immune system stops fighting with the invading agents  and turns to itself. Around one-third of patients who are affected with sepsis die every year. (news-medical.net 7.9.2017).)

- Å anerkjenne sepsis som en global helseprioritet - En WHO- resolusjon.

(Anm: Å anerkjenne sepsis som en global helseprioritet - En WHO- resolusjon. Recognizing Sepsis as a Global Health Priority — A WHO Resolution. “Some very important clinical issues, some of them affecting life and death, stay largely in a backwater which is inhabited by academics and professionals and enthusiasts, dealt with very well at the clinical and scientific level but not visible to the public, political leaders, leaders of healthcare systems... The public and political space is the space in which [sepsis] needs to be in order for things to change.” NEJM (June 28, 2017).)

(Anm: Sepsis – den dödliga sjukdomen som glöms bort. Trots att infektionssjukdomen sepsis förekommer oftare än de vanligaste formerna av cancer och att upp emot hälften som drabbas av den allvarligaste formen dör, så har många knappt hört talas om sjukdomen. Sepsis som är den medicinska termen på blodförgiftning, drabbar omkring 40 000 svenskar varje år. (netdoktor.se 7.6.2017).)

- Hurtigtest finner tegn på sepsis i en enkelt dråpe blod.

(Anm: Hurtigtest finner tegn på sepsis i en enkelt dråpe blod. (- Sepsis, en potensielt livstruende komplikasjon av en infeksjon, har den høyeste byrde mht. død og medisinske utgifter på sykehus over hele verden.) (- Quick test finds signs of sepsis in a single drop of blood. (…) Sepsis, a potentially life-threatening complication of an infection, has the highest burden of death and medical expenses in hospitals worldwide. (medicalnewstoday.com 5.7.2017).)

(Anm: Nye sepsiskriterier kan føre til forsinket behandling. (…) Sepsis er en svært alvorlig tilstand med høy morbiditet og mortalitet (2). Den totale insidensen er ukjent, men man regner med at sepsis er en av de viktigste årsakene til alvorlig, akutt sykdom på verdensbasis (1). (…) Sepsis har inntil nylig vært definert som mistenkt infeksjon med samtidig tilstedeværelse av to eller flere SIRS-kriterier (1). Endringer i hjertefrekvens, kroppstemperatur, respirasjonsfrekvens og leukocytter er kroppens tegn på inflammasjon, og de indikerer ikke nødvendigvis en livstruende, dysregulert vertsrespons på infeksjon. Tidsskr Nor Legeforen 2017; :609-10 (20.4.2017).)

(Anm: LEGENE FORSTO IKKE AT HAN VAR DØDSSYK: Stian (19) døde etter 18 timer på sykehus uten legetilsyn. (…) Helsetilsynet konkluderer med at sykehusets behandling var uforsvarlig. (…) Fikk ikke beskjed. (…) Fastlegen sendte med dem papirer som foreldrene leverte på Akuttmottaket ved Ahus, der sto det; «Diagnose: Obs sepsis».  (tv2.no 29.4.2017).)

(Anm: Svikt i behandlingen av akutt syk ung mann i akuttmottaket – brudd på helselovgivningen. (…) Pasienten ble lagt på observasjonsposten (Akutt 24) ved akuttmottaket frem til neste morgen. I løpet av tiden på observasjonsposten ble han ikke tilsett av lege. På morgenen var han betydelig verre og han fikk tegn på fullt utviklet blodforgiftning. Behandling med antibiotika ble iverksatt, men han døde kort tid etter som følge av meningokokksepsis og hjerneødem. (helsetilsynet.no 2.5.2017).)

(Anm: Sepsis; grunnleggende kliniske observasjoner. Sepsis= En systemisk inflammatorisk respons (SIRS) pga. en infeksjon Tre alvorlighetsgrader: 1) Sepsis (to eller flere symptomer på SIRS som følge av infeksjon) 2) Alvorlig sepsis (sepsis med akutt organdysfunksjon, hypoperfusjon eller hypotensjon) 3) Septisk sjokk (hypotensjon til tross for adekvat væsketerapi, samt forekomst av perfusjonsforstyrrelser og organdysfunksjon) (hnt.no 5.11.2013).)

- Alle bryt lova i behandling av blodforgifting. Pasientar med alvorleg blodforgifting (sepsis) blir undersøkt av lege for seint.

(Anm: Alle bryt lova i behandling av blodforgifting. Pasientar med alvorleg blodforgifting blir undersøkt av lege for seint. Helsetilsynet fann brot ved 24 akuttmottak over heile landet. – Svært alvorleg. – Dette er svært alvorleg, for det dreier seg om ein alvorleg infeksjonssjukdom som i verste fall kan medføra død dersom behandlinga ikkje blir igangsett til riktig tid, seier avdelingsdirektør i Helsetilsynet, Ragnar Hermstad. OVER EIN TIME: Pasientar som kjem inn med teikn på alvorleg infeksjonssjukdom som blodforgifting skal ifølge nasjonale retningslinjer få anitibiotikabehandling innan maks ein time. Alle dei 24 akuttmottaka hadde svikt på dette området. (nrk.no 16.6.2017).)

(Anm: Lege sier improvisert «kur» for sepsis har hatt bemerkelsesverdige resultater. (…) Spesialist i intensivbehandling Paul Marik sier at enkel behandling med infusjon av vitamin C og steroider har bemerkelsesverdig effekt på pasienter med potensielt dødelig tilstand. (independent.co.uk 24.3.2017).)

(Anm: Bivirkninger underrapporteres i videnskabelige tidsskrifter. (...) Mellem 43 og 100 procent af de bivirkninger, der, ifølge det ikke-publicerede materiale, er fundet ved de testede lægemidler, er ikke lagt frem i de videnskabelige artikler, viser Yoon Loke og kollegernes gennemgang. (videnskab.dk 5.10.2016).)

(Anm: Dødsfall på grunn av nøytropen sepsis (blodforgiftning) etter behandling med legemiddelet klozapin – uforsvarlig oppfølging – mangelfull samhandling og informasjon. (…)  Manglende informasjon fra spesialisthelsetjenesten og mangelfull samhandling mellom kommunehelsetjenesten, fastlegen, pasienten og pårørende bidro til hendelsen. Helseforetaket skal gjennomgå hendelsen for å redusere risikoen ved lignende tilfeller. (helsetilsynet.no 12.10.2016).)

(Anm: Eksplosjon av antidepressiva til unge jenter. De ønsker psykologhjelp. I stedet blir de fôret med piller fra fastlegen. Unge jenter har aldri brukt mer antidepressiver. (vg.no 10.9.2016).)

(Anm: Flere barn og unge akuttinnlegges for psykisk sykdom. I fjor utgjorde andelen øyeblikkelig hjelp innleggelser 61 prosent av alle innleggelser. Det er en økning fra 47 prosent i 2012. (dagensmedisin.no 19.9.2016).)

(Anm: Eksplosjon av antidepressiva til unge jenter: Lykkepillegenerasjonen. «Lykkepillen» gjorde Sandra så dårlig at hun ble innlagt på psykiatrisk avdeling. På ti år har bruken av antidepressiver blant unge jenter økt med 83 prosent. Mange får pillene uten en gang å ha snakket med psykolog.  (vg.no 10.9.2016).)

(Anm: Helseminister Bent Høie reagerer på «lykkepille»-praksis: – Veldig urovekkende. ** Kraftig økning i antidepressiva til unge jenter. Helseminister Bent Høie reagerer på den sterke økningen i lykkepillebruk blant unge jenter. Han mener manglende ressurser og fastlegers holdninger er årsaker. Lørdag dokumenterte VG Helg og VG+ konsekvensene av den økende lykkepille-bruken blant unge jenter. (vg.no 10.9.2016).)

(Anm: LO advarer mot trygdebombe. En stadig større del av nordmenn i arbeidsfør alder er uten jobb. LO mener dette er en potensiell trygdebombe. (…) Det trengs 180.000 nye jobber for å få yrkesdeltakelsen opp på samme nivå som i 2008, viser en rapport fra samfunnsøkonomene i LO. I 2008 var 70 prosent av befolkningen mellom 15 og 74 år i jobb. Nå er yrkesdeltakelsen nede i 67,3 prosent., og det er nedgang i alle fylker. (hegnar.no 6.10.2016).)

(Anm: Rekordmange søger akut psykisk hjælp. (- Mens kun 12.099 danskere i 1995 besøgte de psykiatriske akutmodtagelser og skadestuer, er det steget til hele 33.333 i 2015, viser opgørelse fra Sundhedsdatastyrelsen og Danske Regioner, der for kort tid siden blev sendt til Folketinget. (politiken.dk 9.7.2016).)

(Anm: Har vi blitt psykisk sykere? (- Vi vet også at stadig flere får uførepensjon på grunn av psykiske lidelser og at sykefraværet på grunn av psykiske plager og lidelser har økt. Vi tror alle disse forholdene bidrar til vår oppfatning om at stadig flere får en psykisk lidelse eller plage.) (Folkehelseinstituttet fhi.no 10.10.2013).)

(Anm: Høyt fravær på grunn av ME. Minst 270 elever var borte fra skolen i fjor fordi de hadde ME. (aftenposten.no 6.2.2017).)

(Anm: Psykisk ohälsa fortsätter att öka. Antalet svenskar som sjukskrivs på grund av psykisk ohälsa ökar kontinuerligt sedan 2010. Den vanligaste diagnosen är stressrelaterad psykisk ohälsa som till mångt och mycket är arbetsrelaterad. Då evidensbaserad behandling saknas står förebyggande arbete i fokus. (netdoktor.se 14.9.2016).)

(Anm: Psykiatriske skadestuer kan ikke klare presset. Psykiske lidelser hører til nogle af de største sygdomsbyrder, som hvert år koster samfundet et svimlende milliardbeløb i tabt arbejdsfortjeneste og sociale ydelser. (politiken.dk 11.7.2016).)

(Anm: - 9 ting som skjer i hjernen og kroppen på MDMA (Ecstasy). (- 9 Things That Happen in the Brain and Body on MDMA.) (- Derfor, når substansen avsluttes, sitter mennesker igjen med mindre serotonin enn vanlig, noe som kan føre til følelser av depresjon, irritabilitet og tretthet.) (- Siden MDMA frigir så mye serotonin, ødelegger kroppen deretter mer serotonin enn vanlig, ifølge AsapSCIENCE.) (thescienceexplorer.com 24.6.2016).)

Stikprøve afslører mangelfuld information om antidepressiv medicin til gravide og ammende
laegemiddelstyrelsen.dk 27.10.2011 (Lægemiddelstyrelsen)
Lægemiddelstyrelsen har politianmeldt en række virksomheder, fordi de ikke har opdateret indlægssedlen om gravide og ammendes brug af antidepressiv medicin af typen SSRI’er (selective serotonin reuptake inhibitors). Samtidig har styrelsen bedt virksomhederne om at tilbagekalde SSRI’ere med mangelfulde advarsler.

Baggrunden er, at Lægemiddelstyrelsen har kontrolleret, om advarslerne for brugen af medicin til behandling af depression er opdateret i forhold til graviditet og amning. Indlægssedlerne skulle have været opdateret på indlaegsseddel.dk i løbet af 1 måned fra 30. juni 2011, og de nye indlægssedler skulle være i pakningerne inden 3 måneder. (...)

Bivirkningsindberetninger om antidepressiv medicin og graviditet i juni - oktober 2011
laegemiddelstyrelsen.dk 23.10.2011 (Lægemiddelstyrelsen)
Opfølgning på notat om bivirkninger ved antidepressiv medicin og graviditet

Lægemiddelstyrelsen offentliggjorde den 20. september 2011 et oversigtsnotat om antidepressiv medicin af typen SSRI med fokus på sikkerheden og risikoen for bivirkninger hos fostre og nyfødte ved moderens brug af SSRI-præparater.

Notatet indeholder bl.a. en gennemgang af indberetninger om formodede bivirkninger hos børn og fostre efter moderens brug af SSRI-præparater. Det drejede sig om i alt 74 danske bivirkningsindberetninger, der er modtaget i perioden fra den første markedsføring af et SSRI-præparat i slutningen af 1980’erne og frem til 13. juni 2011 (se notatet i boksen til højre). (...)

Styrelse erkender fejl
ekstrabladet.dk 24.10.2011
Sundhedsstyrelsen erkender, at læger og gravide skulle have været informeret om bivirkninger ved lykkepiller

Lægemiddelstyrelsen hemmeligholdte i flere år overfor landets patienter og læger, at der havde været dødsfald og andre alvorlige bivirkninger hos danske babyer som følge af deres mødres brug af lykkepiller.

Og Styrelsen erkender nu, at lægerne skulle have været informeret. Det skriver Ekstra Bladet.

Læs også: Heidis søn døde

Lægemiddelstyrelsen vidste allerede i 2007, at der havde været mindst 48 indberetninger om alvorlige bivirkninger og dødsfald hos danske spædbørn.

Alligevel kom den information først ud til lægerne i 2011, og det skulle være sket tidligere, erkender overlæge i afdeling for forbrugersikkerhed, Doris Stenver.

- Det er væsentligt information for lægerne, og det må vi erkende i dag, siger hun.

Læs også: Gravide proppet med livsfarlige lykkepiller

Lægemiddelstyrelsen er nu i gang med at se på, hvordan kommunikationen kan blive bedre. (...)

SSRI Exposure In Utero Alters Neurobehavioral Development (PDF) (Eksponering for SSRI i svangerskapet endrer utvikling av nevroatferd)
medscape.com 22.8.2011
But Clinical Implications, If Any, Are Unclear

August 22, 2011 — In utero exposure to selective serotonin reuptake inhibitors (SSRIs) appears to alter neurobehavioral development in the fetus, results of a study published online in Neuropsychopharmacology suggest. (...)

(Anm: Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus. Neuropsychopharmacology (2011) 36, 1961–1971
(September 2011)
.)

Selective Serotonin Reuptake Inhibitors Affect Neurobehavioral Development in the Human Fetus (Selektive serotonin reopptakshemmere påvirker utvikling av fosterets nevroatferd hos mennesker)
Neuropsychopharmacology 2011;36:1961–1971
Abstrakt Målet med denne prospektive studien var å undersøke hvorvidt selektive serotonin reopptakshemmere (SSRI-er) som brukes av gravide kvinner påvirker fosterets nevrologiske atferdsutvikling. I denne observasjonsstudien undersøkte vi utviklingsmessige milepæler for fosterets atferd under svangerskapet hos kvinner med psykiske lidelser som tok SSRI-er i løpet av svangerskapet (medisinert gruppe, n = 96) eller som hadde seponert (sluttet med) legemidler tidlig i svangerskapet eller før unnfangelsen (umedisinert gruppe, n = 37 ). Friske ikke-eksponerte fostre hos kvinner uten psykiske lidelser utgjorde kontrollgruppen (n = 130). Observasjoner ved ultralydundersøkelser av fosterets atferd ble gjort tre ganger i svangerskapet (T1-T3). Effekter av SSRI-er ble studert for et bredt spekter av doser (lav, normal eller høy) og for forskjellige typer legemidler. Hos fostre eksponert for standard eller høye SSRI-doser sammenlignet med kontroll, ikke-medisinert, eller lavt medisinert ble påvist betydelig økt motorisk aktivitet hos fostre i begynnelsen (T1) og slutten av andre trimester (T2). De viste spesielt avbrutte ikke-raske øyebevegelser (ikke-REM, stille) ved søvn i løpet av tredje trimester, preget av kontinuerlig fysisk aktivitet, og dermed dårlig hemmet motorisk kontroll under denne søvntilstanden nær term (T3). SSRI-effekter på fosteret var doserelatert, men uavhengig av type av SSRI. Resultatene viser endringer i fosterets nevrologiske utvikling knyttet til standard og høye SSRI-doser som er observerbare gjennom hele svangerskapet. Et førstevalg for type SSRI var ikke tydelig. Stor fysisk aktivitet under ikke-REM-søvn hos SSRI-eksponerte fostre er et unormalt fenomen, men dets betydning for utvikling etter fødsel er uklar. (Abstract The aim of this prospective study was to investigate whether selective serotonin reuptake inhibitors (SSRIs) utilized by pregnant women influence fetal neurobehavioral development. In this observational study we investigated developmental milestones of fetal behavior during the pregnancy of women with psychiatric disorders who took SSRIs throughout gestation (medicated group; n=96) or who had discontinued medication early in gestation or before conception (unmedicated group; n=37). Healthy unexposed fetuses of women without mental disorders comprised the control group (n=130). Ultrasonographic observations of fetal behavior were made three times in pregnancy (T1–T3). Effects of SSRIs were studied over a wide range of dosages (low, standard, or high) and for different drug types. Fetuses exposed to standard or high SSRI dosages compared with control, unmedicated, or low-medicated fetuses showed significantly increased motor activity at the beginning (T1) and end of the second trimester (T2). They particularly exhibited disrupted emergence of non-rapid eye movement (non-REM; quiet) sleep during the third trimester, characterized by continual bodily activity and, thus, poor inhibitory motor control during this sleep state near term (T3). The SSRI effects on the fetus were dose related, but independent of SSRI type. The results demonstrate changes in fetal neurobehavioral development associated with standard and high SSRI dosages that are observable throughout gestation. A first-choice SSRI type was not apparent. Bodily activity at high rate during non-REM sleep in SSRI-exposed fetuses is an abnormal phenomenon, but its significance for postnatal development is unclear.)

(Anm: Antidepressiva (nytteverdi) (mintankesmie.no).)

(Anm: Ny forskning: Lykkepiller gør mere skade end gavn. Folk med depression får intet ud af at tage antidepressivet SSRI, bedre kendt som lykkepiller, viser nyt dansk studie. (jyllands-posten.dk 13.2.2017).)

(Anm: Forskere finner link mellom bruk av antidepressiva, medfødte misdannelser eller dødfødsler. (Researchers Find Link Between Antidepressant Use, Congenital Anomalies or Stillbirths) (…) "Mens denne ekstra risikoen kan virke liten er resultatene etter mitt syn så alvorlig som de kan være." (“While this extra risk may seem small, in my view, the outcomes are as serious as they can be.”) (dgnews.docguide.com 5.12.2016).)

(Anm: Eksponering av foster for antidepressiva kan endre Corpus Callosums mikrostruktur: Presentert ved PAS / ASPN. (…) Fordi "den neonate (nyfødtes) corpus callosum mikrostruktur er assosiert med utero (livmor) SSRI-eksponering og prenatal (før fødsel) mødredepresjon, er tidlige modningsprosesser i denne regionen følsomme for endret 5-hydroksytryptamin (5-HT) signalering under tiden i utero (livmor)," bemerket Campbell. "Disse resultatene - sammen med forstyrret hvit substans’ mikrostruktur i genu hos premature spedbarn - tyder dette på at utviklingen av [corpus callosum] kan være følsom for tidlige uheldige påvirkninger. (Fetal Exposure to Antidepressants May Alter Corpus Callosum Microstructure.) (dgnews.docguide.com 10.5.2017).)

(Anm: Unormal sæd med SSRI antidepressiva. Flere studier har funnet endrede sædparametere etter eksponering for SSRI-antidepressiva. Selv om SSRIs rolle er usikker, er det berettiget å ta hensyn til de observerte effektene på sædkvalitet og informere eksponerte pasienter. (Semen abnormalities with SSRI antidepressants. Several studies have found altered semen parameters after exposure to SSRI antidepressants. Although the role of SSRIs is uncertain, it is justified to take into account the observed effects on sperm quality and to inform exposed patients.) Prescrire Int 2015; 24 (156): 16-17.)

(Anm: Gravide kvinner som tar antidepressiva er mer sannsynlig å få barn med autisme, ifølge studie. Pregnant women who take antidepressants more likely to have a child with autism, study finds. Research data published in the BMJ reveal that antidepressant use during pregnancy increases the risk of autism in children, as reported The Independent Thursday. (firstwordpharma.com 20.7.2017).)

(Anm: - Nye data viser økt risiko for misdannelser når antidepressiva brukes under graviditet. (…) En studie publisert i British Medical Journal (BMJ) avslører at antidepressiva forskrevet til gravide kan øke sjansen for å få en baby med misdannelser.) (New Data Show Heightened Risk of Birth Defects When Antidepressants Are Used During Pregnancy.) (dgnews.docguide.com 19.1.2017).)

(Anm: - Utviklingen av et potensielt livstruende serotonergt syndrom eller nevroleptisk malignt syndrom (NMS)-lignende reaksjoner er rapportert for SNRI-er og SSRI-er alene, inkludert Celexa-behandling, men spesielt ved samtidig bruk av serotonerge legemidler (inklusive triptaner) og legemidler som svekker metabolisme av serotonin (inklusive MAO-hemmere), eller med antipsykotika eller andre dopaminantagonister (fda.gov 6.3.2009).)

(Anm: Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. (…) Conclusions Antidepressants with effects on serotonin reuptake during embryogenesis increased the risk of some organ-specific malformations in a cohort of pregnant women with depression. BMJ Open 2017;7:e013372.)

(Anm: Bruk av antipsykotika er assosiert med en 60 % økt risiko for dødelighet hos pasienter med Alzheimers sykdom. (…) Bruk av to eller flere antipsykotika samtidig ble knyttet til nesten doblet dødsrisiko (200 %) enn ved monoterapi.) (Antipsychotic Drug Use Increases Risk of Mortality Among Patients With Alzheimer’s Disease. JOENSUU, Finland -- December 12, 2016 -- Antipsychotic drug use is associated with a 60% increased risk of mortality among patients with Alzheimer's disease, according to a study published in the Journal of Alzheimer’s Disease. The risk was highest at the beginning of drug use and remained increased in long-term use. Use of 2 or more antipsychotic drugs concomitantly was associated with almost 2 times higher risk of mortality than monotherapy.) (dgnews.docguide.com 12.12.2016).)

(Anm: Antipsykotika dobler dødsrisiko allerede etter 180 dagers bruk. Greater Mortality Risk With Antipsychotics in Parkinson's (Større dødsrisiko med antipsykotika ved Parkinsons) (medicalnewstoday.com 21.6.2015).)

(Anm: (...) For ytterligere å illustrere problemet kan nevnes at antipsykotika forårsaker parkinsonisme (5), og en studie fant at mennesker med Parkinsons sykdom og psykose hadde fire ganger større sannsynlighet for å dø etter tre til seks måneders behandling enn de som ikke fikk antipsykotika. (6) De var også mer utsatt for kognitiv svikt, forverring av parkinsonsymptomer, hjerneslag, infeksjoner og fall. RE: Psykisk syke lever kortere. Tidsskr Nor Legeforen 10.11.2015.)

(Anm: Legemidler som kan gi delirium hos eldre. Delirium ses særlig hos eldre ved akutte sykdommer og skader eller som følge av toksisk eller farmakologisk påvirkning. Eldre personer har mange sykdommer og bruken av legemidler er høy. Mange legemidler, og særlig de med antikolinerg eller dopaminerg effekt, kan gi delirium. Kjennskap til legemidler og kombinasjoner av legemidler som kan gi delirium, er viktig for å kunne forebygge og behandle tilstanden. Tidsskr Nor Legeforen 2005; 125:2366-7 (8.9.2005).)

(Anm: Delirium in hospitalized patients: Risks and benefits of antipsychotics. ABSTRACT Consensus panel guidelines advocate for the judicious use of antipsychotic drugs to manage delirium in hospitalized patients when nonpharmacologic measures fail and the patient is in significant distress from symptoms, poses a safety risk to self or others, or is impeding essential aspects of his or her medical care. Here, we review the use of haloperidol, olanzapine, quetiapine, risperidone, and aripiprazole for this purpose. Cleveland Clinic Journal of Medicine. 2017 August;84(8):616-622.)

(Anm: Post injektionssyndrom. (…) De fleste af disse patienter udviklede symptomer på sedation (fra mild sedation til koma) og/eller delirium (herunder forvirring, desorientering, ophidselse/ uro, angst og anden kognitiv svækkelse). Andre symptomer inkluderede ekstrapyramidale symptomer, dysartri, ataksi, aggression, svimmelhed, svaghed, hypertension eller krampe.) (sundhedsstyrelsen.dk 29.6.2014).)

(Anm: Mødre til børn med misdannelser har øget dødelighed. (…) Bivirkninger har ført til to dødsfald. Den største del af bivirkningerne (42 procent) af de 429 blev indberettet for såkaldte psykostimulerende lægemidler - eksempelvis til behandling af ADHD - efterfulgt af 31 procent for antidepressiver og 24 procent for antipsykotiske lægemidler. (videnskab.dk 20.12.2016).)

(Anm: Antikolinerge effekter av vanlige legemidler knyttet til økt dødelighet hos mennesker over 65. De kombinerte antikolinerge effektene av mange vanlige legemidler øker risikoen for kognitiv svekkelse og død hos personer over 65 år, ifølge resultater fra en storskala studie på den langsiktige helseeffekten av legemidler.(Anticholinergic effects of common drugs are associated with increased mortality in over 65s. The combined anticholinergic effects of many common drugs increase the risk of cognitive impairment and death in people aged over 65, a large scale study of the long term effect of drugs on health has found.) BMJ 2011; 342:d4037 (28 June).)

(Anm: Men experience greater cognitive impairment and increased risk of death following hip surgery. In a study of hip fracture patients, men displayed greater levels of cognitive impairment within the first 22 days of fracture than women, and cognitive limitations increased the risk of dying within six months in both men and women. "While men make up only about 25 percent of all hip fractures, the number of men who fracture their hip is increasing and we know men are more likely to die than women after a hip fracture," said Dr. Ann Gruber-Baldini, lead author of the Journal of the American Geriatrics Society study. (medicalnewstoday.com 10.2.2017).)

(Anm: Det autonome nervesystemet. Det autonome nervesystemets hovedoppgave er å bidra til likevekt i kroppens basale funksjoner. Det vil blant annet si kroppstemperatur, blodtrykk, åndedrett og fordøyelse. (nhi.no 4.3.2015).)

(Anm: Ulike selektive serotonin reopptakshemmeres (SSRI-er) cytotoksisitet mot kreftceller. (Cytotoxicity of different selective serotonin reuptake inhibitors (SSRIs) against cancer cells.) (…) Vi har funnet at paroxetine (paroksetin; Seroxat; Paxil etc.) har cytotoksisk aktivitet mot tumorceller. J Exp Ther Oncol. 2006;6(1):23-9.)

(Anm: Could antidepressants stop prostate cancer from spreading? In almost all cases where prostate cancer spreads to other areas of the body, the disease spreads to the bone first. In a new study, researchers reveal the discovery of an enzyme that helps prostate cancer cells to invade bone. Furthermore, certain antidepressant medications may have the potential to block this enzyme. Study co-author Jason Wu, of Washington State University-Spokane, and colleagues recently reported their findings in the journal Cancer Cell. (medicalnewstoday.com 13.3.2017).)

(Anm: Classic cytotoxic drugs: a narrow path for regulatory approval. Several classic cytotoxic drugs have shown encouraging activity in the treatment of metastatic breast cancer.1–3 However, only a few have received an overwhelming welcome from regulatory authorities and succeeded in obtaining widespread regulatory approval for routine use. For example eribulin was approved for treatment of metastatic breast cancer in several countries including Japan, USA, and Europe, based on data that showed longer overall survival in patients treated with eribulin compared with patients treated with physician's choice of treatment. In contrast ixabcpilone with capecitabine gained approval from the US Food and Drug Agency based on data showing longer progression-free survival compared with capccitabine alone, but did not obtain rcgulatory authorisation in Europc because it is associated with a high incidence of nevropathy.5 Lancet Oncol. 2017 Feb 10. pii: S1470-2045(17)30089-X. [Epub ahead of print].)

(Anm: Ødelagt cellulær "klokke" linket til hjerneskade (Broken Cellular 'Clock' Linked to Brain Damage) (sciencedaily.com 25.11.2013).)

(Anm: Signaling Pathways Linked to Serotonin-Induced Superoxide Anion Production: A Physiological Role for Mitochondria in Pulmonary Arteries. Abstract. Serotonin (5-HT) is a potent vasoconstrictor agonist and contributes to several vascular diseases including systemic or pulmonary hypertension and atherosclerosis. Although superoxide anion ([Formula: see text]) is commonly associated to cellular damages due to [Formula: see text] overproduction, we previously demonstrated that, in physiological conditions, [Formula: see text] also participates to the 5-HT contraction in intrapulmonary arteries (IPA). Front Physiol. 2017 Feb 9;8:76. eCollection 2017.)

(Anm: Bruk av antidepressiva ble assosiert med et betydelig eldre utseende og forskere fant også ut at vekten spilte en viktig faktor. I de sett med tvillinger som var yngre enn 40 år ble tyngre tvillinger oppfattet som eldre. (…) I tillegg mistenker forskerne at den vedvarende avslapping av ansiktsmuskler som antidepressiva forårsaker kan forklare årsaken til at ansiktet faller sammen (henger). (mintankesmie.no).)

(Anm: Minislag (ministroke: transient ischemic attack (TIA)) linket til lavere forventet levetid. (- Minislag kan forårsake demens.) (- Enkelte psykofarmaka kan øke risiko for minislag / demens.) (mintankesmie.no).)

(Anm: Stumme infarkt rammer oftere folk med høy smertetoleranse. Stumme hjerteinfarkt gir ikke de klassiske brystsmertene som ved vanlige infarkt. - Denne pasientgruppen tar enten ikke kontakt med lege, eller de har ikke fått riktig diagnose, sier lege og forsker Andrea Milde Øhrn. (…) Det er vanlig å tenke sterke brystsmerter og akutt behandling når det er snakk om hjerteinfarkt. Det mange kanskje ikke vet, er at man kan ha hatt et hjerteinfarkt uten å vite det. Dette kalles et stumt infarkt, et hjerteinfarkt med få eller ingen symptomer. - Et stumt hjerteinfarkt er et hjerteinfarkt som ikke er erkjent. (nhi.no 3.2.2017).)

(Anm: Sannsynlig karotidyni forårsaket av fluoxetine (Prozac; SSRI-er). (Probable fluoxetine-induced carotidynia.)  Karotidyni er en fokal nakkesmerte (bestemt, avgrenset område), som involverer anatomiske områder til den berørte arteria carotis, og stråler ofte ut i den ipsilateral side (samme side) av ansiktet eller øret. På grunnlag av medisinsk historie og alder har karotidyni konvensjonelt vært klassifisert i klassisk (ikke-migrenøs), migrenøs, og vaskulære varianter. The Lancet 2009;374(9695):1061-1062 (26 September).)

(Anm: Nakkesmerter sætter forskerne skakmat. Kroniske nakkesmerter koster samfundet milliarder og er en af de hyppigste årsager til, at danskere melder sig syge fra job. Forskerne er i vildrede: Ingen behandling er effektiv. (videnskab.dk 22.12.2016).)

(Anm: Antidepressiva linket til hjerterisiko: tvillingstudie. (Antidepressants linked to heart risk: twins study) - Middelaldrende menn som bruker antidepressiva er mer sannsynlig å ha en innsnevring av blodårer, noe som øker risikoen for hjerteinfarkt og slag, enn de som ikke bruker legemidlene, ifølge en studie presentert på lørdag. (Reuters) - Middle-age men who use antidepressants are more likely to have a narrowing of blood vessels, increasing the risk of heart attacks and strokes, than those who do not use the medications, according to a study presented on Saturday.) (reuters.com 2.4.2011).)

(Anm: - Pfizers Zyvoxid (Zyvox) og antidepressiva kan være en dødelig kombinasjon. (- Det antas at når linezolid gis til pasienter, som behandles med serotonerge psykofarmaka, kan forhøyede nivåer av serotonin bygge seg opp i hjernen og forårsake toksisitet (giftighet). Dette er referert til som Serotonin syndrom - tegn og symptomer inkluderer mentale endringer (forvirring, hyperaktivitet, minneproblemer), muskelrykninger, overdreven svetting, skjelving eller risting, diaré, problemer med koordinasjon og / eller feber.) (fda.gov 21.10.2011).)

(Anm: Hva er det forskrivere og pasienter ikke vet om bivirkninger av antidepressiva? (What do prescribers and patients not know about the side effects of antidepressant drugs?) (medicalnewstoday.com 15.9.2016).)

(Anm: Forskere: Alvorlige bivirkninger, når antidepressiver droppes. Angst, depression og selvmordstanker er nogle af de bivirkninger, som tit forekommer, når man holder op med at tage antidepressiv medicin. Bivirkningerne kan i nogle tilfælde være langvarige og kroniske, viser et nyt studie. (videnskab.dk 16.3.2015).)

(Anm: Bruk av visse smertestillende midler (og antidepressiva (+ 31 %)) forbundet med økt risiko for drap (Use of certain painkillers linked with increased risk of homicide) Enkelte legemidler som påvirker sentralnervesystemet - som smertestillende og beroligende benzodiazepiner - er assosiert med økt risiko for å begå et drap, finner en ny studie publisert i tidsskriftet World Psychiatry. (medicalnewstoday.com 1.6.2015).)

(Anm: Psykiatriske patienter ender i private botilbud. Drab og vold har de seneste år fyldt debatten om de danske bosteder for patienter med psykiske problemer. (…) Psykiatriske patienter ender i private botilbud. (…) Mens Folketinget kæmper for en løsning på problemet med vold på offentlige bosteder, vælger flere kommuner at sende tunge patienter til private tilbud. (politiken.dk 18.3.2017.)

(Anm: Aggresjon knyttet til økt risiko for substansmisbruk. Aggression disorder linked to greater risk of substance abuse. (…) In the study, published in the Journal of Clinical Psychiatry, Emil Coccaro, MD, and colleagues analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States. They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use. The findings suggest that a history of frequent, aggressive behavior is a risk factor for later substance abuse, and effective treatment of aggression could delay or even prevent substance abuse in young people. (medicalnewstoday.com 2.3.2017).)

(Anm: Halvparten av norske drap begått av rusede. (…) I 125 av drapene – eller 54 prosent – er det beskrevet i dommen at gjerningspersonen var påvirket av rusmidler under drapet. (nrk.no 13.12.2016).)

- En pasient på UNN døde av blodforgiftning som følge av et legemiddel mot psykiske lidelser, opplyser Statens helsetilsyn.

(Anm: En pasient på UNN døde av blodforgiftning som følge av et legemiddel mot psykiske lidelser, opplyser Statens helsetilsyn. (- Pasienten døde etter kort tid, og dødsårsaken var nøytropen sepsis (blodforgiftning), heter det i tilsynets rapport. (nrk.no 12.10.2016).)

(Anm: Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body, frequently a response of the immune system to infection. (en.wikipedia.org).)

(Anm: Sepsis. Definisjon: SIRS + påvist/mistenkt infeksjon (f. eks. positiv blodkultur). SIRS- kriteriene er: - Feber > 38 ºC eller hypotermi < 36 ºC - Puls > 90/minutt - Respirasjonsfrekvens > 20/minutt eller hypokapni med pCO2 < 4,3 kPa i blodgass - Leukocytose ≥ 12 × 109/l eller leukopeni < 4 × 109/l eller > 10 % umodne leukocytter. (helsebiblioteket.no - Metodebok for indremedisinere, 2012).)

(Anm: Rollen til mitokondriell dysfunksjon (mitokondriedysfunksjon) ved sepsis (blodforgiftning)-indusert multiorgansvikt. (The role of mitochondrial dysfunction in sepsis-induced multi-organ failure). (Virulence. 2013 Nov 1;5(1).)

- Diagnostisering av sepsis. Sepsis, også kjent som blodforgiftning, er kroppens hyperaktive respons på en infeksjon som kan føre til betennelse, vevskader, organsvikt etc.

(Anm: Diagnosing Sepsis. Sepsis, also known as blood poisoning, is the body’s hyperactive response to an infection that can lead to inflammation, tissue damage, organ failure etc. It is a very dangerous state in which the immune system stops fighting with the invading agents  and turns to itself. Around one-third of patients who are affected with sepsis die every year. (news-medical.net 7.9.2017).)

- Å anerkjenne sepsis som en global helseprioritet - En WHO- resolusjon.

(Anm: Å anerkjenne sepsis som en global helseprioritet - En WHO- resolusjon. Recognizing Sepsis as a Global Health Priority — A WHO Resolution. “Some very important clinical issues, some of them affecting life and death, stay largely in a backwater which is inhabited by academics and professionals and enthusiasts, dealt with very well at the clinical and scientific level but not visible to the public, political leaders, leaders of healthcare systems... The public and political space is the space in which [sepsis] needs to be in order for things to change.” NEJM (June 28, 2017).)

(Anm: Sepsis – den dödliga sjukdomen som glöms bort. Trots att infektionssjukdomen sepsis förekommer oftare än de vanligaste formerna av cancer och att upp emot hälften som drabbas av den allvarligaste formen dör, så har många knappt hört talas om sjukdomen. Sepsis som är den medicinska termen på blodförgiftning, drabbar omkring 40 000 svenskar varje år. (netdoktor.se 7.6.2017).)

- Hurtigtest finner tegn på sepsis i en enkelt dråpe blod.

(Anm: Hurtigtest finner tegn på sepsis i en enkelt dråpe blod. (- Sepsis, en potensielt livstruende komplikasjon av en infeksjon, har den høyeste byrde mht. død og medisinske utgifter på sykehus over hele verden.) (- Quick test finds signs of sepsis in a single drop of blood. (…) Sepsis, a potentially life-threatening complication of an infection, has the highest burden of death and medical expenses in hospitals worldwide. (medicalnewstoday.com 5.7.2017).)

(Anm: Nye sepsiskriterier kan føre til forsinket behandling. (…) Sepsis er en svært alvorlig tilstand med høy morbiditet og mortalitet (2). Den totale insidensen er ukjent, men man regner med at sepsis er en av de viktigste årsakene til alvorlig, akutt sykdom på verdensbasis (1). (…) Sepsis har inntil nylig vært definert som mistenkt infeksjon med samtidig tilstedeværelse av to eller flere SIRS-kriterier (1). Endringer i hjertefrekvens, kroppstemperatur, respirasjonsfrekvens og leukocytter er kroppens tegn på inflammasjon, og de indikerer ikke nødvendigvis en livstruende, dysregulert vertsrespons på infeksjon. Tidsskr Nor Legeforen 2017; :609-10 (20.4.2017).)

(Anm: LEGENE FORSTO IKKE AT HAN VAR DØDSSYK: Stian (19) døde etter 18 timer på sykehus uten legetilsyn. (…) Helsetilsynet konkluderer med at sykehusets behandling var uforsvarlig. (…) Fikk ikke beskjed. (…) Fastlegen sendte med dem papirer som foreldrene leverte på Akuttmottaket ved Ahus, der sto det; «Diagnose: Obs sepsis».  (tv2.no 29.4.2017).)

(Anm: Svikt i behandlingen av akutt syk ung mann i akuttmottaket – brudd på helselovgivningen. (…) Pasienten ble lagt på observasjonsposten (Akutt 24) ved akuttmottaket frem til neste morgen. I løpet av tiden på observasjonsposten ble han ikke tilsett av lege. På morgenen var han betydelig verre og han fikk tegn på fullt utviklet blodforgiftning. Behandling med antibiotika ble iverksatt, men han døde kort tid etter som følge av meningokokksepsis og hjerneødem. (helsetilsynet.no 2.5.2017).)

(Anm: Sepsis; grunnleggende kliniske observasjoner. Sepsis= En systemisk inflammatorisk respons (SIRS) pga. en infeksjon Tre alvorlighetsgrader: 1) Sepsis (to eller flere symptomer på SIRS som følge av infeksjon) 2) Alvorlig sepsis (sepsis med akutt organdysfunksjon, hypoperfusjon eller hypotensjon) 3) Septisk sjokk (hypotensjon til tross for adekvat væsketerapi, samt forekomst av perfusjonsforstyrrelser og organdysfunksjon) (hnt.no 5.11.2013).)

- Alle bryt lova i behandling av blodforgifting. Pasientar med alvorleg blodforgifting (sepsis) blir undersøkt av lege for seint.

(Anm: Alle bryt lova i behandling av blodforgifting. Pasientar med alvorleg blodforgifting blir undersøkt av lege for seint. Helsetilsynet fann brot ved 24 akuttmottak over heile landet. – Svært alvorleg. – Dette er svært alvorleg, for det dreier seg om ein alvorleg infeksjonssjukdom som i verste fall kan medføra død dersom behandlinga ikkje blir igangsett til riktig tid, seier avdelingsdirektør i Helsetilsynet, Ragnar Hermstad. OVER EIN TIME: Pasientar som kjem inn med teikn på alvorleg infeksjonssjukdom som blodforgifting skal ifølge nasjonale retningslinjer få anitibiotikabehandling innan maks ein time. Alle dei 24 akuttmottaka hadde svikt på dette området. (nrk.no 16.6.2017).)

(Anm: Lege sier improvisert «kur» for sepsis har hatt bemerkelsesverdige resultater. (…) Spesialist i intensivbehandling Paul Marik sier at enkel behandling med infusjon av vitamin C og steroider har bemerkelsesverdig effekt på pasienter med potensielt dødelig tilstand. (independent.co.uk 24.3.2017).)

(Anm: Bivirkninger underrapporteres i videnskabelige tidsskrifter. (...) Mellem 43 og 100 procent af de bivirkninger, der, ifølge det ikke-publicerede materiale, er fundet ved de testede lægemidler, er ikke lagt frem i de videnskabelige artikler, viser Yoon Loke og kollegernes gennemgang. (videnskab.dk 5.10.2016).)

(Anm: Dødsfall på grunn av nøytropen sepsis (blodforgiftning) etter behandling med legemiddelet klozapin – uforsvarlig oppfølging – mangelfull samhandling og informasjon. (…)  Manglende informasjon fra spesialisthelsetjenesten og mangelfull samhandling mellom kommunehelsetjenesten, fastlegen, pasienten og pårørende bidro til hendelsen. Helseforetaket skal gjennomgå hendelsen for å redusere risikoen ved lignende tilfeller. (helsetilsynet.no 12.10.2016).)

(Anm: Eksplosjon av antidepressiva til unge jenter. De ønsker psykologhjelp. I stedet blir de fôret med piller fra fastlegen. Unge jenter har aldri brukt mer antidepressiver. (vg.no 10.9.2016).)

(Anm: Flere barn og unge akuttinnlegges for psykisk sykdom. I fjor utgjorde andelen øyeblikkelig hjelp innleggelser 61 prosent av alle innleggelser. Det er en økning fra 47 prosent i 2012. (dagensmedisin.no 19.9.2016).)

(Anm: Eksplosjon av antidepressiva til unge jenter: Lykkepillegenerasjonen. «Lykkepillen» gjorde Sandra så dårlig at hun ble innlagt på psykiatrisk avdeling. På ti år har bruken av antidepressiver blant unge jenter økt med 83 prosent. Mange får pillene uten en gang å ha snakket med psykolog.  (vg.no 10.9.2016).)

(Anm: Helseminister Bent Høie reagerer på «lykkepille»-praksis: – Veldig urovekkende. ** Kraftig økning i antidepressiva til unge jenter. Helseminister Bent Høie reagerer på den sterke økningen i lykkepillebruk blant unge jenter. Han mener manglende ressurser og fastlegers holdninger er årsaker. Lørdag dokumenterte VG Helg og VG+ konsekvensene av den økende lykkepille-bruken blant unge jenter. (vg.no 10.9.2016).)

(Anm: LO advarer mot trygdebombe. En stadig større del av nordmenn i arbeidsfør alder er uten jobb. LO mener dette er en potensiell trygdebombe. (…) Det trengs 180.000 nye jobber for å få yrkesdeltakelsen opp på samme nivå som i 2008, viser en rapport fra samfunnsøkonomene i LO. I 2008 var 70 prosent av befolkningen mellom 15 og 74 år i jobb. Nå er yrkesdeltakelsen nede i 67,3 prosent., og det er nedgang i alle fylker. (hegnar.no 6.10.2016).)

(Anm: Rekordmange søger akut psykisk hjælp. (- Mens kun 12.099 danskere i 1995 besøgte de psykiatriske akutmodtagelser og skadestuer, er det steget til hele 33.333 i 2015, viser opgørelse fra Sundhedsdatastyrelsen og Danske Regioner, der for kort tid siden blev sendt til Folketinget. (politiken.dk 9.7.2016).)

(Anm: Har vi blitt psykisk sykere? (- Vi vet også at stadig flere får uførepensjon på grunn av psykiske lidelser og at sykefraværet på grunn av psykiske plager og lidelser har økt. Vi tror alle disse forholdene bidrar til vår oppfatning om at stadig flere får en psykisk lidelse eller plage.) (Folkehelseinstituttet fhi.no 10.10.2013).)

(Anm: Høyt fravær på grunn av ME. Minst 270 elever var borte fra skolen i fjor fordi de hadde ME. (aftenposten.no 6.2.2017).)

(Anm: Psykisk ohälsa fortsätter att öka. Antalet svenskar som sjukskrivs på grund av psykisk ohälsa ökar kontinuerligt sedan 2010. Den vanligaste diagnosen är stressrelaterad psykisk ohälsa som till mångt och mycket är arbetsrelaterad. Då evidensbaserad behandling saknas står förebyggande arbete i fokus. (netdoktor.se 14.9.2016).)

(Anm: Psykiatriske skadestuer kan ikke klare presset. Psykiske lidelser hører til nogle af de største sygdomsbyrder, som hvert år koster samfundet et svimlende milliardbeløb i tabt arbejdsfortjeneste og sociale ydelser. (politiken.dk 11.7.2016).)

(Anm: - 9 ting som skjer i hjernen og kroppen på MDMA (Ecstasy). (- 9 Things That Happen in the Brain and Body on MDMA.) (- Derfor, når substansen avsluttes, sitter mennesker igjen med mindre serotonin enn vanlig, noe som kan føre til følelser av depresjon, irritabilitet og tretthet.) (- Siden MDMA frigir så mye serotonin, ødelegger kroppen deretter mer serotonin enn vanlig, ifølge AsapSCIENCE.) (thescienceexplorer.com 24.6.2016).)

Indberetninger om hjertemisdannelser ved behandling med citalopram og sertralin
irf.dk 20.6.2011 (Institut for Rationel Farmakoterapi (IRF)
På baggrund af en nyhed fra Lægemiddelstyrelsen bringer IRF denne meddelelse

Lægemiddelstyrelsen har, især i den senere tid, modtaget enkelte indberetninger om hjertemisdannelser hos børn, hvor moderen har været behandlet med de antidepressive SSRI-midler citalopram og sertralin.

Det kan imidlertid ikke afgøres ud fra de indberettede hændelser, om der er tale om en årsagssammenhæng med moderens behandling med SSRI og de sete misdannelser, eller om der er tale om tilfældigt opståede misdannelser.

Sammenhæng mellem brug af SSRI og risiko for fosterskader undersøges nærmere

Lægemiddelstyrelsen vil søge at få yderligere belyst, om der er en mulig sammenhæng mellem behandling med SSRI og risiko for fosterskader, og vil herunder rejse sagen i Den Europæiske Bivirkningskomité med henblik på at indhente erfaringer fra de andre medlemsstater. (...)

Selective Serotonin Reuptake Inhibitors and Risk for Major Congenital Anomalies
Obstet Gynecol. 2011 Jun 3. [Epub ahead of print]
OBJECTIVE: To estimate the risk of major congenital anomalies after exposure to selective serotonin reuptake inhibitors during pregnancy. (...)

CONCLUSION: Fluoxetine use is associated with an increased risk of isolated ventricular septal defects and paroxetine is associated with right ventricular outflow tract defects. The absolute risk for these specific cardiac anomalies is small but should guide clinicians not to consider fluoxetine or paroxetine the first option when prescribing selective serotonin reuptake inhibitors to women planning pregnancy. Special attention should be given to alcohol use in pregnant women using selective serotonin reuptake inhibitors. (...)

Antidepressants Taken During Pregnancy And Birth Defects (Antidepressiva brukt under svangerskapet og fødselsdefekter)
healthnewsdigest.com 6.6.2011
While this subject is by no means a new one, the resurgence of TV commercials touting the relevant expertise of various plaintiff's attorneys inspired this article.

(HealthNewsDigest.com) - Ever since the Thalidomide catastrophe of the late 1950s, whereby a sedative drug used during pregnancy for morning sickness—largely in Europe—produced thousands of birth defects, the entire notion of taking drugs during pregnancy was considered beyond the pale for most women. At the time of its introduction into the marketplace, it was assumed (based on what, no one can say) that the placenta provided an effective barrier to exogenous substances. Some accounts suggest that even a single dose of Thalidomide was enough to cause significant damage. (...)

As to linking antidepressant drugs to birth defects, the landmark case is Kilker v. SmithKline Beecham Corp. dba GlaxoSmithKline, 2007-001813, Court of Common Pleas, Philadelphia County, Pennsylvania. On October 13, 2009, the jury found for the plaintiffs, concluding that Glaxo failed to properly warn doctors and pregnant users of Paxil's risk and ordered the company to pay $2.5 million to the family of Lyam Kilker—born with severe heart problems—whose mother took Paxil during her pregnancy.

The case was presented as a classical "failure to warn," a charge which has some credibility. Still, one wonders what sort of doctor would prescribe a powerful drug to a pregnant woman? It is difficult to imagine any doctor not discussing the generic risks (even if specific risks were unknown at the time) of taking drugs while pregnant. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

Depressionsmedicin under graviditet:
Tal med lægen om fordele og ulemper
medicinmedfornuft.dk 1.5.2011
Hvilken medicin kan være risikabel under graviditet?

Medicin med det virksomme paroxetin (Seroxat, Paroxetin) har vist en let øget risiko for medfødte misdannelser, herunder hjertemisdannelser, i 1-3 måned (1. trimester). Den eventuelle risiko svarer ca. til, at risikoen for at føde et barn med misdannelser er øget med ca. 1 % i forhold til, hvis moderen ikke har fået et SSRI. Det betyder én graviditet mere ud af 100 graviditeter end normalt. (...)

Stoffet fluoxetin (Fontex, Fondur, Fluoxetin, Flutin mfl.) har på det seneste vist en lignende øget risiko for hjerte-kar misdannelser som paroxetin. Lægemiddelstyrelsen har siden 2004 fået indberetninger om 2 dødsfald af nyfødte af mødre, der har taget fluoxetin. Dette ud af i alt 20 indberetninger om bivirkninger ved nyfødte børn hos kvinder, der har brugt antidepressiv medicin under graviditet. Derfor anbefaler vi fortsat, at fluoxetin ikke er førstevalg under graviditet, men at man primært vælger et andet SSRI.

Man bør desuden være særligt tilbageholdende med at bruge de nyeste antidepressiva, hvis sikkerhed under graviditet er mindre kendt. Det gælder blandt andet medicin med escitalopram (Cipralex, Seroplex, Entact, Esertia), venlafaxin (Efexor, Vandral, Venlafaxin), duloxetin (Cymbalta, Xeristar, Yentreve) og mirtazapin (Arintapin, Mirtazapin, Combar, Remeron).

Nyere studier har desuden vist, at nyfødte børn har en forøget risiko for at få et alvorligt fald i blodets indhold af ilt lige efter fødslen (Persistent Pulmonary Hypertension of the Newborn, PPHN), hvis deres mødre har fået en medicin med SSRI i graviditeten. Faldet i iltindhold skyldes, at et højt blodtryk i lungerne hindrer den normale åbning af barnets lungeblodkar. Normalt kan ca. 2 ud af 1000 graviditeter resultere i denne lidelse, mens det ved brug af et SSRI er øget til 5 ud af 1000. Risikoen synes ikke at være øget ved brug af anden antidepressiv medicin (trisykliske antidepressiva, TCA). (...)

(Anm: Prozac (fluoxetine). (mintankesmie.no).)

Bivirkninger hos nyfødte når mor har brukt legemidler mot depresjon
legemiddelverket.no 2.3.2011
Lægemiddelstyrelsen i Danmark har meldt at det i perioden fra 1990 til 2011 er registrert to dødsfall hos nyfødte der mor hadde brukt fluoksetin i svangerskapet. Fluoksetin er et legemiddel av typen SSRI. Det er mistanke om at mors bruk av fluoksetin kan ha medvirket til dødsfallene.

Se saken på sidene til Lægemiddelstyrelsen i Danmark.(...)

Risikoen for alvorlige bivirkninger er liten, men det er tre hovedproblemer ved bruk av legemidler mot depresjon hos gravide

  • Det er trolig litt økt risiko for hjertemisdannelser (økning fra 1 % til 2 %) ved bruk av legemidlene paroxetin og fluoxetin i første del av svangerskapet. De fleste misdannelsene er lite alvorlige.
  • Risikoen for høyt blodtrykk i lungekretsløpet (vedvarende pulmonal hypertensjon) øker trolig litt ved bruk av legemidler av typen SSRI’er i siste halvdel av svangerskapet.
  • Risiko for abstinensplager hos den nyfødte. Rapportene fra Danmark viser at man ikke kan utelukke at det kan forekomme dødsfall ved høyt blodtrykk i lungekretsløpet. Det er ikke meldt om slike dødsfall i Norge. (...)

Lykkepiller skyld i flere døde babyer
ekstrabladet.dk 1.3.2011
Omkring 2,4 procent af alle gravide spiser antidepressiver uden at kende risikoen for, hvad det kan gøre ved barnet

I søndags kom det frem, at to spædbørn er døde som følge af, at moren gennem graviditeten havde spist lykkepiller.

Nu viser det sig, at der også har været tre sager med fostre, der er døde i henholdsvis 8., 16. og 33. graviditetsuge, skriver Jyllands-Posten.

Læs også: Lykkepiller kan dræbe spædbørn

Mødrene var i behandling med præparaterne Sertralin, Cipramil og Paroxetin, mens det var Fluoxetin, der sættes i forbindelse med de to tilfælde af spædbørnsdød.
Lægemiddelstyrelsen ved, at der generelt er en underindberetning af dødsfald og alvorlige bivirkninger, og derfor kan der meget vel være flere tilfælde.

Efter sagerne er kommet frem, har Lægemiddelstyrelsen taget fat på at gennemgå indlægssedlerne og produktresuméer for de forskellige former for lykkepiller. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Questions about Antidepressants and Pregnancy
lawyersandsettlements.com 14.1.2011
There’s a lot in the news about pregnancy and antidepressants (SSRI’s in particular—and especially Paxil, which has a Category D rating by the FDA). And we get a lot of comments and emails from readers who are either looking for information about SSRI drugs and pregnancy—or who share their stories about negative side effects they’ve experienced while taking antidepressants. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

Update of Swedish Study Upholds Concern for SSRI Birth Defects (Oppdatering av svensk studie opprettholdeer bekymringer om fødselsdefekter)
lawyersandsettlements.com 13.11.2010
Linkoping, Sweden: Swedish research on maternal use of antidepressants in pregnancy continues to bolster existing concerns about SSRI birth defects, according to a recent issue of Obesity, Fitness & Wellness Week (OFWW). "Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations," according to the authors of the study. (...)

The conclusion?

"Use of TCAs was found to carry a higher risk than other antidepressants, and paroxetine (Aropax, Paxil, Seroxat) seems to be associated with a specific teratogenic property."

Paxil, one of the antidepressants mentioned, is a drug belonging to the SSRI class (selective serotonin reuptake inhibitor) and includes a host of SSRI side effects. One of the most grievous adverse reactions is PPHN, or persistent pulmonary hypertension of the newborn. The latter is considered a serious birth defect.

M. Reis is affiliated with the National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linkoping, Sweden. The study authored by Reis and colleagues updates a previous study and was published in the Journal of Psychological Medicine, published out of New York. (...)

(Anm: Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med. 2010 Oct;40(10):1723-33. Epub 2010 Jan 5.)

Hundreds of Paxil Birth Defect Cases Reported Settled (Hundrevis av fødselsdefekt-saker for Seroxat (Paxil) rapportert forliket)
1888pressrelease.com 30.6.2010
New York, NY (1888PressRelease) June 30, 2010 - An order signed on June 15, 2010 by Justice Sandra Moss, has paved the way for the settlement of of hundreds of Paxil birth defect cases pending against GlaxoSmithKline, GSK. No Paxil birth defect cases have been tried since the October 13, 2009, verdict where a jury awarded $2.5M to the family of Lyam Kilker, a child born with a congenital heart defect caused by Paxil use during pregnancy.

Approximately 600 cases have been filed against GSK, most in the Mass Tort Program in the Court of Common Pleas in Philadelphia. It has been reported by the Legal Intelligencer that Judge Moss, the coordinating judge of Philadelphia's mass tort program, the Complex Litigation Center, said the philosophy of GSK "is to try and settle what they can and to settle in groups." (...)

The most common injuries caused by Paxil are (De mest vanlige skader forårsaket av seroxat (Paxil)):

Heart Birth Defects (Pulmonary Stenosis, Pulmonary Atresia, Atrial or Ventricular Septal Defects, Murmurs, etc)
Lung Birth Defects (Persistent Pulmonary Hypertension)
Craniosynostosis (resulting in an abnormally shaped head)
Abdominal Birth Defects (Omphalocele)
Cranial Birth Defects (Craniosynostosis)

If you or someone you know had a child who was born with a congenital heart defect or other birth defect, and the child was exposed to Paxil (paroxetine) during pregnancy, they may be entitled to significant compensation. For more information go to www.DrugSettlement.com. (...)

Use of antidepressants during pregnancy and the risk of spontaneous abortion (Bruk av antidepressiva under svangerskapet og risiko for spontanabort)
CMAJ 2010; 182 (10) (July 13)
(...) Interpretation: The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Lykkepiller fører til medfødte misdannelser
videnskab.dk 23.6.2010
Gravides brug af medicin til behandling af psykiske lidelser øger risikoen for fosterskader. Risikoen for bivirkninger er så stor, at lægemidlerne ikke bliver testet på gravide. Alligevel bliver medicinen udskrevet til gravide.

Det kan medføre alvorlige bivirkninger som medfødte misdannelser, når kvinder tager 'lykkepiller' og andet psykofarmaka under graviditeten. Det dokumenterer danske forskere.

»En række alvorlige bivirkninger som misdannelser, lav fødselsvægt, for tidlig fødsel, udvikling af abstinenssymptomer og hjertefejl blev rapporteret hos danske børn under to år - formentlig på grund af moderens indtagelse af psykofarmaka under graviditeten,« siger lektor Lise Aagaard.

Hun står bag undersøgelsen sammen med professor Ebba Holme Hansen fra Institut for Farmakologi og Farmakoterapi på Det Farmaceutiske Fakultet på Københavns Universitet. (...)

(Anm: Adverse drug reactions from psychotropic medicines in the paediatric population: analysis of reports to the Danish Medicines Agency over a decade. BMC Research Notes 2010, 3:176 (23 June).)

(Anm: Use of psychotropic drugs during pregnancy and breast-feeding. (…) CONCLUSION: It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how it has to be administered.Acta Psychiatr Scand Suppl. 2015;(445):1-28.)

(Anm: Vil gi gravide bedre informasjon om medisinbruk. Forskere tar formidlingen av risikoen alvorlig, men vil ikke skremme gravide unødig. De lager videoer og samarbeider tverrfaglig for å informere så godt som mulig om medisinbruk i svangerskapet. (forskning.no 24.9.2015).)

Adverse drug reactions from psychotropic medicines in the paediatric population: analysis of reports to the Danish Medicines Agency over a decade (Uheldige legemiddelreaksjoner fra psykotrope medisiner i barnebefolkningen: analyser av rapporter til Lægemiddelstyrelsen i en tiårsperiode)
BMC Research Notes 2010, 3:176 (23 June)
(...) Background The prescribing of psychotropic medicines for the paediatric population is rapidly increasing. In attempts to curb the use of psychotropic medicine in the paediatric population, regulatory authorities have issued various warnings about risks associated with use of these products in childhood. Little evidence has been reported about the adverse drug reactions (ADRs) of these medicines in practice. As spontaneous reports are the main source for information about previously unknown ADRs, we analysed data submitted to a national ADR database. The objective was to characterise ADRs reported for psychotropic medicines in the Danish paediatric population over a decade. (...)

Konklusjon Det høye antall alvorlige ADRer (Adverse Drug Reactions) rapportert for psykotrope medisiner i barnbefolkningen bør skape bekymringer for helsepersonell og leger. Tatt i betraktning det høye antall fødselsdefekter som er rapportert bør større omsorg utvises når disse legemidler forskrives til gravide kvinner. (...) (Conclusion The high number of serious ADRs reported for psychotropic medicines in the paediatric population should be a concern for health care professionals and physicians. Considering the higher number of birth defects being reported greater care has to be given while prescribing these drugs for pregnant women.)

– Barn som er født én uke for tidlig risikerer helseskader
nrk.no 10.6.2010
Forskere ber kvinner revurdere keisersnitt dersom de har muligheten.

Babyer som er født bare én uke for tidlig løper større risiko for å utvikle alvorlige lærevansker som dysleksi og autisme, ifølge en ny, britisk rapport.

Mer enn 400 000 britiske skolebarn deltok i studien, som viste at de som ble født i uke 39 av svangerskapet mer sannsynlig vil trenge hjelp i klasserommet enn de som er født etter 40 uker i mors liv.

Det meldte Reuters på sine nettsider i dag. (...)

(Anm: Slightly early births linked to autism, dyslexia. (reuters.com 8.6.2010).)

(Anm: Antidepressants during pregnancy linked to autism. Prof. Bérard says: (…) Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." The use of selective serotonin reuptake inhibitors (SSRIs) - a common class of antidepressants - during the second and/or third trimester was significantly associated with an increased risk of ASD. (medicalnewstoday.com 14.12.2015).)

(Anm: Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children.  Conclusions and Relevance  Use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester increases the risk of ASD in children, even after considering maternal depression. Further research is needed to specifically assess the risk of ASD associated with antidepressant types and dosages during pregnancy. JAMA Pediatr. 2015 (Published online December 14, 2015).)

More Questions About Paxil Side Effects (Flere spørsmål om Seroxats (Paxils) sideeffekter)
lawyersandsettlements.com 29.5.2010
Chicago, IL: En ny artikkel i ScienceNews reiser spørsmål om risiko for Seroxats (Paxils) sideeffekter og fødselsdefekter hos barn eksponert for antidepressiva før fødselen. Artikkelen referer til studier som antyder udefinerbare forandringer i hjernene til babyer eksponert for antidepressiva av typen selektive serotoninreopptakshemmere (SSRIer). Seroxat (Paxil) er et av legemidlene i SSRI-klassen. (Chicago, IL: A new article in ScienceNews raises questions about the risk of Paxil side effects and Paxil birth defects in children exposed to the antidepressant prior to birth. The article cites studies that suggest subtle changes in the brains of babies exposed to Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants. Paxil is one of the drugs in the SSRI class.)

According to the author of the ScienceNews (06/05/10) article, Susan Gaidos, studies conducted in the past few years indicate that mice and rats exposed to antidepressants either just before or just after birth grew up anxious and depressed. A more recent study, according to Gaidos, suggests that children exposed to antidepressants while in the womb are more likely to appear sad or withdrawn at three years old than those not exposed to antidepressants.

Serotonin is produced naturally in the brain and is released into the spaces between the person's neurons. The neuron that releases the serotonin then takes it back almost immediately. This is called reuptake. Selective Serotonin Reuptake Inhibitors work by preventing serotonin's reuptake. The longer serotonin remains in the space between neurons (known as the synapse), the better the person feels. People who are depressed may feel less so because the serotonin remains in the synapse for longer. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

Common antidepressants 'increase miscarriage risk' (Vanlige antidepressiva "øker risiko for abort")
telegraph.co.uk 1.6.2010
Taking common antidepressants while pregnant significantly increases the chances of suffering a miscarriage, a new study warns.

The risk rose by more than two thirds if expectant mothers were taking the drugs, researchers found.

Previous studies have also found a link between antidepressants and birth defects.(...)

Dr. Anick Berard, from the University of Montreal, who led the research, said: "These results, which suggest an overall class effect of selective serotonin re-uptake inhibitors, are highly robust given the large number of users studied.

Overall, the increased risk was 68 per cent. (...)

Medicineksperter i lommen på lykkepillefirmaer
ekstrabladet.dk 28.5.2011
Eksperterne der skal beskytte os mod farlig medicin tjener penge på pilleindustrien

De medicinske eksperter, der skal vejlede om lykkepiller har selv store økonomiske interesser i, at det går producenterne af lykkepiller godt.

Se hvilke læger, der tjener penge på pilleindustrien

De medicineksperter, der er ansvarlige for information om lykkepiller til landets læger, har selv store økonomiske interesser i producenterne af pillerne.

Ekstra Bladet har tidligere afsløret, at lægernes opslagsværk promedicin, blæste på Lægemiddelstyrelsens advarsler om antidepressiv medicin og ikke tilføjede livsvigtige informationer om, at gravide risikerede alvorlige bivirkninger, hvis de fik lykkepiller fra medicinalgiganterne Lundbeck, Pfizer og Eli Lilly.

Læs også: Læger gav livsfarlige lykkepiller

Nu kan Ekstra Bladet afsløre, at de tre ansvarlige for teksten til lægerne har tætte forbindelser til de selvsamme firmaer.

Den ansvarshavende redaktør Court Pedersen ejer således aktier i Lundbeck. Per Damkier skriver afsnittene om graviditet og medicin og tjener samtidig penge som foredragsholder for Lundbeck og andre medicinalgiganter. Poul Videbeck bliver forgyldt for undervisning hos lykkepille-producenterne Pfizer, Lundbeck Eli Lilly, hvor han også arbejder som konsulent. (...)

Betændt dække over farlige lykkepiller
ekstrabladet.dk 28.5.2011
EFTER at alle alarmlamper blinkede for lykkepiller til gravide, fortsatte de danske praktiserende læger trøstigt med at skrive recepter ud til vordende mødre i over et år.

LÆGERNE anede nemlig ikke, at anbefalingerne om, at lykkepillerne ’kan gives til gravide’, ikke længere holdt stik. Flere nyfødte døde derfor eller kom til verden med misdannelser. Hvor mange ved man ikke endnu.

ÅRSAGEN til den fatale træghed i systemet ligger ikke mindst i hænderne på de medicin-eksperter, der skal sørge for, at ny, vital viden om bivirkninger bliver omgående tilgængelig. Det sker på det digitale opslagsværk promedicin.dk. En ’bibel’ for danske læger og sygeplejersker.

DE SELV samme eksperter, som er ansvarlige for information om lykkepiller til landets læger, er desværre selv sovset ind i givtige forbindelser med pillefirmaerne. Man fristes til at sige: Åh nej – ikke igen!

EN GIFTIG sammenrodning af interesser, som omgående burde standses. Det er utilgiveligt, at der skulle gå et år, fra de første advarsler kom, til de nåede frem til de praktiserende læger. De almindelige læger er af gode grunde vrede over, de måske har sendt spædbørn i døden med deres recepter til mødrene. (...)

Pregnant women warned of antidepressants danger to their unborn child (Gravide kvinner advares mot antidepressiva og farer for deres ufødte barn)
dailymail.co.uk 16.5.2010
Women who use antidepressants while pregnant are being warned by health chiefs about the risks to their unborn child.

The Government’s medicines watchdog advised doctors there is an increased risk that babies will be born with a rare lung condition if expectant mothers take drugs such as Prozac and Seroxat.

The Medicines and Healthcare products Regulatory Agency (MHRA) is recommending they are monitored more carefully because of the risk of developing persistent pulmonary hypertension after birth. (...)

Use of Antidepressants, Nicotine in Pregnancy Linked to Childhood Difficulties (Bruk av antidepressiva, nikotin i svangerskapet linket til vanskeligheter i barndommen)
medscape.com 10.5.2010
May 4, 2010 — Prenatal nicotine exposure may increase the risk of sleep problems in children through adolescence, whereas prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) may increase the risk of behavior problems at the age of 3 years, although the risk may be moderated by the serotonin transporter promoter gene, SLC6A4.

These are the findings of 2 studies appearing in the May issue of Archives of Pediatrics and Adolescent Medicine.

These 2 studies, note the coauthors of an accompanying editorial, focus on compounds that are "at the eye of the storm of current concerns" regarding potential adverse effects of drug and chemical exposure on the developing fetus.

"In both instances, the new studies offer refined methods to further our understanding of these complex questions," write Gideon Koren, MD, and Irena Nulman, MD, of the Division of Clinical Pharmacology, Hospital for Sick Children, Toronto, Ontario, Canada. (...)

The condition normally affects up to two in 1,000 births – but the latest research suggests the risk is more than doubled in women taking antidepressants, affecting five in 1,000 births. The life-threatening condition means infants do not adapt to breathing outside of the womb.

The risk is greater if the medicines known as SSRIs – a new generation of depression wonder drugs – are taken later in the pregnancy. (...)

Antidepressant tied to risk of newborn heart defect (Antidepressiva knyttet til risiko for hjertedefekter hos nyfødte)
reuters.com 4.5.2010
NEW YORK (Reuters Health) - Women who use the antidepressant bupropion during early pregnancy may have an increased risk of having a baby with a particular type of heart defect, a new study suggests.

Researchers caution that it is not clear whether the medication, marketed as Wellbutrin, is the cause. And even if it is, they say, the absolute risk of the heart defect would be small -- affecting just 2 out of every 1,000 infants born to women who used bupropion during the first trimester.
But the findings, published in the American Journal of Obstetrics & Gynecology, do add to questions about the risks of using antidepressants during early pregnancy.

Some studies have already linked other antidepressants -- including some of the commonly used selective serotonin reuptake inhibitors (SSRIs) -- to higher-than-average, though small, risks of certain birth defects.

A study last year, for example, found that among nearly half a million Danish children born between 1996 and 2003, the risk of heart defects was elevated among those whose mothers had used SSRIs such as fluoxetine (Prozac), sertraline (Zoloft) and citalopram (Celexa) during early pregnancy. (...)

(Anm: Risk of Angle-Closure Glaucoma With Bupropion and Topiramate. (…) Conclusions and Relevance: Both bupropion and topiramate are widely prescribed drugs. The risk of angle-closure glaucoma in patients younger than 50 years was twice as high in patients taking bupropion and more than 5 times higher in patients taking topiramate.JAMA Ophthalmol. 2015 Jul 9. [Epub ahead of print].)

(Anm: Can your brain control how it loses control. A new study may have unlocked understanding of a mysterious part of the brain -- with implications for neurodegenerative conditions such as Alzheimer's. The results, published in Translational Vision Science & Technology (TVST), open up new areas of research in the pursuit of neuroprotective therapies. Glaucoma is a neurodegenerative disease where patients lose seemingly random patches of vision in each eye. This random pattern of vision loss is in stark contrast to loss from a brain tumor or stroke, which causes both eyes to develop blind spots in the same location. Scientists have long thought that glaucoma's progression is independent of - or uncontrolled by - the brain. (medicalnewstoday.com 17.8.2015).)

Cold Case Files - Paxil Birth Defects (Kalde arkivbevis - Seroxatrelaterte fødselsdefekter)
scoop.co.nz 2.3.2010
by Evelyn Pringle
Almost like an episode of the TV show, Cold Case Files, the first Paxil birth defect trial was dominated by a story about what happened to the rat pups that died around 1979 and1980, involved in a study in which Paxil was being tested on pregnant female rats.

The animal studies giving Paxil to rats and rabbits were conducted by a Danish company called Ferrosan before the drug maker, that later became part of GlaxoSmithKline, purchased the drug.

The family's lead attorney in the case of Kilker v Glaxo, Sean Tracey from Houston, brought in the world-famous neuropsychopharmocology expert from Wales, Dr David Healy, to testify extensively about rat pup study 295.

In summary, Healy told the jury that all the rat pups born to mothers who received Paxil were dead four days after they were born, while eighty-eight percent of the pups not exposed to Paxil were still alive on day four.

In fact, of the 415 rat pups born to mothers who received Paxil, Healy testified that, “One in every ten or actually maybe more like possibly one in every eight or so were born dead.”

As far as he could make make out, all the rats were not autopsied, Healy said, so the question was why the pups died.

“It's clearly the drug that has caused the death,” he told the jury.

“One of the possible reasons for their death is they're born with birth defects that lead to them actually dying early in infant life,” he testified. “A responsible approach to data like this is to investigate it further and find out just what the cause is.”

Doctor Suzanne Parisian, a former FDA scientist, also served as an expert for the plaintiffs. She testified that the first safety signals that indicated Paxil could cause birth defects were seen in the animal studies conducted in 1979-1981 period, as well.

Parisian said the studies showed birth defects, embryos that died, and rat pups that did not survive.

Adam Peavy, of the Houston firm of Bailey, Perrin and Bailey, handled her testimony. While testifying, Peavy had Parisian review comments in a memo by a Doctor John Baldwin to Glaxo in 1980, discussing the Ferrosan studies, which stated: “There remains the possibility that this compound could be teratogenic at high-dose levels.”

“We need to ascertain whether Ferrosan have conducted or are conducting or intend to conduct a peri- and postnatal study and a neonatal acute toxicity study,” Baldwin wrote.

Based on her review the documents, Parisian told the jury, Glaxo never ascertained whether Ferrosan did the studies and Glaxo never conducted the studies.

As far as she knew, the company never told the FDA about Baldwin's statements either, she said, but “they should have.” (...)

Antidepressants May Impact Infant Development (Antidepressiva kan ha følger for spedbarns utvikling)
lawyersandsettlements.com 28.2.2010
Denmark: A new study suggests that babies who are exposed to antidepressants prior to birth are slower to reach certain developmental milestones. The study will likely add to the growing controversy about whether or not SSRI antidepressants are safe for pregnant women to use. (...)

SSRI Birth Defects Class Action Lawsuit
lawyersandsettlements.com 28.2.2010
SSRI side effects can cause many serious problems for infants, newborns and children. Some studies have linked the use of SSRIs (selective serotonin reuptake inhibitors) while pregnant with birth defects. SSRI birth defects include persistent pulmonary hypertension of the newborn (PPHN—previously called primary pulmonary hypertension of the newborn) and other lung and heart problems that could qualify for class action lawsuit damages. (...)

Mom's Antidepressant Use May Delay Baby's Development
depression.about.com 26.2.2010
If a mother takes an antidepressant during pregnancy, her child may experience delays in certain aspect of his development, according to Dr. Lars Henning Pederson and his research team at Aarhus University Hospital in Denmark.

Pederson's team identified 400 women who had taken antidepressants during pregnancy, as well as 500 women who were depressed but took no medication. Based upon the women's own reports, they then compared how many children hit specific developmental milestones - such as sitting up, following the direction of sounds with their eyes, expressing irritation and walking. (...)

Antidepressants May Slow Fetal Development (Antidepressants kan forsinke fosterutvikling)
medpagetoday.com 22.2.2010
Exposure to antidepressants in the womb was associated with slightly delayed developmental milestones in the first 19 months of life, particularly for boys, researchers found.

At age 6 months, babies who were exposed to antidepressants in utero were twice as likely to be unable to sit without support as those whose mothers had untreated depression during pregnancy (OR 2.1, 95% CI 1.23 to 3.60), according to Lars Henning Pedersen, MD, PhD, of Aarhus University in Denmark, and colleagues.

And at 19 months, although gross motor function was similar in the two groups, exposed children were twice as likely to be unable to occupy themselves for longer than 15 minutes, a measure of attention (OR 2.1, 95% CI 1.09 to 4.02), the researchers reported in the March issue of Pediatrics. (...)

(Anm: Fetal Exposure to Antidepressants and Normal Milestone Development at 6 and 19 Months of Age. PEDIATRICS (Published online February 22, 2010).)

Drugs for depression, anxiety tied to preterm birth (Legemidler mot depresjon knyttet til for tidlig fødsel)
reuters.com 21.1.2010
NEW YORK (Reuters Health) - Pregnant women who take certain drugs for depression or anxiety may have heightened risks of preterm delivery or other birth complications, according to a new study.

Researchers found that among nearly 3,000 women who gave birth in Washington State, those who started taking antidepressants known as selective serotonin reuptake inhibitors (SSRIs) in the second or third trimester had a higher risk of preterm birth.

Compared with their counterparts not on the medications, these women were nearly five times more likely to deliver prematurely.

The same risk was not seen, however, among women who started on an SSRI before pregnancy or during the first trimester. SSRIs include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac). (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

SSRI og graviditet
relis.no 15.01.2010 (RELIS – regionale legemiddelinformasjonssentre)
(...) Vedvarende pulmonal hypertensjon
Maternal bruk av SSRI under svangerskapet er assosiert med vedvarende pulmonal hypertensjon hos den nyfødte (PPHN, persistent pulmonary hypertension of the newborn). PPHN er i utgangspunktet en sjelden, men potensielt fatal tilstand som forekommer hos 1-2 spedbarn per 1000 levende fødte. En kasus-kontrollstudie fra 2006 fant 6,1 ganger økt risiko for PPHN hos nyfødte ved bruk av SSRI etter svangerskapsuke 20 (16). I en annen studie fant man 2,4 ganger økt risiko for PPHN ved bruk av SSRI i tidlig graviditet, og 3,6 ganger økt risiko når SSRI også var brukt i senere del av graviditeten (17). Et par nyere studier har ikke påvist økt risiko for PPHN ved bruk av SSRI (18,19), men fordi PPHN i utgangspunktet er en sjelden tilstand er det nødvendig med store datamaterialer for å kunne påvise en eventuell risikoøkning (7). Flere studier er nødvendig for å kunne fastslå hvor stor den reelle risikoøkningen er, men selv om det skulle dreie seg om en 6-doblet risiko vil den absolutte risikoen for PPHN maksimalt være 6-12 tilfeller per 1000 nyfødte (2). PPHN har en dødelighet på 10-20 %, men enkelte kilder angir at dødeligheten muligens kan reduseres dersom fødselen foregår på et sykehus med barnelegeberedskap (20). RELIS kjenner ikke til at slik risikoreduksjon er dokumentert. (...)

Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data.
Psychol Med. 2010 Jan 5:1-11. [Epub ahead of print]
(...) CONCLUSIONS: Women using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

(Anm: teratogen; som skaper misfoster, som er årsak til lyte hos foster; særleg brukt om visse kjemiske stoff eller medikament. EN teratogenic. ET [gr teras misfoster + gennan skapa]. Kilde: Norsk medisinsk ordbok.)

GlaxoSmithKline Reportedly Paid $1 Billion for Paxil Lawsuits (GlaxoSmithKline har angivelig betalt én milliard dollar for Seroxat-søksmål)
lawyersandsettlements.com 14.12.2009
Philadelphia, PA: According to reports, Paxil-maker GlaxoSmithKline may have paid almost $1 billion to settle Paxil lawsuits alleging serious side effects, including birth defects, addiction and suicides or attempted suicides. (...)

With 600 birth defects lawsuits still waiting in the wings, a $2.5 million settlement for each lawsuit could leave GlaxoSmithKline on the hook for $1.5 billion in birth defect lawsuits alone.

According to Bloomberg, approximately 150 suicide-related lawsuits were settled for an average of $2 million and 300 suicide attempt cases were settled for an average of $300,000. Meanwhile, 10 birth defect lawsuits were settled for an average of $4 million. (...)

GlaxoSmithKline Reportedly Paid $1 Billion for Paxil Lawsuits (GlaxoSmithKline har angivelig betalt én milliard dollar for Seroxat-søksmål)
lawyersandsettlements.com 14.12.2009
Philadelphia, PA: According to reports, Paxil-maker GlaxoSmithKline may have paid almost $1 billion to settle Paxil lawsuits alleging serious side effects, including birth defects, addiction and suicides or attempted suicides. (...)

With 600 birth defects lawsuits still waiting in the wings, a $2.5 million settlement for each lawsuit could leave GlaxoSmithKline on the hook for $1.5 billion in birth defect lawsuits alone.

According to Bloomberg, approximately 150 suicide-related lawsuits were settled for an average of $2 million and 300 suicide attempt cases were settled for an average of $300,000. Meanwhile, 10 birth defect lawsuits were settled for an average of $4 million. (...)

Lykkepille kan skade fosteret
forskning 23.10.2009
Når deprimerte gravide tar antidepressiva, går det utover de ufødte barna. Det viser en nylig offentliggjort dansk undersøkelse. (...)

Men det som er mer interessant er at gravide på antidepressiva fødte 3,8 dager tidligere enn kvinner med psykiske sykdommer som ikke tok lykkepiller.

Samtidig hadde nyfødte barn med mødre som tok lykkepiller, vesentlig større risiko for å få et for lavt resultat i den såkalte Apgar-testen, som brukes til å bedømme barnas helse.

I tillegg var disse barna også i større fare for å ende på kuvøseavdelingen, som er beregnet til å hjelpe spedbarn som er syke eller for tidlig fødte. (...)

SSRIs and congenital defects (SSRIer og medfødte defekter)
Letters
BMJ 2009;339:b4292 (21 October)
Kvinner bør gi informert samtykke før oppstart med SSRIer (Women should give informed consent before starting SSRIs)
(...) One of the best signals of teratogenicity is an increased rate of spontaneous abortions and a key reason for induced abortion is congenital malformations.1 Data on SSRIs in 1998 showed that the rate of abortion (spontaneous and induced) was nearly twice as high in those who had taken SSRIs in the first trimester of pregnancy (1.7, 1.1 to 2.9). (...)

(Anm: Openness and honesty in gaining fully informed consent will benefit both patients and doctors BMJ 2015;350:h1784 (Published 07 April 2015).)

GlaxoSmithKline Buried Paxil Birth Defect Reports, Jury told
dallasfortworthinjurylawyer.com 18.10.2009
In the first Paxil birth defect case to go to trial, jurors heard testimony late last month that manufacturer GlaxoSmithKline (GSK) was aware of reports of birth defects from mothers who took the antidepressant while pregnant but withheld the information from the FDA and consumers. (Kilker v. SmithKline Beecham Corp., No. 070201813 (Pa., Philadelphia Co. Com. Pleas filed Feb. 20, 2007).). (...)

GSK to Pay $2.5 Million to Family in Birth Defects Lawsuit (GSK betaler 2,5 millioner dollar til familie for Seroxat-fødselsdefekter)
lawyersandsettlements.com 13.10.2009
(...) Interne GSK-e-poster indikerer at de visste (Internal GSK Emails Suggest They Knew)

Under rettssaken ba dommeren GSK om å overlevere e-poster skrevet av GSK-ledere, og en slik e-post, et notat skrevet av Bonnie Rossello i 1997, som var spesielt belastende, inneholdt uttalelsen, "Dersom negative, resultater kan begraves." Rosello refererte til hva den farmasøytiske giganten burde gjøre dersom det ble nødvendig å utføre dyrestudier på Seroxat (Paxil), kjent som paroxetine (paroksetin). Ifølge resultater utført av danske utviklere av den kjemiske forbindelsen, tok lave doser av paroxetine livet av unge rotter. (During the court case the judge ordered GSK to hand over emails written by GSK executives, and one such email, written by Bonnie Rossello in a 1997 memo, was particularly incriminating, including the statement, "If neg, results can bury." Rosello was referring to what action the pharmaceutical giant should take if it became necessary to do animal studies with Paxil, known generically as paroxetine. According to results of a study done by the Danish developers of the compound, low-dose paroxetine killed young rats.)

Under rettssaken, fortalte Tracey jurymedlemmene at Food and Drug Administration (FDA) ikke ba om ytterligere sikkerhetsstudier for selektive serotoninreopptakshemmere (SSRIer) - den klasse antidepressiva som Seroxat tilhører - før i 2003. På dette tidspunkt erkjente angivelig GSK at Seroxat var assosiert med en økt risiko for fødselsdefekter. (...) (During the trial, Tracey reportedly told jurors that the Food and Drug Administration (FDA) did not order additional safety studies on selective serotonin reuptake inhibitors (SSRIs)- the class of antidepressants to which Paxil belongs - until 2003. At that point, GSK allegedly acknowledged there was an increased risk of birth defects associated with Paxil.)

Glaxo Ordered to Pay $2.5 Million for Paxil Defects (Update3)
(Glaxo dømt til å betale 2,5 millioner dollar for Seroxat-fødselsskader)
Bloomberg.com 13.10.2009
Oct. 13 (Bloomberg) -- GlaxoSmithKline Plc must pay $2.5 million over claims that its Paxil antidepressant caused birth defects, a Pennsylvania jury concluded in the first of 600 such cases to come to trial. (...)

Glaxo must pay $2.5M in Paxil case (Glaxo må betale 2,5 millioner dollar i Seroxat-sak)
philly.com 13.10.2009
GlaxoSmithKline P.L.C. must pay $2.5 million to settle a claim that its Paxil antidepressant caused severe heart defects in a 3-year-old Bensalem boy, a Philadelphia common pleas jury ruled today.

The verdict is the first in 600 cases alleging that London-based Glaxo knew Paxil caused birth defects and hid those risks to boost profits.

The drug, approved for U.S. use in 1992, generated about $942 million in sales last year, 2.1 percent of Glaxo's total revenue. (...)

Antidepressiv medicin skader barnet i maven
videnskab.dk 6.10.2009
Når deprimerede gravide tager antidepressiver, går det ud over deres ufødte børn, viser en netop offentliggjort dansk undersøgelse. (...)

Men nu viser dansk forskning, at hvis moren tager antidepressiv medicin, kan det gå ud over hendes endnu ufødte barn. Undersøgelsen offentliggøres i dag i oktoberudgaven af det månedlige tidsskrift Archives of Pediatrics & Adolescent Medicine.

Publikationens hovedforfatter er læge Najaaraq Lund fra Aarhus Universitet, som i øjeblikket er i gang med et ph.d.-projekt i det vestafrikanske land Guinea-Bissau.

»Vores resultater viser, at der er en effekt på fosteret. Graviditeten bliver i gennemsnittet kortere, og barnet ser ud til at være påvirket,« fortæller Najaaraq Lund til Videnskab.dk fra Guinea-Bissau. (...)

Hun har systematiseret data fra Skejby Sygehus, der strækker sig fra 1989 til 2006. Det viste sig, at gravide kvinder på SSRI-præparater fødte i gennemsnittet 4,5 dage tidligere end gravide kvinder, der ikke har haft psykiske sygdomme.

Men hvad der er mere interessant, fødte gravide på den antidepressive medicin 3,8 dage tidligere, end kvinder med psykiske sygdomme, som ikke tog lykkepiller. (...)

(Anm: Selective Serotonin Reuptake Inhibitor Exposure In Utero and Pregnancy Outcomes. Arch Pediatr Adolesc Med. 2009;163(10):949-954. (October).)

Depression Is a Dilemma for Women in Pregnancy (Depresjon i svangerskapet er et dilemma for kvinner)
nytimes.com 5.10.2009
(...) Recently, a Danish study in the British medical journal BMJ reported a link between pregnant women’s use of several antidepressants in the S.S.R.I. class, including Celexa and Zoloft, and an increased risk for a common heart defect in babies.

And a paper that appears Tuesday in The Archives of Pediatrics & Adolescent Medicine reports that babies born to mothers who use S.S.R.I. drugs were more likely to have low scores on the five-minute Apgar test, an overall measure of newborn health, and to be admitted to the neonatal intensive care unit. (...)

Glaxo Linked Birth Defect of Fetus to Paxil, Ex-Executive Says (Ifølge tidligere leder linket Glaxo Seroxat til fødselsdefekter hos foster)
bloomberg.com 18.9.2009
Sept. 18 (Bloomberg) -- Officials of GlaxoSmithKline Plc, the U.K.’s largest drugmaker, said in 2001 that a birth defect in the fetus of a woman taking its Paxil antidepressant likely was linked to the drug, according to court testimony.

After analyzing a 2001 e-mail from a Paxil user who aborted her fetus because it had a heart defect, Glaxo officials noted in company files they were “almost certain” the drug was related to the problem, Jane Nieman, a former Glaxo drug-safety executive, told a Pennsylvania jury. (...)

(Anm: Antidepressiva kan skade menns fruktbarhet (DNA), ifølge studie (reuters.com 24.9.2008).)

Trial opens here in Paxil lawsuit
philly.com 15.9.2009
GlaxoSmithKline P.L.C. for years ignored evidence that its antidepressant Paxil may have caused birth defects, a lawyer told a Philadelphia jury today on behalf of a woman who says that taking the drug during her pregnancy caused her three year-old son's heart problems. (...)

The trial is the first of more than 600 cases alleging that Glaxo knew Paxil caused birth defects and hid those risks to pump up profits. Approved for U.S. use in 1992, the drug generated about $942 million in sales last year, 2.1 percent of Glaxo's total sales. (...)

In the late 1980s, at about the same time as the rat study, an internal Glaxo scientist warned that "there remains the possibility that this compound could be teratogenic at higher dose levels." A teratogenic agent is one that can cause birth defects. Tracey said Glaxo had ignored links between Paxil and birth defects for 20 years. (...)

IMB advises against 'Seroxat' in pregnancy (IMB advarer mot Seroxat i svangerskapet)
irishtimes.com 18.8.2009
THE IRISH Medicines Board (IMB) has advised women who want to become pregnant and are taking the antidepressant Seroxat to discuss the risks and benefits of continued treatment beforehand with their doctor.

It has also advised that pregnant women who are taking the antidepressant should not stop their treatment without seeking advice from their doctors.
Some studies have found an increased risk of birth defects, particularly heart defects, associated with the use of Seroxat during the first three months of pregnancy. These findings are not new, but last week Irish psychiatrist Prof David Healy, who is based in Wales, said he believed many GPs still prescribed Seroxat to women without adequately informing them of the risks. (...)

A number of legal actions will soon begin in the US over the antidepressant. Lawyers representing women suing GlaxoSmithKline claim the manufacturer knew, or should have known, about the birth defects more than 10 years ago because of research findings. (...)

Effect of exposure to selective serotonin reuptake inhibitors in utero on fetal growth: potential role for the IGF-I and HPA axes. (Effekt av selektive serotoninreopptakshemmere (SSRI) i livmor på fostervekst; mulig rolle for IGF-I og HPA axes)
Pediatr Res. 2009 Feb;65(2):236-41.
To investigate the possible effect of fetal exposure to selective serotonin reuptake inhibitors (SSRIs) on somatic growth and on hormones of the hypothalamic-pituitary-adrenal (HPA) and insulin-like growth factor (IGF)-I axes, we compared the anthropometric parameters and hormonal profile of 21 SSRI-exposed infants and 20 matched controls. The SSRI group was characterized by lower crown-heel length (p < 0.01), smaller head circumference (p = 0.08), and higher percentage of infants with birth weight, birth length, and head circumference below the 10th percentile (p < 0.045, p = 0.08, p < 0.04, respectively), in addition to a significantly lower cord blood level of cortisol (p < 0.03) and higher level of thyroid-stimulating hormone (TSH) (p < 0.004). Infants exposed to citalopram had a lower cord blood IGF-I level than infants exposed to paroxetine (p < 0.001) and controls (p < 0.003). Placental IGF-I receptor (IGF-IR) expression was significantly higher in the SSRI group than in controls (p < 0.01). Urine 5-hydroxyindoleacetic acid (5-HIAA) level was negatively correlated with birth weight (r = -0.71, p < 0.025) and with dehydroepiandrosterone (DHEA) level (r = -0.71, p < 0.025). The Finnegan score was correlated with dehydroepiandrosterone sulfate (DHEAS) (r = 0.8, p < 0.005) and cortisol (r = 0.62, p = 0.05). Fetal exposure to SSRIs causes impaired intrauterine growth accompanied by alterations in the IGF-I and HPA axes. The findings may raise concern regarding maternal use of SSRIs during pregnancy. (...)

(Anm: IGF-I; Insulin-like growth factor 1; Almost every cell in the human body is affected by IGF-1, especially cells in muscle, cartilage, bone, liver, kidney, nerves, skin, and lungs. In addition to the insulin-like effects, IGF-1 can also regulate cell growth and development, especially in nerve cells, as well as cellular DNA synthesis. (wikipedia.org).)

(Anm: HPA axes; The hypothalamic-pituitary-adrenal axis (HPA or HTPA axis), also known as the limbic-hypothalamic-pituitary-adrenal axis (LHPA axis), is a complex set of direct influences and feedback interactions among the hypothalamus (a hollow, funnel-shaped part of the brain), the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal (or suprarenal) glands (small, conical organs on top of the kidneys). The interactions among these organs constitute the HPA axis, a major part of the neuroendocrine system that controls reactions to stress and regulates many body processes, including digestion, the immune system, mood and emotions, sexuality, and energy storage and expenditure. A wide variety of species, from the most ancient organisms to humans, share components of the HPA axis. It is the common mechanism for interactions among glands, hormones, and parts of the midbrain that mediate the general adaptation syndrome (GAS). (wikipedia.org).)

Selective Serotonin Reuptake Inhibitor Use and Risk of Gestational Hypertension (Bruk av selektive serotoninreopptakshemmere (SSRI) og risiko for svangerskapshypertensjon)
Am J Psychiatry 2009; 166:320-328
(...) RESULTS: Gestational hypertension was present in 9.0% of the 5,532 women who were not treated with SSRIs and 19.1% of the 199 women who were treated with SSRIs. Among women who received treatment, gestational hypertension was present in 13.1% of the 107 women who received treatment only during the first trimester and in 26.1% of the 92 women who continued treatment beyond the first trimester. The occurrence of preeclampsia was 2.4% among women who were not treated with SSRIs, 3.7% among women who were exposed to SSRIs only during the first trimester, and 15.2% among women who continued SSRI treatment beyond the first trimester. Relative to women who did not receive treatment, the adjusted relative risk of preeclampsia was 1.4 for women who discontinued treatment and 4.9 for women who continued treatment. (...)

Paxil Birth Defects: "I Wish I Hadn't Taken It" (Seroxat-fødselsdefekter; "Jeg ønsker at jeg ikke hadde tatt det")
lawyersandsettlements.com 24.2.2009
Ft Worth, TX: Kathryn's baby girl was born with a hole in her heart, a defect possibly due to her baby's exposure to the selective serotonin reuptake inhibitor (SSRI) antidepressant Paxil during pregnancy. Now, many years later, Kathryn feels guilty and frustrated because her daughter has many long-term health problems. (...)

Gravide bør unngå lykkepiller
dinside.no 26.11.2008
Kan skade barnets hjerte. (...)

Det er en gruppe leger og forskere fra Israel, Italia og Tyskland som står bak undersøkelsen, der de fulgte 2.191 kvinner gjennom svangerskapet. Av disse hadde 410 tatt Paroxetin, 314 hadde tatt Fluoxetin, mens 1.467 ikke hadde tatt noen av legemidlene, og derfor fungerte som kontrollgruppe. (...)

Resultatene viste at risikoen for å føde barn med hjerteproblemer var 2,8 prosent i Fluoxetin-gruppen, 2 prosent i Paroxetin-gruppen og 0,6 prosent blant kvinnene som ikke brukte antidepressive midler i løpet av svangerskapet. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Strong Link Found Between Two Antidepressants and Infant Heart Problems (Sterk link funnet mellom to antidepressiva og spedbarns hjerteproblemer)
depression.about.com 25.11.2008
Women who took the antidepressants Prozac (fluoxetine) or Paxil (paroxetine) in their first trimester were significantly more likely to give birth to babies with heart problems than women who did not take them, according to a new study published in the November issue of the British Journal of Clinical Pharmacology. (...)

(Anm: British Journal of Clinical Pharmacology. Paroxetine and fluoxetine in pregnancy: a prospective, multicentre, controlled, observational study 2008;66: 695-705.)

SSRI Birth Defects: This Experience will go on for a Lifetime (SSRI-fødselsdefekter: Dette eksperiment er livsvarig)
lawyersandsettlements.com 24.11.2008
Oak Harbour, WA: Sara was prescribed Symbyax, which contains the SSRI Prozac, in her third trimester of pregnancy because her psychiatrist was concerned that she would have issues of post-partum depression. Unfortunately, Sara's son was born with serious birth defects—birth defects that are very possibly SSRI-related. (...)

[READ MORE SSRI ARTICLES] (...)

Women Not Warned About SSRI-Related Lung Birth Defect (Kvinner advares ikke om SSRI-relaterte fødselsdefekter på lunger)
opednews.com 2.10.2007
A study of nearly 500,000 women by researchers at the University of Pittsburgh Medical Center, in the September 18, 2007, Annals of Internal Medicine, found that nearly 50% of women taking a prescription drug that could cause birth defects did not receive warnings to avoid pregnancy. The authors note that the pregnancy risks of a drug should be discussed with women before they begin taking it. (...)

Risiko for misdannelser ved bruk av antidepressiva i svangerskapet

Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study (Selektive serotoninreopptakshemmere i svangerskap og medfødte misdannelser: befolkningsbasert kohortstudie)
BMJ 2009;339:b3569 (23 September)
(...) Konklusjon Der er en økt forekomst av defekter i hjerteskillevegger hos barn av mødre forskrevet SSRI tidlig i svangerskapet, spesielt sertraline og citalopram. Den sterkeste forbindelsen ble påvist hos barn av kvinner som innløste forskrivninger på mer enn én type SSRI. (...) (Conclusion There is an increased prevalence of septal heart defects among children whose mothers were prescribed an SSRI in early pregnancy, particularly sertraline and citalopram. The largest association was found for children of women who redeemed prescriptions for more than one type of SSRI.)

Selective serotonin reuptake inhibitors and congenital malformations
Editorials
BMJ 2009;339:b3525 (23 September)
(...) In the linked population based cohort study from Denmark (doi:10.1136/bmj.b3569), Pedersen and colleagues confirm a previously reported doubling of risk for septal heart defects after early exposure in pregnancy to SSRIs (odds ratio 1.99, 95% confidence interval 1.12 to 3.53).4 (...)

Lack of consistency across these studies with respect to specific malformations and specific drugs makes it difficult to translate the findings into clinical practice. (...)

One explanation for this inconsistency, assuming that SSRIs do cause specific birth defects, is differences in study designs. For example, although Pedersen and colleagues linked records for 496 881 singleton live born infants, they identified only 1370 mothers who redeemed multiple prescriptions for an SSRI in the perinatal period. Therefore, the study may have been insufficiently powered to detect the previously suggested twofold to threefold increased risk for anencephaly, omphalocele, craniosynostosis, or right ventricular outflow tract defects, all of which occur at least an order of magnitude less frequently than septal defects. (...)

SSRI babies need monitoring (SSRI-spedbarn trenger overvåking)
6minutes.com.au 13.8.2009
Newborns exposed to antidepressants in late pregnancy are at risk of discontinuation symptoms and are more likely to suffer from jaundice, a Victorian study finds.

In more than 50 pregnant women who took part in a prospective study, newborns exposed to SSRI antidepressants showed more symptoms including reflux, poor sleeping and feeding, crying, sneezing and tremor than those who were not exposed.

Neonates that were exposed to antidepressants were also more likely to be admitted to special care nurseries, reflecting difficulties in diagnosing antidepressant discontinuation syndrome, the report authors say in the Australian and New Zealand Journal of Psychiatry (43:846-54)
.
“Symptoms such as tremor, irritability and jitteriness may be easily confused with convulsions, which may result in misdiagnosis and significant associated morbidity for the infant,” they say. “This suggests the need to clarify diagnostic criteria for the neonatal to improve identification and management.”

(Anm: Serotonin discontinuation syndrome following in utero exposure to antidepressant medication: prospective controlled study. Australian and New Zealand Journal of Psychiatry 2009;43(9):846–854) (August).)

More pregnant women on anti-depressants
marieclaire.co.uk 17.2.2009 marieclaire.co.uk
The number of women taking anti-depressants has dramatically risen over the last 15 years, a study suggests.

Researchers at University College London found that the proportion of pregnancies in which anti-depressants were prescribed increased four-fold between 1992 and 2006, from 0.8% to 3.3%. (...)

Paxil Birth Defects – What are the Odds? (Seroxatrelaterte fødselsdefekter - Hva er oddsen?)
lawyersandsettlements.com 30.12.2008
Elkton, VA: While birth defects related to antidepressant use during pregnancy may be just a second hand bad news story for many people, they are all too real for hundreds, if not thousands of women across the US who know firsthand about the implications of selective serotonin uptake receptors or SSRI birth defects. (...)

Is it OK to take antidepressants while pregnant? (Er det OK å ta antidepressiva under svangerskap?)
cnn.com 6.1.2009
Is it OK to take antidepressants while pregnant? (...)

Paxil and Zoloft "Hurting Babies" (Seroxat og Zoloft "Skader babyer)
lawyersandsettlements.com 18.10.2008
Chicago, IL: Women who take SSRIs such as Paxil or Zoloft when pregnant try to deal with the devastating aftermath, but they often find their lives are forever changed. They have children born with birth defects or other serious health problems. Some have children who do not survive past a few weeks. Many say they believe if they had not taken Paxil, Zoloft or other SSRIs, their children would have been fine. (...)

In-Utero SSRI Exposure Related to Prolonged QTc Interval
Psychiatr News 2008;43(20):22 (October 17) (American Psychiatric Association)
Certain antidepressants taken by pregnant women at the start of labor can pass through the placental barrier and lead to prolonged QT intervals in their newborns.

Newborns who have been exposed to selective serotonin-reuptake inhibitors (SSRIs) in the womb may be at risk for irregular heart rate, according to an observational study published in the September Pediatrics.

Between 2000 and 2005, 52 newborns whose mothers took SSRIs at the onset of labor had a significantly longer QTc interval (QT interval standardized by adjusting for heart rate) than 52 healthy controls with matched gestational health born to mothers not taking any medication just before delivery.

The QTc interval in the newborns of mothers who took SSRIs was 409 ± 42 milliseconds, mean ± standard deviation; in the control infants whose mothers did not take an SSRI, the interval was 392 ± 29 milliseconds. A QTc interval of greater than 460 milliseconds was defined as pathologically prolonged. (...)

(Anm: Antenatal Use of Selective Serotonin-Reuptake Inhibitors and QT Interval Prolongation in Newborns. PEDIATRICS 2008;122(3):e710-e715 (September 2008).)

Not Enough Research on SSRIs and Pregnancy (Ikke nok forskning på SSRI og graviditet)
lawyersandsettlements.com 15.10.2008
San Antonio, TX: Kerri T. wants women to know that antidepressants and pregnancy don't mix. Kerri says that she was never told about the link between SSRIs and birth defects and she believes her daughter's health problems are the result of exposure to an SSRI antidepressant.

"During my whole pregnancy, I took 300 mgs of Effexor XR," Kerri says. "My psychiatrist never told me about any of the warnings and I never saw any of the sample packets where it said that if the baby was exposed to Effexor in the third trimester there could be problems and longer hospital stays. (...)

[READ MORE SSRI BIRTH DEFECTS ARTICLES] (...)

No Link Between Antidepressants And Birth Defects
medicalnewstoday.com 23.5.2008
Expectant mothers can safely use prescribed antidepressants during their first trimester, according to a new study from the Université de Montréal and Ste. Justine Hospital published in the May edition of the British Journal of Psychiatry. (...)

(Anm: first trimester; første tredjedel av svangerskapet.)

Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: population-based study
Br J Psychiatry. 2008 May;192:338-43.
BACKGROUND: Late-gestational serotonin reuptake inhibitor (SRI) exposure has been linked to adverse neonatal outcomes; however, the impact of timing and duration of exposure is unknown. AIMS: To determine whether late-gestational exposure to an SRI is associated with increased risk of adverse neonatal outcome relative to early exposure. METHOD: Population-based maternal and neonatal health records were linked to prenatal maternal prescription records for an SRI medication (n=3500). RESULTS: After controlling for maternal illness and duration of exposure, using propensity score matching, neonatal outcomes did not differ between late and early exposure (P>0.05). After controlling for maternal illness, longer prenatal exposure increased the risks of lower birth weight, respiratory distress and reduced gestational age (P<0.05). CONCLUSIONS: Using population health data, length of gestational SRI exposure, rather than timing, increased the risk for neonatal respiratory distress, lower birth weight and reduced gestational age, even when controlling for maternal illness and medication dose. These findings highlight the importance of distinguishing the specific impact of medication exposure from exposure to maternal illness itself. (...)

(Anm: Barn med lav fødselsvekt mer psykisk syke - Angstlidelser og ADHD vanligst. (dagbladet.no 20.12.2010).)

Evaluation of the Risk of Congenital Cardiovascular Defects Associated With Use of Paroxetine During Pregnancy
Am J Psychiatry Published April 1, 2008 doi: 10.1176/appi.ajp.2008.07040574
OBJECTIVE: In 2005–2006, several studies noted an increased risk of cardiovascular birth defects associated with maternal use of paroxetine compared with other antidepressants in the same class. In this study, the authors sought to determine whether paroxetine was associated with an increased risk of cardiovascular defects in infants of women exposed to the drug during the first trimester of pregnancy. (...)

(...) The authors also contacted the authors of published database studies on antidepressants as a class to determine how many of the women in those studies had been exposed to paroxetine and the rates of cardiovascular defects in their infants. (...)

CONCLUSIONS: Paroxetine does not appear to be associated with an increased risk of cardiovascular defects following use in early pregnancy, as the incidence in more than 3,000 infants was well within the population incidence of approximately 1%. (...)

Medikamentel behandling af depression under graviditet eller amning
Statusartikel
Ugeskr Læger 2007;169(16):1442
(...) Nyere antidepressiva
Indtil omkring 2004 har behandling med selektive serotoningenoptagelseshæmmere (SSRI)-præparater (med undtagelse af escitalopram og fluvoxamin hvor data er meget begrænsede) under graviditeten været anset for ret sikker og ikke forbundet med uønsket udfald af svangerskabet. I de seneste to år er der publiceret flere studier med signaler, som dels har medført en del faglig kontrovers, og dels har kompliceret anvendelsen af SSRI-medikamenter under graviditeten.

Paroxetin må i lyset af anden tilgængelig og terapeutisk ligeværdig behandling anses for at være kontraindiceret under graviditeten. I to uafhængige opgørelser har man påvist, at første trimester-eksponering for paroxetin er forbundet med en lille, men ret sikker øget risiko for kardiale misdannelser [2]. Den absolutte risiko synes at være øget fra omkring 1% til 2%. En tilsvarende risiko er ikke observeret for andre SSRI-medikamenter. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Antidepressants: Are they safe during pregnancy?
mayoclinic.com 18.12.2007
Taking antidepressants during pregnancy may pose risks for your baby — but stopping may pose risks for you. Get the answers to important questions about antidepressants and pregnancy. (...)

SSRIs and Newborns
lawyersandsettlements.com 12.12.2007
Toronto, ON: When mothers took SSRIs during pregnancy, "The babies couldn't be consoled, they didn't sleep well, cried a lot, were difficult to feed and had tremors," explains Dr. Gideon Koren, Director and Professor of Motherisk, a program at The Hospital for Sick Children in Toronto dedicated to antenatal drug, chemical, and disease risk counselling. Some SSRIs have also been linked to birth defects.

Dr. Koren says this large clinic he founded in 1985 was the first to expose the effects of antidepressants on newborns. One of the key findings in their 2002 study published in the Archives of Pediatrics & Adolescents Medicine pointed out that babies born to women who took SSRI antidepressants showed withdrawal symptoms similar to an adult stopping medication cold turkey. (...)

(Anm: Babies with drug withdrawal syndrome more likely to be readmitted (medicalnewstoday.com 1.10.2015).)

Use of Antidepressants in Pregnancy Affects Neonatal Outcomes: Presented at AACAP (Bruk av antidepressiva påvirker nyfødte barn: Presentert hos AACAP)
docguide.com 29.10.2007
BOSTON, MA -- October 29, 2007 -- Babies born to mothers who take antidepressant medication during pregnancy have high levels of cortisol in cord-blood at birth, and their mothers are more likely to experience delivery complications, according to a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP). (...)

The Neonatal Intensive Care Network Neurobehavioural Scale (NNNS) was utilised to provide a comprehensive examination of the normal and the at-risk neonates. A higher score on each scale means a higher level of the construct. NNNS scores for tremulousness were 3.5 for the babies in the high-risk + medication subjects and 2.25 for babies born to both groups of nonmedicated subjects (P <.05).

Levels of adrenocorticotropic hormone in the cord blood were found to be 325 pg/mL in high-risk patients taking medication compared with 225 pg/mL in the nonmedicated group and 125 pg/mL in the low-risk group. (...)

The major limitation of the study, Dr. Marcus noted, is the fact that high-risk/depressed women using medication had greater symptom severity than those not using medication, so the affect of symptom severity on these results requires further examination.

This research is supported by grants from the National Institute of Mental Health. (...)

Gir antidepressiver økt risiko for misdannelser?
Geir Jacobsen
Tidsskr Nor Lægeforen 2007; 127: 2497 (4.10.2007)
Det er fortsatt uklart om bruk av antidepressive legemidler blant gravide gir økt risiko for misdannelser. Det viser to nye studier i New England Journal of Medicine.

To nye studier har ikke kunnet fastslå om bruk av selektive serotoninreopptakshemmere (SSRI) i første trimester av svangerskapet eller senere er forbundet med misdannelser i sentralnervesystemet, hjertet eller mage-tarm-kanalen (1, 2). Enkeltmedikamenter kan være knyttet til spesielle misdannelser, men det dreier seg om sjeldne tilstander og usikre konklusjoner.

- Depresjon forekommer blant 10 - 20 % av gravide kvinner, og SSRI-preparater er den vanligste behandlingen i Skandinavia, sier overlege Anne Brantberg ved Nasjonalt senter for fostermedisin i Trondheim. (...)

Risikoen ved bruk må veies mot gevinsten av behandlingen, og i dag er det ikke indikasjon for å avbryte en vellykket behandling i svangerskapet. Det bør understrekes at studiene omfattet risikoen for misdannelser etter bruk av SSRI-preparater i løpet av graviditeten, og at effekten på barnet etter fødselen ikke ble undersøkt, sier Brantberg. (...)

Risks of congenital malformations and perinatal events among infants exposed to antidepressant medications during pregnancy
Pharmacoepidemiol Drug Saf. 2007 Aug 30; [Epub ahead of print]
(...) RESULTS: Infants exposed to SSRIs or TCAs during pregnancy had a significant increase in preterm delivery risk. Fullterm infants exposed to SSRIs during the third trimester had an increased risk for respiratory distress syndrome, endocrine and metabolic disturbances, hypoglycemia, temperature regulation disorders, and convulsions. Third-trimester exposure to TCAs was also associated with an increased risk for respiratory distress syndrome, endocrine and metabolic disturbances, and temperature regulation disorders. There were 182 infants exposed to Paroxetine, and these infants did not have an increased risk of cardiac septal defects.(...)

Both SSRIs and TCAs used during the third trimester appeared to increase the risk for perinatal complications and their use should be managed carefully among pregnant women with depression. (...)

Prenatal Antidepressants Linked to Preterm Births
newsmax.com 17.8.2007
Antidepressant drug use during pregnancy, but not depression itself, is associated with an increased risk of preterm birth and lower fetal age at delivery, according to results of a study published in the American Journal of Psychiatry. (...)

Effects of Antenatal Depression and Antidepressant Treatment on Gestational Age at Birth and Risk of Preterm Birth
Am J Psychiatry 164:1206-1213 (August 2007)
(...) KONKLUSJONER: Bruk av antidepressiva før fødsel var assosiert med kortere svangerskap og økt risiko for at det oppstår for tidlig fødsel. De depressive symptomer, som ble registrert, var ikke assosiert med en slik risiko. Disse resultater tyder på at det er legemidler, snarere enn depresjon, som er indikator for kortere svangerskap. (...) (CONCLUSIONS: Prenatal antidepressant use was associated with lower gestational age at birth and an increased risk of preterm birth. Presence of depressive symptoms was not associated with this risk. These results suggest that medication status, rather than depression, is a predictor of gestational age at birth.)

Paroxetine and congenital malformations: meta-Analysis and consideration of potential confounding factors
Clin Ther. 2007 May;29(5):918-26
BACKGROUND: Antidepressants have been commonly used by women of childbearing age. Recent studies suggest that paroxetine, a selective serotonin reuptake inhibitor (SSRI), might specifically increase teratogenic risk. (...)

CONCLUSIONS: Based on the results of this metaanalysis, first-trimester exposure to paroxetine appears to be associated with a significant increase in the risk for cardiac malformation. However, a detection bias cannot be ruled out as contributing to the apparent increased detection of cardiovascular malformation of children exposed in utero to paroxetine. A significantly greater number of women were using paroxetine for anxiety or panic when compared with women using other SSRIs. (...)

Clinical & Research NewsBirth-Defect Data Show SSRI Risks Are Minimal
Psychiatr News 2007;42(14);1 (July 20) © 2007 American Psychiatric
New research indicates that SSRIs may slightly raise the risk of birth defects when taken during the first trimester of pregnancy. Such risk, however, must be weighed against the risks of no SSRI treatment. (...)

Risk of Heart Defects Found
Louik found that of 127 infants born with omphalacele, three had been exposed to sertraline. She estimated that mothers who took the drug during their first trimester had a 5.7 higher odds of having an infant with omphalacele, but noted that the confidence interval (CI) for this finding ranged from 1.6 to 20.7. (...)

Mothers who took paroxetine during the first trimester of pregnancy had three times higher odds of giving birth to an infant with right ventricular outflow tract obstruction defects [CI: 1.3 to 8.8], a calculation based on six exposed infants. (...)

For instance, compared with nonobese mothers on SSRIs, obese mothers on SSRIs had 3.5 times higher odds of giving birth to an infant with conotruncal heart defects, 2.8 higher odds of giving birth to an infant with septal heart defects, and 5.9 percent higher odds of giving birth to an infant with craniosynostosis. (...)

CDC Leads SSRI Disinformation Media Blitz
lawyersandsettlements.com 20.7.2007
(...) The public needs to know that the CDC study was funded in part by GlaxoSmithKline, the maker of Paxil, which carries the strongest FDA warnings about birth defects developing in infants exposed to the drug in the womb.

Experts point out that the hundreds of headlines failed to disclose the best kept secret about SSRIs - that the drugs do not work. "When tested in head-to-head competition it would take more space than a newspaper article will permit to explain how hard the researchers have to "work" to "prove" that these antidepressants work at all," says SSRI expert, Dr Grace Jackson, author of "Rethinking Psychiatric Drugs: A Guide for Informed Consent." (...)

Most importantly, experts say, the researchers diluted the FDA warning about studies that found babies exposed to SSRIs after the 20th week of pregnancy, have a 6-fold increased risk of developing persistent pulmonary hypertension, a life-threatening lung disorder. (...)

Antidepressants linked to serious birth defects (Antidepressiva linket til alvorlige fødselsdefekter)
foodconsumer.org 29.6.2007
Infants born to women who took antidepressants during the first trimester of their pregnancies are at higher risk of serious birth defects, according to two new studies published in the New England Journal of Medicine. (...)

In one study, Zoloft was associated with six-times higher risk of omphalocele, a problem involving intestines or other abdominal organs. The risk was experienced in 1 out of every 5,000 births, according to government statistics.

Another study linked antidepressants to doubled risk of three congenital problems including anencephaly in which part of skull and brain is missing, craniosynostosis in which skill bones are closed prematurely and intestinal defects. (...)

(Anm: omfalocele; utposing av tarm gjennom ei større glipe i bukveggen hos eit foster, dekt av eit tynt overdrag av bukhinne og fosterhinne (amnion); også kalla exomphalos EN omphalocele ET [gr omphalos navle + kele brokk] Kilde: Norsk medisinsk ordbok.)

(Anm: anencefalus; misfoster utan hjerne; misdanninga har grunnlag i nevralrøyrsdefekt; misfoster med anencefali (anenkefali) EN anencephalus
ET [gr an ikkje + enkefalos hjernen] Kilde: Norsk medisinsk ordbok.)

Some Antidepressants Pose Birth Defect Risks (Enkelte antidepressiva har risiko for fødselsdefekter)
health.usnews.com 27.6.2007
Pregnant women with depression often find themselves choosing between the lesser of two evils. Should they take antidepressants and risk the slight but real possibility of birth defects? Or should they forgo treatment and chance a relapse? (...)

Two new studies published in this week's New England Journal of Medicine could help women make a more informed decision.

One study of nearly 10,000 infants born with birth defects and nearly 6,000 healthy infants found that women who took sertraline (Zoloft) in the first few months of pregnancy had twice the risk of having a baby born with a heart defect, while those on paroxetine (Paxil) had more than three times the risk.

Paxil also increased the risk of a rare hernia called an omphalocele. But this doesn't mean antidepressants are unsafe: The heart defects seen in the study normally occur in 5 out of 10,000 babies, so a doubling of the risk means they occur in 10 in 10,000 and a tripling in 15 in 10,000—thus, a baby's risk is still far less than 1 percent. (...)

(Anm: First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects. N Engl J Med 2007; 356:26775-83.

(Anm: Correction. First-Trimester Use of Selective Serotonin-Reuptake Inhibitors and the Risk of Birth Defects. N Engl J Med 2015; 373:686August 13, 2015.)

Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects. N Engl J Med 2007; 356: 2684-92.

Teratogenicity of SSRIs -- Serious Concern or Much Ado about Little?" N Engl J Med 2007; 356:2732-33.)

Antidepressants Rated Low Risk in Pregnancy
nytimes.com 28.6.2007
Taking an antidepressant like Prozac may increase a pregnant woman’s risk of having a baby with a birth defect, but the chances appear remote and confined to a few rare defects, researchers are reporting today.

The findings, appearing in two studies in The New England Journal of Medicine, support doctors’ assurances that antidepressants are not a major cause of serious physical problems in newborns.

But the studies did not include enough cases to adequately assess risk of many rare defects; nor did they include information on how long women were taking antidepressants or at what doses. The studies did not evaluate behavioral effects either; previous research has found that babies suffer withdrawal effects if they have been exposed to antidepressants in the womb, and that may have implications for later behavior. (...)

The other study, led by Sura Alwan of the University of British Columbia, found that use of antidepressants increased the risk of craniosynostosis, a condition in which the bones in the skull fuse prematurely. Rare gastric and neural tube defects may also be more common in babies exposed to the medications, the studies suggested. (...)

Studies Find No Link Between SSRIs and Congenital Heart Disease
medpagetoday.com 28.6.2007
(...) Explain to interested patients that these studies found a small increase in the absolute risk of some rare birth defects but the overall risk was very small.

Discuss the potential risks and benefits of pharmacological treatment of depression with interested patients. (...)

Carol Louik, Sc.D., of Boston University, and colleagues from the Slone Epidemiology Center Birth Defects Study reported a significant association between sertraline (Zoloft) and omphalocele (odds ratio 5.7; 95% CI, 1.6 to 20.7, three exposed patients). Sertraline was also associated with an increased risk of septal defects (OR 2.0, 95% CI, 1.2-4.0; 13 exposed patients).

Likewise in their study of 9,849 infants with birth defects and 5,860 without birth defects there was a significant association between use of paroxetine (Paxil) and right ventricular flow tract obstruction defects (OR 3.3; 95% CI, 1.3 to 8.8, six exposed patients). (...)

Liten risk för gravid att ta antidepressiva
dn.se 27.6.2007
Antidepressiva läkemedel är i princip ofarliga för gravida kvinnor och deras foster. Det visar de två hittills största studierna på fosterskador och antidepressiva mediciner. (...)

- Det här är lugnande besked för deprimerade kvinnor som är oroliga för att ta sin medicin, säger Olav Spigset, professor i klinisk farmakologi vid St Olavs hospital i Trondheim. Han är författaren till Läkemedelsverkets rekommendationer för behandling av deprimerade gravida kvinnor i Sverige. (...)

Depression är en allvarlig, potentiellt dödlig sjukdom och en deprimerad gravid kvinna behöver behandling. (...)

Studies link antidepressant use to birth defects
latimes.com 27.6.2007
Infants born to women taking commonly prescribed antidepressants during the first trimester of their pregnancies have an increased risk of serious birth defects, though the danger remains tiny, according to two studies published Thursday.

The reports in The New England Journal of Medicine found a higher risk of developmental problems affecting the intestines, brain and skull. Although life-threatening, all the defects are rare and normally occur in no more than one in 2,500 births.

"The take-home message is that we are talking about very small risks," said University of California, San Diego, epidemiologist Christina Chambers, who has studied the effects of antidepressants but wasn't involved in the new research. (...)

Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects
Volume 356:2684-2692 (June 28)
(...) Results There were no significant associations between maternal use of SSRIs overall during early pregnancy and congenital heart defects or most other categories or subcategories of birth defects. Maternal SSRI use was associated with anencephaly (214 infants, 9 exposed; adjusted odds ratio, 2.4; 95% confidence interval [CI], 1.1 to 5.1), craniosynostosis (432 infants, 24 exposed; adjusted odds ratio, 2.5; 95% CI, 1.5 to 4.0), and omphalocele (181 infants, 11 exposed; adjusted odds ratio, 2.8; 95% CI, 1.3 to 5.7).

Conclusions Maternal use of SSRIs during early pregnancy was not associated with significantly increased risks of congenital heart defects or of most other categories of birth defects. Associations were observed between SSRI use and three types of birth defects, but the absolute risks were small, and these observations require confirmation by other studies. (...)

Teratogenicity of SSRIs — Serious Concern or Much Ado about Little?
Volume 356:2732-2733 (June 28)
In the fall of 2005, GlaxoSmithKline called attention to recently collected safety data indicating an increased risk of major congenital malformations among infants exposed during organogenesis to GlaxoSmithKline's selective serotonin reuptake inhibitor (SSRI), paroxetine. Among 527 fetuses exposed to paroxetine in the first trimester, 23 were born with major congenital malformations. Most of the malformations were cardiovascular, and the majority of those were ventricular septal defects. As compared with infants born to women taking any other antidepressant agent during the first trimester, the adjusted odds ratio for any malformation was 2.2 (95% confidence interval [CI], 1.3 to 3.6). Previously published . . . [Full Text of this Article] (...)

Paxil and Birth Defects (Seroxatrelaterte fødselsdefekter)
galvestonbay.injuryboard.com 15.6.2007
(...) Women that took Paxil during their first three months of pregnancy were one and a half to two and a half times more like to have a baby with a serious heart defect as were women that received other antidepressants. This statistic shows that Paxil has extreme influence on babies.

One of the most common side effects of Paxil use is the development of heart problems such as persistent pulmonary hypertension of the newborn (PPHN) in unborn children of women that use the drug. This condition is characterized by the failure of the newborn's lungs to "switch over" to breathing air after birth, which can restrict the amount of oxygen to a baby's delicate body. PPHN can result in a number of serious and potentially life-threatening complications such as hearing loss, heart or kidney failure, and death. This can not go unnoticed by pregnant women. (...)

Viagra could double risk of hearing loss Viagra kan doble risiko for hørseltap
reuters.com 19.5.2010
A new US study suggests men who take Pfizer's Viagra (sildenafil) or similar drugs for erectile dysfunction may double their chances of hearing impairment, bolstering a Food and Drug Administration warning from 2007 about this side effect.

High doses of Viagra have been shown to damage hearing in mice, but until now only a few anecdotal cases had been described in humans. (...)

Even after accounting for other factors linked to hearing loss, hard-of-hearing men still had twice the odds of taking Viagra, said McGwin, whose findings appear in the journal Archives of Otolaryngology--Head & Neck Surgery. (...)

(Anm: Behandling med Viagra förvärrar hjärt-lungsjukdom. Sildenafil bör inte användas som långtidsbehandling av kärlförtränging i lungorna, enligt en ny studie. Substansen sildenafil, som bland annat förekommer i potensläkemedlet Viagra, används främst för behandling av erektionsproblem. För sina kärlvidgande egenskaper används substansen också som off label-behandling vid olika kärlsjukdomar. (…) Nya opublicerade studieresultat, som presenterades vid den pågående hjärtkonferensen ESC i Barcelona i Spanien, visar dock att behandling med sildenafil gav sämre överlevnad och fler sjukhusinläggningar än placebo. (…) De spanska forskarna bakom studien kunde inte identifiera någon subgrupp av patienter som hade nytta av sildenafil. Deras slutsats är därför att man bör undvika att använda sildenafil som långtidsbehandling av pulmonell arteriell hypertension för patienter som genomgått klaffoperation. (lakemedelsvarlden.se 30.8.2017).)

(Anm: Antibiotics increase risk of hearing loss in patients with deadly bacterial infections (medicalnewstoday.com 30.7.2015).)

(Anm: Role of antioxidants in prevention of age-related hearing loss: a review of literature. (…) High-quality clinical trials are needed to investigate if ARHL can be delayed or prevented in humans. However, it seems that targeting several cell-death pathways is better than targeting the only oxidative stress pathway. Eur Arch Otorhinolaryngol. 2017 Apr;274(4):1821-1834. Epub 2016 Nov 17.)

(Anm: The Ibuprofen Risks You Need to Know (…) But if they’re used more frequently, or over long periods of time, they may pose dangers to the heart, kidneys, bone and even hearing. (…) “People need to be more aware of the potential downsides of long-term analgesic use,” says Dr. Gary Curhan at Brigham and Women’s Hospital, who led the hearing loss study. MORE: If You Take Ibuprofen Often, Read This (time.com 20.4.2017).)

(Anm: Antibiotics used to treat cystic fibrosis increases risk of permanent hearing loss. A powerful class of antibiotics provides life-saving relief for people with cystic fibrosis; however, a new study for the first time reveals the levels at which high cumulative dosages over time significantly increases the risk of permanent hearing loss in these patients. (…) The study, published in the Journal of Cystic Fibrosis, suggests physicians who treat patients with cystic fibrosis may be able to consider alternative strategies for treating the symptoms of respiratory infections associated with CF, especially if patients are responsive to different classes of antibiotics. (medicalnewstoday.com 27.2.2017).)

Moderate kidney disease linked to hearing loss
reuters.com 1.10.2010
(Reuters Health) - Older adults with moderate kidney disease may require screening for hearing loss, according to the authors of a new study.

In the study, of adults aged 50 years and older, 54 percent of people with moderate kidney disease had some extent of hearing loss, while 30 percent of those with the disease suffered severe hearing loss.

That's higher than in the general population: According to the National Institute on Deafness and Other Communication Disorders, hearing loss affects 18 percent of U.S. adults aged 45 to 64.

Earlier studies had shown a link between kidney disease and hearing loss in certain rare syndromes. However, the new study, published today in the American Journal of Kidney Diseases, expands on that by showing that the link can exist for any older adult with kidney disease. (...)

(Anm: Change in Prevalence of Hearing Loss in US Adolescents. JAMA. 2010;304(7):772-778 (August 18).)

Viagra could double risk of hearing loss Viagra kan doble risiko for hørseltap
reuters.com 19.5.2010
A new US study suggests men who take Pfizer's Viagra (sildenafil) or similar drugs for erectile dysfunction may double their chances of hearing impairment, bolstering a Food and Drug Administration warning from 2007 about this side effect.

High doses of Viagra have been shown to damage hearing in mice, but until now only a few anecdotal cases had been described in humans. (...)

Even after accounting for other factors linked to hearing loss, hard-of-hearing men still had twice the odds of taking Viagra, said McGwin, whose findings appear in the journal Archives of Otolaryngology--Head & Neck Surgery. (...)

(Anm: Behandling med Viagra förvärrar hjärt-lungsjukdom. Sildenafil bör inte användas som långtidsbehandling av kärlförtränging i lungorna, enligt en ny studie. Substansen sildenafil, som bland annat förekommer i potensläkemedlet Viagra, används främst för behandling av erektionsproblem. För sina kärlvidgande egenskaper används substansen också som off label-behandling vid olika kärlsjukdomar. (…) Nya opublicerade studieresultat, som presenterades vid den pågående hjärtkonferensen ESC i Barcelona i Spanien, visar dock att behandling med sildenafil gav sämre överlevnad och fler sjukhusinläggningar än placebo. (…) De spanska forskarna bakom studien kunde inte identifiera någon subgrupp av patienter som hade nytta av sildenafil. Deras slutsats är därför att man bör undvika att använda sildenafil som långtidsbehandling av pulmonell arteriell hypertension för patienter som genomgått klaffoperation. (lakemedelsvarlden.se 30.8.2017).)

(Anm: Antibiotics increase risk of hearing loss in patients with deadly bacterial infections (medicalnewstoday.com 30.7.2015).)

(Anm: Role of antioxidants in prevention of age-related hearing loss: a review of literature. (…) High-quality clinical trials are needed to investigate if ARHL can be delayed or prevented in humans. However, it seems that targeting several cell-death pathways is better than targeting the only oxidative stress pathway. Eur Arch Otorhinolaryngol. 2017 Apr;274(4):1821-1834. Epub 2016 Nov 17.)

(Anm: The Ibuprofen Risks You Need to Know (…) But if they’re used more frequently, or over long periods of time, they may pose dangers to the heart, kidneys, bone and even hearing. (…) “People need to be more aware of the potential downsides of long-term analgesic use,” says Dr. Gary Curhan at Brigham and Women’s Hospital, who led the hearing loss study. MORE: If You Take Ibuprofen Often, Read This (time.com 20.4.2017).)

(Anm: Antibiotics used to treat cystic fibrosis increases risk of permanent hearing loss. A powerful class of antibiotics provides life-saving relief for people with cystic fibrosis; however, a new study for the first time reveals the levels at which high cumulative dosages over time significantly increases the risk of permanent hearing loss in these patients. (…) The study, published in the Journal of Cystic Fibrosis, suggests physicians who treat patients with cystic fibrosis may be able to consider alternative strategies for treating the symptoms of respiratory infections associated with CF, especially if patients are responsive to different classes of antibiotics. (medicalnewstoday.com 27.2.2017).)

Moderate kidney disease linked to hearing loss
reuters.com 1.10.2010
(Reuters Health) - Older adults with moderate kidney disease may require screening for hearing loss, according to the authors of a new study.

In the study, of adults aged 50 years and older, 54 percent of people with moderate kidney disease had some extent of hearing loss, while 30 percent of those with the disease suffered severe hearing loss.

That's higher than in the general population: According to the National Institute on Deafness and Other Communication Disorders, hearing loss affects 18 percent of U.S. adults aged 45 to 64.

Earlier studies had shown a link between kidney disease and hearing loss in certain rare syndromes. However, the new study, published today in the American Journal of Kidney Diseases, expands on that by showing that the link can exist for any older adult with kidney disease. (...)

(Anm: Change in Prevalence of Hearing Loss in US Adolescents. JAMA. 2010;304(7):772-778 (August 18).)

Paxil and the Damage Zone
houston.injuryboard.com 14.6.2007
(...) The parents had no idea that Paxil could be a concern, initially. Roy started to research Paxil on the internet and found that it is extremely difficult to understand the scope of this terrible drug as well as the misery it has caused. The tragedy is that the wife didn't even need to take Paxil. Roy thinks that the drug is extremely over-prescribed. (...)

Taking Zoloft During Pregnancy Linked to Birth Defects
lawyersandsettlements.com 7.6.2007
Washington, DC: Less than a year ago, in July 2006, the FDA issued a Public Health Advisory on a birth defect found to be associated with Zoloft and other selective serotonin reuptake inhibitor antidepressants by a study in the February 2006 New England Journal of Medicine that found a higher risk of a life-threatening lung disorder in infants exposed to SSRIs, stating:

"A recently published case-control study has shown that infants born to mothers who took selective serotonin reuptake inhibitors (SSRIs) after the 20th week of pregnancy were 6 times more likely to have persistent pulmonary hypertension (PPHN) than infants born to mothers who did not take antidepressants during pregnancy."

PPHN infants have difficulty making the transition from breathing inside the womb to normal breathing after delivery, often leading to respiratory failure that requires mechanical ventilation. Even when treated, between 10% to 20% of babies born with PPHN do not survive. (...)

Groups Warn Against Taking Paxil While Pregnant
lawyersandsettlements.com 13.5.2007
Houston, TX: Paxil, a drug marketed as a way to treat depression, may have caused a lot of suffering for families after fetuses exposed to the drug were born with birth defects. Women took Paxil while pregnant, believing professionals who told them that Paxil was perfectly safe.

The truth is that Paxil can cause serious birth defects in infants. Defects that have been reported include minor valve problems, heart murmurs, and holes in the heart. In some cases, infants have had defects so severe they required heart transplants. (...)

The FDA has upgraded the Paxil warning from category "C" to category "D." Category "D" drugs have been shown to have a risk to fetuses. (...)

Pregnant Women, Those Planning Pregnancy Should Avoid Taking Antidepressant Paxil, ACOG Opinion Says
kaisernetwork.org 4.12.2006
Pregnant women or those who are planning for pregnancy should avoid taking GlaxoSmithKline's antidepressant Paxil because it can increase the risk of birth defects, according to an opinion published by an American College of Obstetricians and Gynecologists committee in the December issue of ACOG's journal Obstetrics & Gynecology, the AP/Seattle Post-Intelligencer reports (AP/Seattle Post-Intelligencer, 11/30). (...)

Warning on Paxil (Advarsel for Seroxat)
nytimes.com 1.12.2006
Women who are pregnant, or plan to be, should avoid taking Paxil because of a risk of birth defects, the American College of Obstetricians and Gynecologists has warned. The group published the alert in the December issue of its flagship journal, Obstetrics & Gynecology. Almost a year ago, the Food and Drug Administration and the drug’s maker, GlaxoSmithKline, issued warnings about an increased risk of birth defects in babies born to mothers taking Paxil. (...)

Parents blame antidepressant for toddler's heart defect
cnn.com 29.11.2006
POSTED: 5:20 p.m. EST, November 29, 2006

•A mom fears the Paxil she took while pregnant caused her son's heart defect
•FDA says two studies suggest paroxetine, or Paxil, increases birth defect risk
•Paxil's labeling was changed last year to warn about the risks of birth defects (...)

Antidepressants, pregnancy don't mix
freep.com 29.11.2006
Women should talk to their doctor about the risks of taking depression medicine during pregnancy, according to a new recommendation issued today by the American College of Obstetricians and Gynecologists.

One antidepressant, Paxil, sold generically as paroxetine, should be avoided, according to the association's Committee on Obstetric Practice.

Exposure to depression medicine late in pregnancy has been associated in several studies with short-term problems in newborns, including mild respiratory distress, excessively rapid respiration, jitteriness, poor muscle tone and readmission to the hospital, according to the committee. Last year, the federal Food and Drug Administration issued a public health warning about Paxil and pregnancy and changed its label to so-called Category D. Drugs in that classification have been found to be harmful to human fetuses. (...)

Mom's SSRI use may raise risk of birth defects
reuters.co.uk 8.11.2006
- The use of selective serotonin reuptake inhibitor (SSRI) antidepressant drugs early in pregnancy seems to moderately raise the risk of congenital malformations in offspring, suggests the results of a Danish population-based cohort study.

"Human data on the teratogenicity of SSRIs are limited," note Dr. Pia Wogelius from Aarhus University Hospital and colleagues in the November issue of Epidemiology. (...)

(Anm: Maternal Use of Selective Serotonin Reuptake Inhibitors and Risk of Congenital Malformations. Epidemiology. 17(6):701-704 (November 2006).)

SSRI use during pregnancy is associated with fetal abnormalities
News roundup
BMJ 2006;333:824 (21 October)
Women who take selective serotonin reuptake inhibitors (SSRIs) during early pregnancy may increase the risk of having a child with a congenital malformation, a new study reports. However, the researchers say that it is not clear whether the increased risk is due to the drugs themselves or to other factors related to the women’s underlying disease. (...)

Neonatal Outcomes After Prenatal Exposure to Selective Serotonin Reuptake Inhibitor Antidepressants and Maternal Depression Using Population-Based Linked Health Data
Arch Gen Psychiatry 2006;63:898-906
(...) Conclusion With linked population health data and propensity score matching, prenatal SE-D exposure was associated with an increased risk of low birth weight and respiratory distress, even when maternal illness severity was accounted for. (...)

Treatment Challenges of Depression in Pregnancy
fda.gov 19.7.2006
FDA Public Health Advisory List of Drug Names

Decisions about how to treat depression in pregnant women are increasingly complex. Patients and physicians must carefully consider and discuss together the potential benefits and risks of treatment with antidepressants during pregnancy. Two new studies provide important information to be considered in making such decisions. The studies included women who had been treated with antidepressant drugs that act as selective serotonin reuptake inhibitors (SSRIs) or, in a few cases, other antidepressants. SSRI medications are the most commonly used drugs to treat depression in the U.S. (...)

F.D.A. Takes Action on Antidepressants and Migraine Drugs
nytimes.com 20.7.2006
WASHINGTON, July 19 (AP) — The Food and Drug Administration asked Wednesday that manufacturers of Prozac and similar antidepressants change their labels to include information about an uncommon but life-threatening lung problem that can affect babies born to mothers who take the drugs during pregnancy.

The agency also issued an alert about the possible risk of combining antidepressant medications with common migraine drugs called triptans, saying a life-threatening condition called serotonin syndrome might occur when the drugs are combined.

The agency said it was seeking more information on both risks. (...)

FOSTER DØDE - etter bruk av lykkepille
SJOKKRAPPORT: 8 døde 140 alvorlige bivirkninger
(PDF)
vg.no 20.5.2006
Et foster og åtte voksne døde etter bruk av såkalte lykkepiller de tre siste årene. Legemiddelverket holder antidepressiva som mulig dødsårsak. Dødsfallene omtales i en fersk, upublisert og rystende bivirkningsrapport fra Statens legemiddelverk (SLV).

I tillegg til dødsfallene har SLV i det samme tidsrommet fått 140 meldinger om alvorlige bivirkninger etter bruk av lykkepiller.

Ikke kjent i Norge
Fosterdød mens mor tar antidepressiva er meldt i utlandet, men ikke tidligere kjent i Norge. Såkalte lykkepiller, som kom på 90-tallet, blir på fagspråket kalt SSRI (selektive serotonin reopptakshemmere).

- Det er rapportert lignende hendelser fra andre land. Når det gjelder fosterskade, har vi bare data for paroksetin (virkestoff i noen SSRI-preparater), sier avdelingsoverlege Steinar Madsen ved Statens legemiddelverk som understreker at man ikke vet om fosteret døde som følge av SSRI, men at det anses som mulig dødsårsak. (...)

SSRI og graviditet
Utposten 2005; 34(7): 42-3. (13.12.2005)
Spørsmål
Vi får jevnlig henvendelser om SSRI og bruk under svangerskap. Hvor stor risiko er det for at det kan oppstå misdannelser eller andre neonatale tilstander?

Svar
En artikkel fra 2004 omhandler bruken av nye antidepressive legemidler under graviditet og amming (1). I denne konkluderes det med at behandling med antidepressive legemidler under graviditet ikke har vist å medføre noen økt risiko for misdannelser hos barnet, at mange av de nyere antidepressiva har begrenset dokumentasjon og at studier av langtidseffekter på barn som regel mangler. (...)

I løpet av 2005 har det tilkommet nye data: På grunn av mulige signaler om kardiovaskulære defekter etter eksponering for bupropion (Zyban) ba Food and Drug Administration (FDA) i USA produsenten, Glaxo Smith Kline, om en gjennomgang av data både for Zyban og forskjellige SSRI. Det ble gjort en analyse av sammenhengen mellom utlevering av forskjellige antidepressiva i løpet av første trimester av svangerskapet og forekomst av medfødte misdannelser. Resultatene er nå offentliggjort (3). Man fant at paroxetin, men ikke bupropion, ga økt risiko for medfødte misdannelser i forhold til andre antidepressiva. Misdannelsene var blant annet kardiovaskulære, i form av ventrikkelseptumdefekter. I september 2005 ble det sendt ut et brev om dette til amerikansk helsepersonell, et såkalt ”Dear doctor-letter” (4). Så langt er ikke dette tatt inn i norsk preparatomtale.

Foreløpige resultater fra en dansk registerundersøkelse (5) viser økt forekomst av misdannelser hos barn født av mødre som var behandlet med SSRI i 1. trimester. Materialet omfattet ca. 1000 kvinner som hadde brukt SSRI i denne perioden, og hele databasen omfattet ca. 150 000 gravide. Forekomsten av misdannelser var 4/100 i kontrollgruppen uten SSRI og 5/100 i SSRI-gruppen. Resultatene er foreløpige og det er uklart om det er legemidlene, underliggende sykdom eller andre faktorer som er årsaken. Det fremgår ikke av de data som er lagt frem pr. i dag om det er gjort separate analyser for hver enkelt substans. (...)

Konklusjon
Bruk av antidepressiva under graviditet og amming bør vurderes individuelt for den enkelte kvinne og bare brukes hvis fordelene oppveier en mulig risiko. Fluoksetin er det SSRI som er mest studert under graviditet, men som kan tenkes å være mindre egnet ved eventuell fremtidig amming. Nyere resultater tyder på at det kan være forskjell på SSRIer når det gjelder risiko for medfødte misdannelser, og at risikoen er større for paroxetin enn de øvrige ved eksponering i første trimester. (...)

Paxil Alert for Pregnant Women
New York Times 29.9.2005
The popular antidepressant Paxil may increase the risk of birth defects if pregnant women take it during the first trimester, federal health officials announced late Tuesday.

The Food and Drug Administration posted the warning on its Web site after the drug's manufacturer, the British company GlaxoSmithKline, sent the agency and doctors a letter that cited evidence from a new study. Glaxo said in the letter that it had changed the drug's label to reflect the possibility of the increased risk. (...)

The study involved 3,581 pregnant women and found a 4 percent incidence of birth defects in those taking Paxil during the first trimester, versus a 2 percent incidence in those taking other antidepressants. The risk in the general population was 3 percent, said Mary Anne Rhyne, a Glaxo spokeswoman. Among the most common malformations were ventricular septal defects: holes or other flaws in the wall between two of the heart's chambers.

The letter said previous studies of antidepressants and birth defect risk had been mixed. Some small analyses found an association; a large Swedish study did not. (...)

MedWatch - The FDA Safety Information and Adverse Event Reporting Program
fda.gov.27.9.2005
GlaxoSmithKline (GSK) and FDA notified healthcare professionals of changes to the Pregnancy/PRECAUTIONS section of the Prescribing Information for Paxil and Paxil CR Controlled-Release Tablets to describe the results of a GSK retrospective epidemiologic study of major congenital malformations in infants born to women taking antidepressants during the first trimester of pregnancy. This study suggested an increase in the risk of overall major congenital malformations for paroxetine as compared to other antidepressants [OR 2.2; 95% confidence interval, 1.34-3.63]. Healthcare professionals are advised to carefully weigh the potential risks and benefits of using paroxetine therapy in women during pregnancy and to discuss these findings as well as treatment alternatives with their patients.

Read the complete MedWatch 2005 Safety summary, including links to the Dear Healthcare Professional Letter and revised labeling, at:

http://www.fda.gov/medwatch/safety/2005/safety05.htm#Paxil2 (...)

Typiske og atypiske antipsykotika

Antipsychotics During Pregnancy Relation to Fetal and Maternal Metabolic Effects
Arch Gen Psychiatry. 2012;69(7):715-721 (July 2012)
Context Knowledge about the effects of exposure to the newer antipsychotics during pregnancy is limited.

Objective To investigate the effects of maternal use of antipsychotics during pregnancy on gestational diabetes and fetal growth. (…)

Main Outcome Measures Odds ratios (ORs) with 95% CIs for gestational diabetes and being small for gestational age (SGA) and large for gestational age for birth weight, birth length, and head circumference.

Results Exposure to other antipsychotics was associated with an increased risk of gestational diabetes (adjusted OR, 1.77 [95% CI, 1.04-3.03]). The risk increase with olanzapine and/or clozapine was of similar magnitude but not statistical significance (adjusted OR, 1.94 [95% CI, 0.97-3.91]). Infants exposed to either group of antipsychotics had increased risks of being SGA on birth weight, whereas only exposure to other antipsychotics yielded increased risks of being SGA for birth length and head circumference. None of the risks for SGA measurements remained significant after adjusting for maternal factors. There were no increased risks of being large for gestational age for birth weight or birth length after exposure to olanzapine and/or clozapine, but the risk increased for head circumference (OR, 3.02 [95% CI, 1.60-5.71]).

Conclusions Women who used antipsychotics during pregnancy had increased risks of gestational diabetes. The increased risks of giving birth to an SGA infant seemed to be an effect of confounders, such as smoking. Except for macrocephaly, olanzapine and/or clozapine exposure was not associated with anabolic fetal growth. (…)

(Anm: Clozapine-induced myocarditis, a widely overlooked adverse reaction. Acta Psychiatr Scand. 2015 Apr 11. [Epub ahead of print].)

Birth weight of infants after maternal exposure to typical and atypical antipsychotics: prospective comparison study
Br J Psychiatry. 2008 May;192:333-7.
BACKGROUND: The effects of in utero exposure to atypical antipsychotics on infant birth weight are unknown. AIMS: To determine whether atypical and typical antipsychotics differ in their effects on birth weight after maternal exposure during pregnancy. METHOD: Prospective data on gestational age and birth weight collected by the National Teratology Information Service for infants exposed to typical (n=45) and atypical (n=25) antipsychotics was compared with data for a reference group of infants (n=38). RESULTS: Infants exposed to atypical antipsychotics had a significantly higher incidence of large for gestational age (LGA) than both comparison groups and a mean birth weight significantly heavier than those exposed to typical antipsychotics. In contrast those exposed to typical antipsychotics had a significantly lower mean birth weight and a higher incidence of small for gestational age infants than the reference group. CONCLUSIONS: In utero exposure to atypical antipsychotic drugs may increase infant birth weight and risk of LGA. (...)

Antipsykotika og Large-for-Gestational-Age (LGA) Infant

Birth weight of infants after maternal exposure to typical and atypical antipsychotics: prospective comparison study
British Journal of Psychiatry (2008) 192: 333-337 (May 1)
(...) Results
Infants exposed to atypical antipsychotics had a significantly higher incidence of large for gestational age (LGA) than both comparison groups and a mean birth weight significantly heavier than those exposed to typical antipsychotics. In contrast those exposed to typical antipsychotics had a significantly lower mean birth weight and a higher incidence of small for gestational age infants than the reference group.
Conclusions
In utero exposure to atypical antipsychotic drugs may increase infant birth weight and risk of LGA. (...)

(Anm: Large-for-Gestational-Age (LGA) Infant. (The Merck Manual Online).)

- Studier knytter epilepsilegemidler til fødselsdefekter

Epilepsimedel kopplas till autism
dagensmedicin.se 30.4.2013
Ny dansk forskning tyder på att risken för autismspektrumstörningar ökar om mamman tar läkemedel som innehåller valproat under graviditeten.

Mediciner med substansen valproat är enligt Läkemedelsverket förstahandsval vid generaliserade anfall hos epilepsipatienter. Redan i dag är dock rekommendationen att om möjligt välja andra mediciner hos gravida eftersom valproat tycks kunna öka risken för fosterskador.

Och nu kommer alltså ytterligare stöd för att substansen bör undvikas om det finns andra alternativ.

Forskare vid universitetssjukhuset i Århus har följt upp alla barn som föddes i Danmark under åren 1996-2006, totalt 655 615 stycken. Hos 508 av dem hade mamman hämtat ut recept på valproat under graviditeten.

Exponering för valproat under fostertiden var kopplat till en femfaldigt ökad risk för autism, och trefaldigt ökad risk för autismspektrumstörning, som förutom autism även omfattar bland annat Aspergers syndrom och atypisk autism.

Den absoluta risken var 2,5 procent för autism och 4,4 procent för autismspektrumstörning om mamman tagit valproat under graviditeten.

Studien publiceras i tidskriften Jama, och forskarna skriver att fynden måste balanseras mot nyttan med behandlingen hos kvinnor som behöver valproat för att hålla sin epilepsi under kontroll. (...)

(Anm: Prenatal Valproate Exposure and Risk of Autism Spectrum Disorders and Childhood Autism (Prenatal eksponering for Valproate (Orfiril) og risiko for autismespekterforstyrrelser og barneautisme) JAMA. 2013;309(16):1696-1703 (April 24, 2013).)

Valproate Sodium and related products (valproic acid and divalproex sodium): Risk of Birth Defects
fda.gov 3.12.2009
(...) [Posted 12/03/2009] The FDA notified health care professionals and patients about the increased risk of neural tube defects and other major birth defects, such as craniofacial defects and cardiovascular malformations, in babies exposed to valproate sodium and related products (valproic acid and divalproex sodium) during pregnancy. Healthcare practitioners should inform women of childbearing potential about these risks, and consider alternative therapies, especially if using valproate to treat migraines or other conditions not usually considered life-threatening. (...)

Epilepsy Drug May Boost Birth Defect Risk (Epilepsilegemidler kan øke risiko for fødselsdefekter)
healthfinder.gov 21.7.2008
Women who take topiramate should discuss preconception planning with their doctor. (...)

MONDAY, July 21 (HealthDay News) -- Pregnant women who use the epilepsy drug topiramate alone or in combination with other epilepsy drugs may be increasing their risk of birth defects, British researchers report.

Topiramate (brand name Topamax) is a common anti-seizure medication used by many with epilepsy. It's also used to treat migraine headaches. Many similar drugs also increase the risk of birth defects, but until this report, the link between birth defects and topiramate had not been well studied. (...)

The report is published in the July 22 issue of the journal Neurology. (...)

Craig's team found that of the 178 babies born, 16 (4.8 percent) suffered from major birth defects. Among the babies with birth defects, three of the mothers were taking topiramate exclusively, while 13 were taking topiramate plus other epilepsy drugs. (...)

Study Ties Epilepsy Drug to Fetal Risk
latimes.com 8.8.2006
One in five women who took the widely used epilepsy drug valproate in a clinical trial had pregnancies resulting in birth defects or fetal death, researchers said Monday.

The drug, sold as Depakote by Abbott Laboratories Inc., was substantially riskier to unborn children than three competing medicines examined in the study. The researchers found cases of malformed hearts and genitals, cleft palate and artery deformities among children born to women taking the drug.
The report in the journal Neurology was the latest to document the potential dangers of valproate to fetuses. The drug is also used to treat headaches and some psychiatric conditions, including bipolar disorder. (...)

Teratogenicity of antiepileptic drugs
Editorial
BMJ 2006;333:615-616 (23 September)
Women should consider stopping, minimising, or switching drugs before pregnancy

Prescribing for women with epilepsy is complicated by the potential teratogenicity of antiepileptic drugs. Current guidelines recommend that the most effective drug should be chosen before conception and prescribed at its lowest effective dose, ideally as monotherapy.1 2 But which antiepileptic drug is safest in pregnancy?

Early research on the safety of antiepileptic drugs in pregnancy was unreliable. Several countries set up pregnancy registries in the late 1990s, and data from these registries are now appearing. (...)

(Anm: teratogen; som skaper misfoster, som er årsak til lyte hos foster; særleg brukt om visse kjemiske stoff eller medikament. EN teratogenic. ET [gr teras misfoster + gennan skapa]. Kilde: Norsk medisinsk ordbok.)

Epilepsy drug warning for pregnancies
netdoctor.co.uk 8.8.2006
A drug used to treat epilepsy could increase the risk of foetal death and birth defects when taken by pregnant mothers, new research suggests.

According to a study published in the latest edition of the journal Neurology, the drug valproate was found to pose a significantly higher risk to unborn babies when compared with alternative epilepsy drug treatments.

In a study of 333 mothers, 20 per cent of those taking valproate while pregnant experienced still births or birth defects in their child.

The rate was much lower for the alternative drugs phenytoin, carbamazepine and lamotrigine. (...)

Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register.
J Neurol Neurosurg Psychiatry. 2006;77(2):193-8 (Feb.)

OBJECTIVE: To assess the relative risk of major congenital malformation (MCM) from in utero exposure to antiepileptic drug (AEDs). (...)

CONCLUSIONS: Only 4.2% of live births to women with epilepsy had an MCM. The MCM rate for polytherapy exposure was greater than for monotherapy exposure. Polytherapy regimens containing valproate had significantly more MCMs than those not containing valproate. For monotherapy exposures, carbamazepine was associated with the lowest risk of MCM. (...)

Lamictal

FDa says GlaxoSmithKline drug may be linked to birth defects
marketwatch.com 29.9.2006
LONDON (MarketWatch) -- GlaxoSmithKline PLC's (GSK) antidepressant drug Lamictal may cause birth defects in babies exposed to the drug during the first three months of pregnancy, a notice on the U.S. Food and Drug Administration Web site said. (...)

Lamotrigin

Lamotrigin och risken för läppgomspalt
lakemedelsverket.se 20.6.2006
En analys har nyligen genomförts av ett register av gravida kvinnor som använt läkemedel mot epilepsi i USA och Kanada. Analysen antyder att risken för läppgomspalt, en typ av fosterskada där läpp och/eller gom inte sluts på ett normalt sätt under fosterutvecklingen, kan vara ökad om modern behandlats med lamotrigin under graviditetens tre första månader. (...)

- ACE-hemmere (blodtrykksmedisin)

Misdannelser av vanlig medisin
mozon.no 13.6.2006
En stor amerikansk studie viser at kvinner som tar blodtrykksmedisin, av typen ACE-hemmere, under svangerskapets første trisemester har dobbelt så stor risiko for å føde barn med alvorlige hjerte- og hjerneproblemer.

Tidligere har man ikke knyttet noen fare til bruk av medikamentet tidlig i svangerskapet, men nå viser det seg imidlertid at gravide kvinner som tar ACE-hemmere i første trisemester, øker risikoen for å føde barn med misdannelser, skriver MSNBC. (...)

ACE-hämmare skall ej användas under graviditet
under graviditet

www.lakemedelsverket 8.6.2006
Denna vecka publiceras i New England Journal of Medicine en studie, som funnit att blodtryckssänkande läkemedel av typen ACE-hämmare som givits under tidig graviditet tycks orsaka ökad risk för allvarliga missbildningar.

Studien omfattar 209 nyfödda barn vars mödrar behandlats med ACE-hämmare (läkemedel som innehåller kaptopril, enalapril, lisinopril, ramipril, kinapril, cilazapril, fosinopril, och trandolapril) under graviditetens första tre månader och som jämförelse studerades cirka 29 507 barn till mödrar, som inte fått sådan behandling. Risken för missbildningar var högre i gruppen som exponerats för ACE-hämmare (relativ risk 2,7 med ett 95 % konfidensintervall 1,7-4,3).

Resultaten innebär att ungefär en kvinna av tjugo som använt ACE-hämmare under tidig graviditet kan riskera att föda ett barn med allvarlig missbildning.
I Sverige gäller sedan tidigare rekommendationen att ACE-hämmare inte skall användas under graviditet. Så snart graviditet konstateras rekommenderas byte till annat blodtryckssänkande läkemedel. (...)

- Er inhalasjonlegemidler mot astma linket til fødselsdefekter?

Are asthma inhalers linked to birth defects? Thousands of pregnant women at centre of inquiry into health problems in babies
dailymail.co.uk 11.3.2012
Probe: A Europe-wide study is looking into the health effects of asthma inhalers

Thousands of pregnant women taking prescription drugs for asthma, epilepsy, diabetes and depression are at the centre of a major inquiry into birth defects and health problems in babies.

Asthma inhalers, man-made insulin, new anti-epileptics and Prozac-style anti-depressants called SSRIs, are being probed in the Europe-wide study of nearly four million births.

Pregnant women with long-term conditions have no choice but to take their medicines, and around one in five expectant mothers suffer from depression which could require treatment.

Last night, the Royal College of Obstetricians and Gynaecologists urged women to keep taking their medication in spite of the investigation, and to talk to their doctor if worried.

In the Euromedicat study, due to be published next year, medical records are being matched with national registers of congenital abnormalities in newborns, including cleft palate, spina bifida and heart defects.

Scientific co-ordinator Dr Marian Bakker, of the University Medical Centre in Groningen, in the Netherlands, said: ‘It is very important work because for many drugs, the safety evidence has not been established yet. We are absolutely not saying to women to avoid all drugs during pregnancy but it should be very carefully weighed up because it is very difficult to establish safety in pregnancy.’ (...)

Østrogen

Neonatal Estrogen Exposure Leads to Prostate Cancer in Rats
medpagetoday.com 1.6.2006
CHICAGO, June 1 — It's a complicated trail twixt man and rats, but neonatal environmental estrogen exposure in the rodents appears to predispose them to prostate cancer as adults. (...)

Antibiotika

Birth Defects Associated with Use of Antibiotics During Pregnancy (Fødselsdefekter assosiert med bruk av antibiotika under svangerskapet)
pediatrics.jwatch.org 18.11.2009
Published in Journal Watch Pediatrics and Adolescent Medicine November 18, 2009
Sulfonamides and nitrofurantoins were associated with birth defects. (...)

Comment: The authors note the limitations of this retrospective study, including the major limitation that causality cannot be determined. However, the results are reassuring. Penicillins, erythromycins, and cephalosporins appear to be safe. Sulfonamides and nitrofurantoins appear to be associated with several birth defects and should be avoided if possible. Quinolones, used infrequently by women in this study, are not recommended for use during pregnancy. (...)

(Anm: Editorials. Cardiovascular risks associated with clarithromycin. A growing literature suggests these risks are not negligible. Concerns about the cardiovascular risks of macrolide antibiotics surfaced in the 1980s, with case reports and clinical studies describing arrhythmias and QT prolongation with erythromycin. BMJ 2016;352:i23  (Published 14 January 2016).)

Antibiotika kan eventuellt ge fosterskador
lakemedelsvarlden.se 3.11.2009
Amerikanska forskare har sett ett möjligt samband mellan antibiotikabehandling i tidig graviditet och fosterskador. Men de vanligaste antibiotikapreparaten tycks vara säkra att använda.

En bakterieinfektion kan innebära en stor risk för en gravid kvinna och hennes foster och antibiotika är ett av de läkemedel som är vanligast förekommande under en graviditet. Nu har amerikanska forskare studerat eventuella risker för fostret då antibiotikabehandlingen inträffar någon gång under månaden innan befruktning och fram till tredje graviditetsmånadens slut. (...)

Resultaten visar på ett möjligt samband mellan antibiotikaanvändning och fosterskador för sulfonamider och nitrofurantoinpreparat, läkemedel som bland annat används för att behandla urinvägsinfektioner. Användningen av dessa preparat var associerad med sex respektive fyra typer av fosterskador, bland annat hjärtfel. (...)

- Hvorfor testes ikke legemidler på gravide kvinner

Why Aren't Drugs Tested on Pregnant Women?
abcnews.go.com 24.2.2006
Government Has Approved a Clinical Drug Trial Using Expectant Moms (...)

Glucocorticoid drugs

Drug risk to mother's descendants
bbc.co.uk 27.12.2005
Drugs given to a woman at risk of having a premature baby may affect the brains and behaviour of her grandchildren, research suggests.

Glucocorticoid drugs are used to speed up the development of a foetus's lungs.
New Scientist magazine reports that University of Toronto researchers gave the drugs to pregnant guinea pigs.

They found behavioural problems, such as hyperactivity, were more likely not only in the animals' offspring, but in the next generation too. (...)

- Risiko for medfødte misdannelser etter eksponering for astmamedisin i første trimester av svangerskapet - en kohort koblingsstudie.

Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy - a cohort linkage study.
BJOG. 2016 May 12. [Epub ahead of print]
(…) OBJECTIVE: To examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.

DESIGN: Meta-analysis of aggregated data from three cohort studies.

SETTING: Linkage between healthcare databases and EUROCAT congenital anomaly registries.

POPULATION: 519 242 pregnancies in Norway (2004-2010), Wales (2000-2010) and Funen, Denmark (2000-2010).

METHODS: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.

MAIN OUTCOME MEASURES: ORs for all congenital anomalies and specific congenital anomalies.

RESULTS: Overall exposure prevalence was 3.76%. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99% CI 1.09-1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99% CI 1.15-10.04). For severe congenital heart defects, an increased OR (1.97; 1.12-3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20-4.67).

CONCLUSION: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken. (…)

- Beroligende medisiner kan være farlig for fosteret

Beroligende medisiner kan være farlig for fosteret
Nasjonalt folkehelseinstitutt 19.9.2005
Bruk av beroligende medisiner (f.eks. Vival, Valium eller Stesolid) under graviditet kan ha alvorlige virkninger på fosteret. Særlig uheldig er det hvis pillene kombineres med alkohol. Gravide med angst eller depresjon må derfor ta kontakt med lege for råd og ikke drive selvmedisinering med slike preparater. Dette er et av de resultatene som fremkommer i en fersk oversiktsartikkel fra Folkehelseinstituttet.

Disse farene har man vært klar over i mange år, men nå er det behov for å få ut denne kunnskapen på nytt til både gravide og helsepersonell.

Virkestoffet i Vival, Valium, Stesolid og flere andre typer beroligende medisiner er benzodiazepiner som ofte brukes ved behandling av generalisert angst og ved fobier. Benzodiazepiner er den enkelte gruppe av psykofarmaka som forskrives aller mest. Mange kan ha et gammelt pilleglass stående og reflekterer ikke over risikoen ved å bruke disse preparatene under svangerskap. (...)

(Anm: Benzodiazepines linked to worsened COPD in older adults. (clinicalpsychiatrynews.com).)

(Anm: Combining opioids with anti-anxiety medicines linked to greater risk of overdose. Taking opioids (strong prescription painkillers) together with benzodiazepines (widely used to treat anxiety and sleep problems) is associated with greater risk of opioid overdose, finds a study in The BMJ. (medicalnewstoday.com 16.3.2017).)

(Anm: Benzodiazepines Increase Risk of Hip Fractures in Patients With Alzheimer’s Disease. JOENSUU, Finland -- November 23, 2016 -- The use of benzodiazepines and related drugs increase the risk of hip fracture by 43% in patients with Alzheimer’s disease, according to a study published in the Journal of the American Medical Directors Association. The hip fracture risk was investigated in community-dwelling Finnish persons with Alzheimer’s disease. (dgnews.docguide.com 23.11.2016).)

(Anm: Benzodiazepiner knyttet til forverret KOLS hos eldre voksne. (Benzodiazepines linked to worsened COPD in older adults.) (clinicalpsychiatrynews.com).)

(Anm: COPD; Kronisk obstruktiv lungesykdom, ofte forkortet til KOLS, er en samlediagnose for en rekke nært beslektede sykdommer med kronisk og mer eller mindre irreversibel nedsettelse av lungefunksjonen. (no.wikipedia.org).)

(Anm: Fatigue in COPD: an important yet ignored symptom. Lancet Respir Med. 2017 Apr 21. pii: S2213-2600(17)30158-3. [Epub ahead of print].)

(Anm: Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing. (…) INTERPRETATION: Confirmation of a COPD diagnosis using pulmonary function testing is associated with a decreased risk of death and admission to hospital for COPD. In ambulatory patients, this effect may be from increased use of appropriate COPD medications. The findings of this study validate current guideline recommendations that encourage pulmonary function testing for diagnosis in all patients with suspected. COPD. CMAJ 2017;189(14) (First published November 14, 2016).)

(Anm: What are pulmonary function tests (PFTs)? Pulmonary function tests (PFTs) are a group of tests that measure how well your lungs work. This includes how well you’re able to breathe and how effective your lungs are able to bring oxygen to the rest of your body. (healthline.com 4.11.2015).)

(Anm: Potential of stem cell therapy to repair lung damage. A new study has found that stem cell therapy can reduce lung inflammation in an animal model of chronic obstructive pulmonary disease (COPD) and cystic fibrosis. Although, still at a pre-clinical stage, these findings have important potential implications for the future treatment of  patients. (sciencedaily.com 27.3.2017).)

(Anm: Asthma vs. COPD: Differences and Similarities (medicalnewstoday.com 11.2.2017).)

(Anm: Inhalers for COPD: What Types Are There? What are the different types of COPD inhalers available and how do they affect the body? What are the possible risks and side effects? (medicalnewstoday.com 13.2.2017).)

(Anm: COPD and Pneumonia: What's the Connection? (medicalnewstoday.com 10.2.2017).)

(Anm: Kan rødbetjuice være bra for kolspasienter? (…) Nitrat reduserer oksygenforbruket. (…) Lavere oksygentrykk i blodet under søvn. Søvnrelaterte pusteforstyrrelser kan gi dårlig søvnkvalitet og symptomer som trøtthet og hodepine. Kolspasienter kan oppleve å sove ganske mye, men føler seg likevel ikke uthvilt, forteller avdelingsoverlege på Glittre Nils Henrik Holmedahl. Holmedahl er medisinsk ansvarlig for forskningsprosjektet. (aftenposten.no 20.2.2017).)

(Anm: Exacerbation of COPD: Causes, Warning Signs, and Treatment (medicalnewstoday.com 4.2.2017).)

(Anm: What is the Pathophysiology of COPD? Treatment and prevention (medicalnewstoday.com 8.2.2017).)

(Anm: Diet Tips for COPD. COPD is a chronic lung condition that includes two conditions: emphysema and chronic bronchitis. Together, these conditions damage the lungs and airways, making it more difficult to breathe. Common symptoms include shortness of breath, chronic cough with mucus, wheezing, and fatigue. (medicalnewstoday.com 7.2.2017).)

(Anm: - Flere hundre tusen nordmenn går rundt med lungesykdommer de ikke vet om. (…) Sykdommen er økende på verdensbasis, og siden 2010 har det i Norge blitt 40% økning i antall sykhusinnleggelser for kolsbehandling, ifølge Dagens Medisin. (lommelegen.no 23.1.2017).)

(Anm: Incidence of GOLD-defined chronic obstructive pulmonary disease in a general adult population. (…) CONCLUSION: Approximately 6% developed COPD over 9 years. Smoking and aging were important incidence predictors. Our study suggests a substantial underdiagnosis of COPD among adults in this community.Int J Tuberc Lung Dis. 2005 Aug;9(8):926-32.)

(Anm: COPD and Life Expectancy: What's the Outlook? (…) When a person has COPD, the damage to their lungs cannot be reversed, and the condition therefore tends to worsen with time. Currently, there is no cure for COPD. (medicalnewstoday.com 3.1.2017).)

(Anm: COPD vs. Emphysema: What's the Difference? (medicalnewstoday.com 23.12.2016).)

(Anm: COPD - what causes the lungs to lose their ability to heal? (medicalnewstoday.com 19.12.2016).)

(Anm: Key Facts and Common Myths About COPD (medicalnewstoday.com 1.2.2017).)

(Anm: Breathing Exercises for People with COPD (medicalnewstoday.com 7.1.2017).)

(Anm: Antipsykotika kan øke risiko for respirasjonssvikt ved KOLS. Risiko var doseavhengig; ingen trygg dose påvist. (Antipsychotics May Boost Respiratory Failure Risk in COPD. Risk was dose-dependent; no safe dose found. (medpagetoday.com 8.1.2017).)

(Anm: ACAAI: Asthma-COPD Overlap Studies Needed. Proliferation of ACOS papers, but, as yet, no clinical trials. It is very difficult to know what to do in asthma-COPD overlap syndrome because we don't have randomized trials looking specifically at this patient population," said R. Stokes Peebles, MD, of Vanderbilt University in Nashville, speaking at the American College of Allergy, Asthma and Immunology 2016 Annual Scientific Meeting. (medpagetoday.com 18.11.2016).)

(Anm: COPD patients with moderately low oxygen deficiencies don't benefit from long-term oxygen.- (…) The findings, published in the New England Journal of Medicine, are based on research examining oxygen treatment outcomes in 738 COPD patients with moderately low blood oxygen levels at 42 clinical centers in the United States. The study began in 2009 and ended in 2015. Patients who received supplemental oxygen over the course of the study showed no significant differences in rate of hospitalizations, time to death after diagnosis, exercise capacity or quality of life when compared to patients who did not receive supplemental oxygen. (medicalnewstoday.com 28.10.2016).)

(Anm: Mange ignorerer symptomer på KOL. (…) Hoste, slim fra lungerne og åndenød i mere end to måneder kan være symptomer på den kroniske lungesygdom KOL, som hvert år er medvirkende til op mod 5.500 dødsfald. Sygdommen kan bremses, hvis den opdages i tide. (sundhedsstyrelsen.dk 19.9.2016).)

(Anm: Ekstreme klimaforandringer er allerede et faktum i Europa. Uanset hvor meget, der diskuteres – ekstrem tørke, hedebølger og voldsom regn er allerede et faktum i Europa, konkluderer rapport fra EU’s Miljøagentur, EEA. Dansk professor advarer om nye sygdomme og hårde vilkår for landbruget i Østeuropa. Professor Jørgen E. Olesen fra Aarhus Universitet er én af forfatterne bag rapporten ”Climate change, impacts and vulnerability in Europe 2016”, der udsendes hvert fjerde år, og han er ikke i tvivl: »Vi har allered... (jyllands-posten.dk 24.1.2017).)

(Anm: CDC: COPD-Related Deaths Down in Men, Less So in Women. —COPD death rates continue to climb among black women. (…) From 2000 through 2014, age-adjusted COPD-related deaths decreased by 22.5% in men, versus just 3.8% among women. These decreases were mainly in the 65-84 age group. Still, the death rate remained higher for men than women, although this gender gap has decreased, the report noted. (medpagetoday.com 9.9.2016).)

(Anm: Forskning giver nyt håb for KOL-patienter. Lungesygdommen KOL dræber hvert år tusindvis af danskere. Men det skal forskning fra SDU være med til at forhindre. Nøglen er særlige bio-markører. (…) Kronisk obstruktiv lungesygdom, i daglig tale KOL, er den femte hyppigste dødsårsag i Danmark. Det skyldes ikke mindst, at sygdommen er svær at opdage i tide. (…) I Center for Kronisk Obstruktiv Lungesyndrom (CeKOL) arbejder man på at udvikle en teknik med såkaldte biomarkører – dvs. målbare stoffer i kroppen, der øges eller sænkes, i takt med at KOL udvikler sig. (sdu.dk 16.8.2016).)

(Anm: Opioids May Up Mortality Risk in COPD Patients. —Increased risk for adverse outcomes in older adults regardless of dose (medpagetoday.com 19.7.2016).)

(Anm:  Svakelighet er vanlig hos pasienter med KOLS. — Kan gå utover tiltak for å forlenge overlevelse. (Frailty Is Common in Patients With COPD. — May compromise interventions to prolong survival. The rate of frailty in patients with chronic obstructive pulmonary disease (COPD) referred for pulmonary rehabilitation is over twice that of the general population of older people, and these patients have a high risk for discontinuing the exercise therapy. (…) He added that pulmonary rehabilitation exercise programs tailored to frail patients with COPD would help more people access the treatment.) (medpagetoday.com 18.6.2016).)

(Anm: Sleep Quality Tied to COPD Exacerbation Risk. —Causality direction still uncertain. SAN FRANCISCO -- Poor sleep quality was strongly associated with an increased risk for COPD exacerbations over 18 months of follow up in an analysis of data from a Canadian prospective cohort study reported here. (…) Shorofsky presented the analysis of data from the Canadian Cohort of Obstructive Lung Disease (CanCOLD) in poster presentation at the American Thoracic Society annual meeting. "Our finding suggest that poor sleep and COPD are strongly related, but it is a chicken-egg issue," Shorofsky told MedPage Today. (medpagetoday.com 20.5.2016).)

(Anm: New way to predict COPD progression; new treatment may be on the horizon. New research has found that a process initiated in white blood cells known as neutrophils may lead to worse outcomes for some patients with chronic obstructive pulmonary disease (COPD). The discovery may help identify patients at higher risk for COPD progression, who might also show little benefit from standard treatments. (medicalxpress.com 15.5.2016).)

(Anm: Nytt KOL-test ska rädda liv. Identifieras lungsjukdomen KOL i ett tidigt skede skulle antalet som diagnostiseras öka med över 50 procent men dödligheten skulle minska. Genom ett extra utandningstest är detta möjligt. Den dödliga sjukdomen KOL, kroniskt obstruktiv lungsjukdom, är relativt vanligt och orsakas huvudsakligen av tobaksrökning. Sjukdomen leder till svår invaliditet och risken för tidig död ökar kraftigt. Det rapporterar Dagens nyheter. (netdoktor.se 6.5.2016).)

(Anm: COPD health-care delivery: a holistic and dynamic approach is needed. (…) The proposed stratification reflects a very traditional, provider oriented and static assessment approach. Particularly in the group with so-called simple COPD, medicalisation should be avoided: People should be empowered not only to actively adapt a healthy lifestyle, with smoking cessation and regular physical activity, but also to manage the diversity of factors, determinants, and contexts that can influence health.The Lancet Respiratory Medicine 2016;4(6)e30–e31 (June 2016).)

(Anm: Study reveals COPD linked to increased bacterial invasion. Chronic obstructive pulmonary disease (COPD) is a common smoking-related lung illness and the third leading cause of death in the United States. Scientists have long believed that inhaling toxic gases and particles from tobacco smoke causes inflammation of the small airways in the lungs, leading to the development of COPD. However, the theory doesn't explain why airway inflammation and disease progression continue even after the patient stops smoking. (medicalnewstoday.com 28.4.2016).)

(Anm: COPD may cause structural changes within the brain. Patients with COPD demonstrate decrease in areas of the brain that process breathlessness, fear, and sensitivity to pain. (medicalnewstoday.com 10.2.2016).)

(Anm: Avføring avslører: Vikingene ga oss KOLS. Forskerne har lenge diskutert hvorfor lungesykdommer som KOLS og emfysem forekommer så hyppig i dag. Nå viser det seg at de livsfarlige lungesykdommene stammer fra vikingene. (…) Proteinet førte i stedet til lungesykdommer A1AT skulle beskytte vikingene mot det enorme ormeangrepet de ble utsatt for, og virket proteinet som det skulle, ville det beskytte lungene og leveren mot de skadelige proteasene. Men var proteinet defekt, førte det til antitrypsinmangel, som er den prosessen som i dag fører til lungesykdommer som astma samt KOLS, pluss leversykdommer som skrumpelever. (historienet.no 10.2.2016).)

(Anm: Inflammatory bowel disease and risk of mortality in COPD. Eur Respir J. 2016 May;47(5):1357-64. Epub 2016 Feb 11.)

(Anm: Når håpet kveles. Morten Wanvik er syk i kroppen, men frisk i sinnet. Hans verste fiende er hans egne lunger. (…) Hvert år de siste årene har 60 personer stått i kø for å få nye lunger i Norge. Morten Wanvik er alvorlig syk, men er blant dem som ikke kommer seg inn i køen. Han har 18 prosent lungekapasitet igjen. (…) Lungen til venstre er frisk. Til høyre ser du en kols-lunge. (nrk.no 27.2.2016).)

(Anm: NICE recommends pulmonary rehabilitation programmes for patients with COPD. BMJ 2016;352:i768 (Published 08 February 2016).)

(Anm: Do asthma and COPD truly exist? Defining a patient's symptoms using the historical diagnostic labels of asthma and chronic obstructive pulmonary disease (COPD) is an outdated approach to understanding an individual's condition, according to experts writing in the European Respiratory Journal. (medicalnewstoday.com 29.1.2016).)

(Anm: New studies published in Nature Immunology further understanding of immune system in COPD and lupus (medicalnewstoday.com 26.4.2016).)

(Anm: Cardiac dysfunction during exacerbations of chronic obstructive pulmonary disease. Summary. Chronic obstructive pulmonary disease (COPD) and cardiovascular disease often coexist, and acute cardiac events frequently occur during COPD exacerbations. Even when cardiac complications are not clinically apparent, biochemical evidence of cardiac dysfunction is often noted during exacerbations and portends poor prognosis. Diagnosis of cardiac disease in COPD can be difficult and necessitates a high degree of clinical suspicion. However, the additional strain of an exacerbation could be a pivotal moment, during which previously unsuspected cardiac dysfunction is exposed. In this Review, we present evidence about cardiac involvement in exacerbations of COPD, and discuss diagnostic challenges and treatment opportunities. The Lancet Respiratory Medicine 2016;4(2):138–148 (February 2016).)

(Anm: Neuromuscular electrical stimulation to improve exercise capacity in patients with severe COPD: a randomised double-blind, placebo-controlled trial. The Lancet Respiratory Medicine 2016;4(1):27-36.)

(Anm: Researchers develop new method for looking into the lungs. For the first time, researchers have succeeded in producing 3D images showing oxygen and CO2 transport in the lungs. The new method provides hope for better treatment of COPD and lung cancer. (medicalnewstoday.com 21.12.2015).)

(Anm: A man with COPD, fever, and leucocytosis. A 68 year old man with severe chronic obstructive pulmonary disease (COPD), who was on home oxygen and still smoked, presented to the emergency room with fever, fatigue, and leucocytosis (14×109 white blood cells/L). Computed tomography was performed (fig 1⇓). What is the diagnosis? BMJ 2015;351:h6067 (Published 13 November 2015).)

(Anm: Leading researchers call for action on inhaled corticosteroid overuse in patients with COPD. A new study published in the International Journal of COPD highlights a problem with over-prescription of inhaled corticosteroids for low-risk patients with chronic obstructive pulmonary disease (COPD). (medicalnewstoday.com 19.10.2015).)

(Anm: Risiko for medfødte misdannelser etter eksponering for astmamedisin i første trimester av svangerskapet - en kohort koblingsstudie. ( Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy - a cohort linkage study. (…) CONCLUSION: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken.) BJOG. 2016 May 12. [Epub ahead of print].)

(Anm: Inhaled Corticosteroids Are Associated with Pneumonia in COPD Patients. David J. Amrol, MD reviewing Suissa S et al. Chest 2015 Nov. In a case-control study, discontinuing ICS in patients with chronic obstructive pulmonary disease lowered relative risk for pneumonia. Chronic obstructive pulmonary disease (COPD) guidelines recommend adding inhaled corticosteroids (ICS) when patients continue to have exacerbations while taking long-acting bronchodilators. However, ICS use in COPD patients is associated with excess risk for pneumonia and, in some studies, patients who discontinue their ICS exhibit little or no deterioration. Researchers performed a case-control study using the Canadian national healthcare database to determine if withdrawal of ICS in COPD patients leads to a shorter time to first severe pneumonia (i.e., causing death or hospitalization). NEJM 2015 (November 19, 2015).)

(Anm: pneumonia; pneumoni; (SML-artikkel) det samme som lungebetennelse. Kilde: Store norske leksikon.)

(Anm: Bacterial Pneumonia: Get the Facts (medicalnewstoday.com 26.8.2016).)
(Anm: Mycoplasma Pneumoniae: What You Need to Know (medicalnewstoday.com 26.8.2016).)

(Anm: Inflammatory markers linked with an increased risk of premature death in adults with COPD (medicalnewstoday.com 18.3.2015).)

(Anm: Inflammatory markers linked with an increased risk of premature death in adults with COPD (medicalnewstoday.com 18.3.2015).)

(Anm: Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), and chronic obstructive airway disease (COAD), among others, is a type of obstructive lung disease characterized by chronically poor airflow. (en.wikipedia.org).)

(Anm: Legemiddel som stjeler kvinners liv: Det er mer vanedannende enn heroin, med skremmende bivirkninger. Så hvorfor, 50 år etter lanseringen, forskrives fortsatt Valium til millioner av mennesker? (dailymail.co.uk 7.3.2013).)

Beroligende medisiner kan være farlig for fosteret
Nasjonalt folkehelseinstitutt 19.9.2005
Bruk av beroligende medisiner (f.eks. Vival, Valium eller Stesolid) under graviditet kan ha alvorlige virkninger på fosteret. Særlig uheldig er det hvis pillene kombineres med alkohol. Gravide med angst eller depresjon må derfor ta kontakt med lege for råd og ikke drive selvmedisinering med slike preparater. Dette er et av de resultatene som fremkommer i en fersk oversiktsartikkel fra Folkehelseinstituttet.

Disse farene har man vært klar over i mange år, men nå er det behov for å få ut denne kunnskapen på nytt til både gravide og helsepersonell.

Virkestoffet i Vival, Valium, Stesolid og flere andre typer beroligende medisiner er benzodiazepiner som ofte brukes ved behandling av generalisert angst og ved fobier. Benzodiazepiner er den enkelte gruppe av psykofarmaka som forskrives aller mest. Mange kan ha et gammelt pilleglass stående og reflekterer ikke over risikoen ved å bruke disse preparatene under svangerskap. (...)

- Risiko for medfødte misdannelser etter eksponering for astmamedisin i første trimester av svangerskapet - en kohort koblingsstudie.

Risk of congenital anomalies after exposure to asthma medication in the first trimester of pregnancy - a cohort linkage study. Risiko for medfødte misdannelser etter eksponering for astmamedisin i første trimester av svangerskapet - en kohort koblingsstudie.
BJOG. 2016 May 12. [Epub ahead of print]
(…) OBJECTIVE: To examine the effect of maternal exposure to asthma medications on the risk of congenital anomalies.

DESIGN: Meta-analysis of aggregated data from three cohort studies.

SETTING: Linkage between healthcare databases and EUROCAT congenital anomaly registries.

POPULATION: 519 242 pregnancies in Norway (2004-2010), Wales (2000-2010) and Funen, Denmark (2000-2010).

METHODS: Exposure defined as having at least one prescription for asthma medications issued (Wales) or dispensed (Norway, Denmark) from 91 days before to 91 days after the pregnancy start date. Odds ratios (ORs) were estimated separately for each register and combined in meta-analyses.

MAIN OUTCOME MEASURES: ORs for all congenital anomalies and specific congenital anomalies.

RESULTS: Overall exposure prevalence was 3.76%. For exposure to asthma medication in general, the adjusted OR (adjOR) for a major congenital anomaly was 1.21 (99% CI 1.09-1.34) after adjustment for maternal age and socioeconomic position. The OR of anal atresia was significantly increased in pregnancies exposed to inhaled corticosteroids (3.40; 99% CI 1.15-10.04). For severe congenital heart defects, an increased OR (1.97; 1.12-3.49) was associated with exposure to combination treatment with inhaled corticosteroids and long-acting beta-2-agonists. Associations with renal dysplasia were driven by exposure to short-acting beta-2-agonists (2.37; 1.20-4.67).

CONCLUSION: The increased risk of congenital anomalies for women taking asthma medication is small with little confounding by maternal age or socioeconomic status. The study confirmed the association of inhaled corticosteroids with anal atresia found in earlier research and found potential new associations with combination treatment. The potential new associations should be interpreted with caution due to the large number of comparisons undertaken. (…)

- Betennelsesdempende medisiner

Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion
CMAJ 2011; 183(15) (October 18)
Background: The association between the use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy and the risk of spontaneous abortion remains unclear because of inconsistent research results and the lack of evidence for an effect due to specific types or dosages of nonaspirin NSAIDs. We aimed to quantify the association between having a spontaneous abortion and types and dosages of nonaspirin NSAIDs in a cohort of pregnant women. (...)

Interpretation: Gestational exposure to any type or dosage of nonaspirin NSAIDs may increase the risk of spontaneous abortion. These drugs should be used with caution during pregnancy. (...)

(Anm: NSAID Use Is Associated with Elevated Risk for Bleeding in Patients with Atrial Fibrillation Receiving Antithrombotic Therapy Ann Intern Med 2014 Nov 18; 161:690.)

(Anm: Värktabletter kopplas till hjärtproblem. Det finns ett samband mellan en högre risk för hjärtsvikt och medicinering med värktabletter som Voltaren, Ipren och Magnecyl, enligt en ny stor studie. Studien som publicerats i British Medical Journal visar att personer, som inom de senaste 14 dagarna tagit så kallade NSAID-läkemedel, har en 19 procent högre risk för att tas in på sjukhus för hjärtsvikt, jämfört med personer som tagit tabletterna längre tillbaka i tiden. (dagensmedicin.se 30.9.2016).)

(Anm: Mange NSAID knyttet til hjertefeil. Many NSAIDs Associated With HF. 'A clear risk to some... and tighter regulation is justified'. (…) For the individual drugs, odds ratios ranged from 1.16 (95% CI 1.07-1.27) for naproxen to 1.83 (95% CI 1.66-2.02) for ketorolac, and were significant for the following: Diclofenac – Ibuprofen – Indomethacin – Ketorolac – Naproxen – Nimesulide – Piroxicam – Etoricoxib - Rofecoxib (medpagetoday.com 29.9.2016).)

(Anm: NSAID; non-steroidal anti-inflammatory drugs; Ikkesteroide antiinflammatoriske midler (no.wikipedia.org).)

(Anm: «Ufarlige» smertestillende knyttet til økt risiko for hjertestans. 'Harmless' Painkillers Associated With Increased Risk of Cardiac Arrest. Painkillers considered harmless by the general public are associated with increased risk of cardiac arrest, according to research published in the March issue of European Heart Journal - Cardiovascular Pharmacotherapy.1 Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs worldwide and some, including ibuprofen, are available over the counter. (pharmpro.com 16.3.2017).)

(Anm: Combination of NSAIDs and gastric protection can lead to inflammation in small intestine. Patients with inflammatory diseases are often prescribed non-steroidal anti-inflammatory drugs. They are also often recommended to use a proton pump inhibitor to protect their stomach. (news-medical.net 11 .4.2017).)

(Anm: Reseptfrie NSAID-er linkes til økt risiko for hjertestans, ifølge studie. Smertestillende legemidler som anses ufarlige for publikum er assosiert med økt risiko for hjertestans, ifølge forskning publisert i dagens utgave av European Heart Journal - Cardiovascular Pharmacotherapy. (…) Disse inkluderte de ikke-selektive NSAID-er (diclofenac, naproxen, ibuprofen) og COX-2-hemmere (rofecoxib celekoksib). Over-the-counter NSAIDs linked to elevated risk of cardiac arrest, study finds. Painkillers considered harmless by the general public are associated with increased risk of cardiac arrest, according to research published today in the March issue of European Heart Journal - Cardiovascular Pharmacotherapy. (…) These included the non-selective NSAIDs (diclofenac, naproxen, ibuprofen), and COX-2 selective inhibitors (rofecoxib, celecoxib). (news-medical.net 15.3.2017).

(Anm: Ibuprofen er knyttet til 31 % økning i risiko for hjertestans. Ibuprofen linked to 31% increase in risk of cardiac arrest. A study emerging from Denmark has found that the use of over-the-counter pain killer, Ibuprofen, is associated with an increased risk of cardiac arrest. In particular, the research warned against the view of nonsteroidal anti-inflammatory drugs (NSAID) as without risk and advised against people using the pain killers who had pre-existing cardiovascular problems. (…) Of those who were taking NSAIDs, the use of ibuprofen was associated with a 31% increase in the risk of cardiac arrest. As well as this, patients taking diclofenac, another NSAID – only available by prescription in the USA and the UK, were found to have a 50% increase in the risk of cardiac arrest. (pharmatimes.com 16.3.2017).)

(Anm: Kardiovaskulære risici ved behandling med nonsteroide antiinflammatoriske lægemidler (NSAID). KONKLUSION NSAID-behandling er associeret med en lang række kardiale komplikationer i form af destabilisering af blodtryksbehandling, hjertesvigt, myokardieinfarkt, atrieflimren, venøs tromboemboli, blødning ved kombinationsbehandling med antitrombotika og pludselig hjertedød. Selv korttidsbehandling synes at være associeret med en øget risiko, og særligt diclofenac har en uheldig risikoprofil. Dertil kommer, at der er en dosisrelateret øgning i de kardiovaskulære risici forbundet med NSAID-behandling, hvorimod den terapeutiske og smertestillende effekt ikke øges tilsvarende. NSAID-behandling frarådes derfor til patienter med hjerte-kar-sygdom, og anvendelse af diclofenac frarådes generelt. Ugeskr Læger 2016;178:V08160612.)

(Anm: Using NSAIDs during a cold may increase heart attack risk. Taking ibuprofen or other nonsteroidal anti-inflammatory drugs to help relieve cold or flu symptoms may seem harmless, but new research suggests otherwise. It could increase the risk of heart attack. Study co-author Dr. Cheng-Chung Fang, of the National Taiwan University Hospital, and colleagues recently reported their findings in The Journal of Infectious Diseases. (medicalnewstoday.com 6.2.2017).)

(Anm: NSAIDs offer little benefit for spinal pain, review finds. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen offer little more clinical benefit to patients with spinal pain than a placebo, a systematic review and meta-analysis has found. The review of 35 randomised placebo controlled trials involving 6065 people, published in the Annals of the Rheumatic Diseases,1 found that NSAIDs did provide some relief from pain and disability but found little evidence that they were more effective than placebo. Researchers found that, in every six patients treated with an NSAID, only one would benefit. BMJ 2017;356:j605 (Published 06 February 2017).)

(Anm: Demente rammes i højere grad af hjerte-kar-sygdom. Hjerteforeningen følger ministerens arbejde med handlingsplan om demens, der er essentiel for hjertepatienter også. Demens og hjerte-kar-sygdomme har fælles risikofaktorer, siger forskningschef. (hjerteforeningen.dk 3.10.2016).)

(Anm: NSAID-preparat farligt efter hjärtinfarkt. Antiinflammatoriska läkemedel av NSAID-typen är farligt ihop med blodförtunnare efter hjärtinfarkt. (lakemedelsvarlden.se 25.2.2015).)

(Anm: Vanlige smertestillende «øker risiko for hjertesvikt". (Common painkillers 'increase heart failure risk' (…) The British Medical Journal study looked at 10 million people, aged 77 on average, who took the drugs. (…) 'Use with caution' The British Heart Foundation (BHF) said patients should be on the lowest dose possible of NSAIDs for the shortest possible time.) (bbc.com 29.9.2016).)

(Anm: Vanlige smertestillende knyttet til svak økning i risiko for hjerteinfarkt. Common Painkillers Tied to Slight Rise in Heart Attack Risk. TUESDAY, May 9, 2017 (HealthDay News) -- Commonly used painkillers such as Motrin, Advil and Aleve might increase your risk for heart attack, even in the first week of use, a new study suggests. Overall, these drugs and others known as nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of a heart attack by 20 to 50 percent, compared with not using them, researchers found. (medicinenet.com 9.5.2017).)

(Anm: Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. (…) Conclusions The risk of hospital admission for heart failure associated with current use of NSAIDs appears to vary between individual NSAIDs, and this effect is dose dependent. This risk is associated with the use of a large number of individual NSAIDs reported by this study, which could help to inform both clinicians and health regulators. BMJ 2016;354:i4857 (Published 28 September 2016).)

(Anm: Gigtmedicin skal bruges med omtanke til hjertepatienter. (…) Læger, der udskriver gigtmedicin af typen NSAID (non-steroide anti-inflammatoriske lægemidler), bør være særligt opmærksomme på, at denne type medicin giver en øget risiko for hjertesygdomme hos patienter. Det drejer sig specifikt om produkterne Diclofenac, Ibuprofen og Naproxen. I produktresumeerne for de nævnte produkter, står det udførligt beskrevet, at disse midler er kontraindicerede ved svær hjerteinsufficiens. (laegemiddelstyrelsen.dk 17.3.2016).)

(Anm: Potential Hazards of Adding Nonsteroidal Anti-inflammatory Drugs to Antithrombotic Therapy After Myocardial Infarction. Time for More Than a Gut Check. JAMA. 2015;313(8):801-802. (February 24).)

(Anm: Aspirin: is it really a 'wonder drug'? (medicalnewstoday.com 29.10.2015).)

(Anm: Aspirin not an effective treatment for atrial fibrillation, study suggests. New research suggests that aspirin may not be as effective as previously believed for treating patients with atrial fibrillation. In fact, for patients who had a catheter ablation to lower their risk of stroke, the risks of using aspirin may outweigh the benefits. (…) In fact, the American College of Cardiologists report that more than 1 in 3 patients with A-fib who have an "intermediate-to-high" risk of stroke are treated with aspirin instead of oral blood thinners, even when medical guidelines advise the use of anticoagulants. (medicalnewstoday.com 15.5.2017).)

- Hvorfor aspirin kan være farlige for eldre mennesker.

(Anm: Why Aspirin May Be More Dangerous for Older People. (…) Studies have shown that low doses of the blood-thinner can significantly lower the risk of heart problems, especially among people who have already had a heart attack or stroke. But in a study published in the Lancet, researchers say that the risks of aspirin haven’t been properly studied in older people. Most of the studies showing the over-the-counter drug’s benefits have included younger people under 65 years. However, most people who are currently taking daily aspirin for their heart are older. (time.com 14.6.2017).)

(Anm: Bleeding Risks With Aspirin Use for Primary Prevention in Adults: A Systematic Review for the U.S. Preventive Services Task Force. (…) Conclusion: Consideration of the safety of primary prevention with aspirin requires an individualized assessment of aspirin's effects on bleeding risks and expected benefits because absolute bleeding risk may vary considerably by patient.Ann Intern Med. 2016 Apr 12. [Epub ahead of print].)

(Anm: Aspirin Therapy Fails to Reduce ARDS. —Rate at 7 days unchanged. (…) SAN FRANCISCO -- Initiating aspirin therapy to emergency room patients at risk of lung injury does not influence the chance that these patients will experience acute respiratory distress syndrome (ARDS), researchers reported here. (medpagetoday.com 17.5.2016).)

(Anm: OTC Antacids Linked to Bleeding Risk: The Pain Medicine News Report. Over-the-counter antacids that contain aspirin may increase the risk of serious bleeding, according to FDA reports. (medpagetoday.com 23.6.2016).)

(Anm: Antacid. An antacid is a substance which neutralizes stomach acidity, which in turn relieves heartburn, indigestion or stomach upset.[1] (en.wikipedia.org).)

Taking non-aspirin NSAIDs in early pregnancy doubles risk of miscarriage, study shows (Inntak av ikke-aspirin NSAID-er tidlig i svangerskapet dobler risiko for spontanabort)
BMJ 2011; 343:d5769 (9 September)
The risk of miscarriage among women who took any type and dosage of non-steroidal anti-inflammatory drug (NSAID), excluding aspirin, in early pregnancy is more than double that among pregnant women who did not, concludes a new study published in the journal of the Canadian Medical Association (CMAJ doi:10.1503/cmaj.110454).

The principal investigator, Anick Bérard, professor in the Faculty of Pharmacy at the University of Montreal, said, “We consistently saw that the risk of having a spontaneous abortion was associated with gestational use of diclofenac, naproxen, celecoxib, ibuprofen, and rofecoxib alone or in combination, suggesting a class effect. We did not see a dose-response relationship.”

The highest risk was associated with diclofenac alone, and the lowest risk was in users of rofecoxib alone, the researchers said. Naproxen was the most commonly used non-aspirin NSAID, followed by ibuprofen. (...)

(Anm: NSAID; non-steroidal anti-inflammatory drugs; Ikkesteroide antiinflammatoriske midler (no.wikipedia.org).)

(Anm: «Ufarlige» smertestillende knyttet til økt risiko for hjertestans. 'Harmless' Painkillers Associated With Increased Risk of Cardiac Arrest. Painkillers considered harmless by the general public are associated with increased risk of cardiac arrest, according to research published in the March issue of European Heart Journal - Cardiovascular Pharmacotherapy.1 Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs worldwide and some, including ibuprofen, are available over the counter. (pharmpro.com 16.3.2017).)

(Anm: Combination of NSAIDs and gastric protection can lead to inflammation in small intestine. Patients with inflammatory diseases are often prescribed non-steroidal anti-inflammatory drugs. They are also often recommended to use a proton pump inhibitor to protect their stomach. (news-medical.net 11 .4.2017).)

(Anm: Reseptfrie NSAID-er linkes til økt risiko for hjertestans, ifølge studie. Smertestillende legemidler som anses ufarlige for publikum er assosiert med økt risiko for hjertestans, ifølge forskning publisert i dagens utgave av European Heart Journal - Cardiovascular Pharmacotherapy. (…) Disse inkluderte de ikke-selektive NSAID-er (diclofenac, naproxen, ibuprofen) og COX-2-hemmere (rofecoxib celekoksib). Over-the-counter NSAIDs linked to elevated risk of cardiac arrest, study finds. Painkillers considered harmless by the general public are associated with increased risk of cardiac arrest, according to research published today in the March issue of European Heart Journal - Cardiovascular Pharmacotherapy. (…) These included the non-selective NSAIDs (diclofenac, naproxen, ibuprofen), and COX-2 selective inhibitors (rofecoxib, celecoxib). (news-medical.net 15.3.2017).

(Anm: Ibuprofen er knyttet til 31 % økning i risiko for hjertestans. Ibuprofen linked to 31% increase in risk of cardiac arrest. A study emerging from Denmark has found that the use of over-the-counter pain killer, Ibuprofen, is associated with an increased risk of cardiac arrest. In particular, the research warned against the view of nonsteroidal anti-inflammatory drugs (NSAID) as without risk and advised against people using the pain killers who had pre-existing cardiovascular problems. (…) Of those who were taking NSAIDs, the use of ibuprofen was associated with a 31% increase in the risk of cardiac arrest. As well as this, patients taking diclofenac, another NSAID – only available by prescription in the USA and the UK, were found to have a 50% increase in the risk of cardiac arrest. (pharmatimes.com 16.3.2017).)

(Anm: NSAIDs can cause changes to cell membranes; findings could have wide repercussions for drug developers (medicalnewstoday.com 25.8.2014).)

(Anm: Study examines NSAID use, risk of anastomotic failure following surgery (medicalnewstoday.com 21.1.2015).)

(Anm: Diklofenak og hjerteinfarkt (legemiddelverket.no 13.9.2006).)

(Anm: Diclofenac; fornorsket: diklofenak; markedsføres under handelsnavn som bl.a. Voltaren, Voltarol, Diclon, Diclodan, Dicloflex, Difen og Cataflam (pdr.net).)

(Anm: Vanlige smertestillende legemidler linket til en høyere risiko for hjerteproblemer. Common Pain Meds Are Linked to a Higher Risk of Heart Problems. Ibuprofen and other common painkillers are linked to an increased risk of cardiac arrest, according to a new Danish study published in the European Heart Journal—Cardiovascular Pharmacotherapy. The authors say these drugs should be used with caution and that people with heart problems may want to avoid them. (time.com 15.3.2017).)

(Anm: Diklofenak og ibuprofen er assosiert med øket risiko for hjertestans. Diclofenac and ibuprofen are associated with increased risk of cardiac arrest. Use of the non-steroidal anti-inflammatory drugs (NSAIDs) diclofenac and ibuprofen are associated with a significantly increased risk of cardiac arrest, a large Danish study has found. The authors of the study, which was reported in the European Heart Journal: Cardiovascular Pharmacotherapy,1 said that the findings were a stark reminder that NSAIDs were not harmless and should only be used after consulting a healthcare professional. BMJ 2017;356:j1358 (Published 16 March 2017).)

(Anm: Medisiner hjelper lite mot ryggsmerter. En ny studie viser at medisiner som Ibux og Voltaren ikke hjelper noe særlig mot akutte ryggsmerter. Eksperter mener det bør forskes mer på andre behandlingsmetoder. (nrk.no 4.2.2017).)

(Anm: Forskningschef: Gigtmidlet diclofenac bør ikke bruges. Hjerteforeningens forskningschef Gunnar Gislason mener, at der for hjertepatienter er høj risiko ved brugen af gigtmidlet diclofenac, og den modsvarer ikke effekten. (hjerteforeningen.dk 17.3.2016).)

(Anm: Diclofenac tablets now only available as a prescription medicine (medicalnewstoday.com 14.1.2015).)

Piller gir hjertefeil hos nyfødte
mozon.no 30.8.2006
Gravide som tar betennelsesdempende medisiner under svangerskapet, har større risiko for å føde barn med hjertefeil.

Medikamentene som faller inn under gruppen NSAID’er eller såkalte Cox-2-hemmere, er mye brukt som smertestillende ved revmatiske plager. Voltaren, Naproxen og Celebra er kjente preparater i Norge.

Undersøkelsen fra Canada er den første i sitt slag som konkluderer med at barn kan få hjertefeil dersom mor bruker slike medisiner i løpet av første rimester.Resultatene viser at kvinner som tok NSAID’er hadde dobbel så stor risiko for å få en baby med misdannelser, enn de kvinnene som ikke tok slike preparater. Risikoen for å få en baby med hull i hjertet eller delte hjertekamre var hele tre ganger så høy.

- Dersom disse resultatene stemmer, er dette viktig informasjon til vordende mødre. Rundt halvparten av alle graviditetene i USA er uplanlagte. Mange vet ikke at de er gravid før langt ut i første trimester, sier medisinsk direktør Nancy Green, til tidsskriftet WebMD.

Tidligere forskning viser at også blodtrykksmedisin kan gi hjertefeil hos nyfødte. (...)

(Anm: Diklofenak og hjerteinfarkt (legemiddelverket.no 13.9.2006).)

(Anm: Diclofenac; fornorsket: diklofenak; markedsføres under handelsnavn som bl.a. Voltaren, Voltarol, Diclon, Diclodan, Dicloflex, Difen og Cataflam (pdr.net).)

(Anm: Vanlige smertestillende legemidler linket til en høyere risiko for hjerteproblemer. Common Pain Meds Are Linked to a Higher Risk of Heart Problems. Ibuprofen and other common painkillers are linked to an increased risk of cardiac arrest, according to a new Danish study published in the European Heart Journal—Cardiovascular Pharmacotherapy. The authors say these drugs should be used with caution and that people with heart problems may want to avoid them. (time.com 15.3.2017).)

(Anm: Diklofenak og ibuprofen er assosiert med øket risiko for hjertestans. Diclofenac and ibuprofen are associated with increased risk of cardiac arrest. Use of the non-steroidal anti-inflammatory drugs (NSAIDs) diclofenac and ibuprofen are associated with a significantly increased risk of cardiac arrest, a large Danish study has found. The authors of the study, which was reported in the European Heart Journal: Cardiovascular Pharmacotherapy,1 said that the findings were a stark reminder that NSAIDs were not harmless and should only be used after consulting a healthcare professional. BMJ 2017;356:j1358 (Published 16 March 2017).)

(Anm: Medisiner hjelper lite mot ryggsmerter. En ny studie viser at medisiner som Ibux og Voltaren ikke hjelper noe særlig mot akutte ryggsmerter. Eksperter mener det bør forskes mer på andre behandlingsmetoder. (nrk.no 4.2.2017).)

(Anm: Forskningschef: Gigtmidlet diclofenac bør ikke bruges. Hjerteforeningens forskningschef Gunnar Gislason mener, at der for hjertepatienter er høj risiko ved brugen af gigtmidlet diclofenac, og den modsvarer ikke effekten. (hjerteforeningen.dk 17.3.2016).)

(Anm: Diclofenac tablets now only available as a prescription medicine (medicalnewstoday.com 14.1.2015).)

NSAID under graviditet
Institut for Rationel Farmakoterapi.
Nyheder fra irf.dk 26.9.2005
En artikel i Jyllandsposten 15. september 2005 kritiserede Lægemiddelstyrelsen og de praktiserende læger for ikke at være opmærksomme på risikoen for fosterskader, især hjertemisdannelser, hvis gravide indtager acetylsalicylsyre (ASA) eller NSAID i øvrigt. Det fremgår også, at den svenske lægemiddelstyrelse i en rapport har gjort opmærksom på dette. (...)

2 populationsstudier fra henholdsvis 2001 og 2003 viser en let øget risiko for præterm fødsel. Man har dog ikke med sikkerhed kunnet fastslå, om det er medicinen eller de gravides grundsygdom, der kan være årsagen (3,4). Studierne viste ingen øget risiko for malformationer, specielt ikke hjertemisdannelser.

2 svenske registerundersøgelser viste over en 3½-årig periode, at indtagelse af NSAID tidligt i graviditeten medførte en let øget risiko for hjertemisdannelser af ikke alvorlig art med en oddsratio (OR) på 1,86 (95% sikkerhedsgrænser 1,32-2,62) (5). Registerundersøgelserne var baseret på det svenske fødselsregister. En større undersøgelse fra samme register i perioden 1995-2001 viste en øget risiko for hjertemisdannelser generelt for NSAID med OR 1,24 (0,99-1,55), nonsignifikant. Der var kun en signifikant sammenhæng for naproxen: OR 1,7 (1,14-2,54) (6).Der foreligger desuden dyreforsøg, der viser en tydelig sammenhæng mellem NSAID-indtagelse tidligt i graviditeten og flere misdannelser. (...)

Konklusion
Indikationen for NSAID og ASA i 1. og 2. trimester må nøje overvejes. Risikoen for præmatur fødsel eller hjertemisdannelser er meget lille, hvis den er til stede. Derfor kan NSAID eller ASA anvendes i lavest mulig dosis i kortest mulig tid, hvis den gravide har smerter, inflammatorisk ledsygdom og lign. Anvendelse i 3. semester og ved fødslen er kontraindiceret. Det skyldes risikoen for præmatur lukning af ductus arteriosus, nyresygdom hos den nyfødte, blødningsproblemer og hæmning af den fødendes veaktivitet. (...)

Erytromycin

Erytromycin kan skade fosteret
Tidsskr Nor Lægeforen 6.7.2005
Gravide bør ikke få erytromycin tidlig i svangerskapet. Ifølge en ny svensk studie kan antibiotikumet gi hjertemisdannelser hos fosteret. (...)

Fetal valproate syndrome (FVS)

A male with fetal valproate syndrome and autism
Dev Med Child Neurol. 1997 Sep;39(9):632-4
Fetal valproate syndrome (FVS) is characterized by minor craniofacial anomalies, major organ malformations, and developmental delay. We report on a patient who has a clinical phenotype compatible with both FVS and autism. The presence of an autistic disorder in a previously reported case of FVS and similar findings in our patient suggest that a relation between this known teratogen and autism may exist. (...)

Narkotika

Flere blir født narkomane
dagsavisen.no 29.1.2007
Stadig flere barn blir født narkomane med sterke abstinenser. Prevensjon burde være et krav for å få metadon, mener fagfolk. (...)

'DES Daughters' Face Higher Breast-Cancer Risk

'DES Daughters' Face Higher Breast-Cancer Risk
healthfinder.gov 8.8.2006
In utero exposure to the synthetic estrogen is to blame, study says.

-- Women whose mothers took DES, a synthetic estrogen, while pregnant have nearly double the risk of breast cancer.

That's the main finding of a study published in the August issue of Cancer Epidemiology, Biomarkers and Prevention that compared women exposed to DES in utero to a group of comparably aged women who weren't exposed to the excess hormone levels. (...)

5 av 6 gravide går på medisiner

5 av 6 gravide går på medisiner
aftenposten.no 3.3.2008
Forskere kjenner ikke konsekvensene.
Forskerne er overrasket over at en så stor andel gravid bruker reseptbelagte medisiner. (...)

Ukjente konsekvenser
- Vi ser nå at en stor andel av kvinnene bruker reseptbelagte medikamenter under svangerskapet. Det hadde vi ikke ventet oss, sier professor II Anders Engeland ved Institutt for samfunnsmedisinske fag ved Universitetet i Bergen.
På sikt ønsker forskerne å studere nærmere eventuelle konsekvenser for fosteret.

I dag er denne kunnskapen meget begrenset ettersom det ikke er etisk forsvarlig å teste medisiner på gravide.

- Det finnes nesten bare resultat fra dyreforsøk tilgjengelig, og da kan man ikke være sikker på om effekten vil være den samme på et menneske, sier Engeland. (...)

Når det gjelder typen skade som fostret kan få, har forskningen i stor grad fokusert på risikoen for misdannelser, men effekten av forskjellige medikamenter kan også påvirke mental eller motorisk utvikling. Det kan bli oppdaget flere år etter fødselen.

Gravide må foreløpig vente noen år før legevitenskapen kan gi helt sikre råd i henhold til skadevirkninger. (...)

Diverse artikler

Hyperthyroid Drugs Tied to Birth Defects (Hyperthyroide legemidler knyttet til fødselsskader)
medpagetoday.com 20.10.2013
SAN JUAN -- Two of the most commonly used drugs for treating hyperthyroidism were linked to birth defects when used in early pregnancy, though they have differing effects, researchers reported here.

In an analysis of Danish national data, infants born to mothers taking propylthiouracil (PTU) early in pregnancy had about a 50% higher risk of birth defects, and those taking methimazole (MMI) had a 75% greater risk than children born to women in the general population not taking the drug, Peter Laurberg, MD, of Aalborg University Hospital in Denmark, and colleagues reported at the Amerian Thyroid Association meeting. (...)

Gravide trenger ikke stole på pakningsvedlegget
nrk.no 26.5.2013
Av etiske hensyn kan ikke medisiner prøves ut på gravide og ammende. Først når legemidlet har vært lenge på markedet, er det samlet nok kunnskap til å kunne si om gravide og ammende kan bruke medisinen. Derfor står det her i pakningsvedlegget 'bør unngås'.

– Stol mer på legen din enn tablettesken, råder legemiddelekspert. Gravide kan for eksempel ta allergimedisiner, noe mange ikke vet.

– Gravide får ofte motstridende råd og informasjon om legemidler, deriblant allergimedisiner, sier Helle Lindland-Tjønn ved regionalt legemiddelinformasjonssenter (RELIS) Sør-Øst, til NRK.no. (...)

– Forsiktig formulering i pakningsvedlegget skyldes at det er mangel på systematiske data, sier Steinar Madsen i Legemiddelverket. (...)

Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study (Foreldres depresjon, mors antidepressant bruk under svangerskapet, og risikoen forautismespekterforstyrrelser: befolkningsbasert kasus kontrollstudie (case-control study))
BMJ 2013;346:f2059 (19 April 2013)
(...) Objective To study the association between parental depression and maternal antidepressant use during pregnancy with autism spectrum disorders in offspring.
Design Population based nested case-control study.

Conclusions In utero exposure to both SSRIs and non-selective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability. Whether this association is causal or reflects the risk of autism with severe depression during pregnancy requires further research. However, assuming causality, antidepressant use during pregnancy is unlikely to have contributed significantly towards the dramatic increase in observed prevalence of autism spectrum disorders as it explained less than 1% of cases. (...)

Too Many Pills in Pregnancy (For mange piller for gravide)
nytimes.com 25.2.2013
well.blogs.nytimes.com The thalidomide disaster of the early 1960s left thousands of babies with deformed limbs because their mothers innocently took a sleeping pill thought to be safe during pregnancy.

In its well-publicized wake, countless pregnant women avoided all medications, fearing that any drug they took could jeopardize their babies’ development. (...)

SSRI Birth Defect Study Could be Misleading (Studie på SSRI-fødselsdefekter kan være misvisende)
lawyersandsettlements.com 16.1.2013
Boston, MA: While new research appears to excuse selective serotonin reuptake inhibitors (SSRI) antidepressants from concern over SSRI birth defects, the authors of previous studies raising concerns about potential birth defects noted a key component of the study that could be construed as misleading.

According to Parents (1/3/13), a study of 1.6 million women residing in Nordic countries exhibited a higher rate of stillbirth and infant death on behalf of study participants who took SSRI antidepressants while pregnant, against those participants who did not. However, research authors were quick to qualify that risk of SSRI side effects as stemming from factors other than SSRI drugs.

Dr. Olaf Stephansson told the Huffington Post that the increase in SSRI birth defects was due to “an increased proportion of smokers, older [maternal] age, diabetes and hypertensive disease.”

The clinical epidemiologist with Karolinska University Hospital in Sweden maintained the increased risks in SSRI Side Effects were attributable to the aforementioned risk factors, “and not the medication.”

Men ikke så fort, sier Dr. Adam Urato, leder for obstetrikk og gynekologi ved MetroWest Medical Center i Massachusetts. I en kommentarer til Huffington Post, bemerket dr. Urato at studien fokuserte på utleverte legemidler i motsetning til inntatte legemidler, og disse tallene er ofte ganske forskjellife," sa han. (But not so fast, says Dr. Adam Urato, the chair of Obstetrics and Gynecology at MetroWest Medical Center in Massachusetts. In comments to the Huffington Post, Dr. Urato noted the study focused on dispensed drugs as opposed to ingested drugs, “and these numbers are often quite different,” he said.)

According to Parents, data used in the study were gleaned from prescription registries, together with patient and birth registries in Denmark, Finland, Iceland, Norway and Sweden. And the choice of data has its supporters??"among them Dr. Katherine Moore, assistant professor of psychiatry with the Mayo Clinic. "This data is some of the best in the world [for] doing population-based research," she said, in comments published in Parents. "It integrates data from multiple sources: out-patient and in-patient, pharmacy records. This study offers additional evidence supporting the safety of SSRI use in pregnancy."

But that doesn’t placate Dr. Urato, who himself was an author on an earlier study published in November in Human Reproduction that found women who ingest SSRI drugs while pregnant may have a greater risk of complications including birth defects such as PPHN (persistent pulmonary hypertension of the newborn), premature birth and miscarriage.

Looking at dispensed drugs v. ingested selective serotonin reuptake inhibitors, noted Dr. Urato, could result in a woman being incorrectly classified as taking an SSRI (and having a good outcome), whereas in actual fact the woman may have belonged to the group classified as not taking an SSRI. (...)

Selective Serotonin Reuptake Inhibitors During Pregnancy and Risk of Stillbirth and Infant Mortality (Selektive serotoninreopptakshemmere under svangerskapet og risikoen for dødfødsel og spedbarnsdødelighet)
JAMA. 2013;309(1):48-54 (January 2, 2013)
Objective To study risk of stillbirth and infant mortality associated with use of SSRIs during pregnancy.

Design, Setting, and Participants Population-based cohort study from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) at different periods from 1996 through 2007. The study included women with singleton births. We obtained information on maternal use of SSRIs from prescription registries. Maternal characteristics, pregnancy, and neonatal outcomes were obtained from patient and medical birth registries.

Main Outcome Measures We used logistic regression to estimate relative risks of stillbirth, neonatal death, and postneonatal death associated with SSRI use during pregnancy taking into account maternal characteristics and previous psychiatric hospitalization. (...)

Conclusions and Relevance Among women with singleton births in Nordic countries, no significant association was found between use of SSRIs during pregnancy and risk of stillbirth, neonatal mortality, or postneonatal mortality. However, decisions about use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with ma ternal mental illness. (...)

Because the Nordic countries have similar nationwide registries of births and dispensed drugs, studies on the effect of medications on birth outcomes are possible. By using these data sources and taking into account previous psychiatric disease and maternal characteristics, we aimed to elucidate whether SSRI exposure during pregnancy was associated with increased risks of stillbirth, neonatal death, and postneonatal death. (...)

(Anm: SSRI Birth Defect Study Could be Misleading (Studie på SSRI-fødselsdefekter kan være misvisende) (lawyersandsettlements.com 16.1.2013).)

Legemiddelassistert rehabilitering (LAR):
Mangler kunnskap om effekt av legemidler brukt av gravide i LAR

fhi.no 17.12.2012
Mange pasienter i LAR, deriblant gravide, sliter med psykiske og fysiske problemer og får gjerne reseptbelagte legemidler i tillegg til LAR-legemidler (metadon og buprenorfin). Men effekten av LAR-legemidler på gravide og fostre er ikke sikkert fastslått, og det finnes enda mindre kunnskap om effekten av samtidig bruk av andre legemidler. Det viser resultater fra en studie Folkehelseinstituttet har deltatt i.

- Manglende kunnskap kan føre til at en del gravide i LAR ikke får legemidlene de trenger for psykiske og fysiske plager, mens andre gravide i LAR kanskje får legemidler som øker risiko for skade på fosteret, sier Marte Handal, forsker på Folkehelseinstituttet. (...)

(Anm: Prescription drug use among pregnant women in opioid Maintenance Treatment. Addiction. 2012 Aug 13. [Epub ahead of print].)

Antidepressants during pregnancy speed babies’ language development, study finds (Antidepressiva under graviditet fremskynder babyers språkutvikling, ifølge studien)
theglobeandmail.com 10.10.2012
Babies of mothers who took antidepressants such as Prozac, Zoloft and Celexa during pregnancy show signs of early language development, according to a study from the University of British Columbia.

In contrast, babies of depressed mothers who were not treated with the most widely prescribed class of antidepressant drugs (selective serotonin reuptake inhibitors or SSRIs) show a delayed ability to attune to their native language, researchers found.

In the study, published on Monday in the Proceedings of the National Academy of Sciences, babies were divided into three groups: those exposed to SSRIs in utero, those of depressed mothers who weren’t on SSRIs and those of mothers with no symptoms of depression.

Researchers tested how the babies responded to language at 36 weeks gestation, by measuring their heart rates, and at six and 10 months after birth, by measuring changes in heart rate and eye movement in response to sounds and videos of people talking in the babies’ native and non-native tongues.

Janet Werker, a psychology professor at UBC and senior author of the study, explains that babies begin to respond to the sounds of language and the facial movements of talking very early in life. At about nine months of age, however, babies typically begin to ignore the consonants used in languages other than their native tongue as they focus on learning their native language.

In this aspect of language development, babies exposed to SSRIs were “at least three months advanced,” Werker says.

But she notes that this accelerated learning “isn’t necessarily a good thing.” The study looked at only a few measures of the larger system of language acquisition. If some aspects progress before others, there is a risk of mistiming in the language system, which could affect overall language development, she explains. (...)

Zoloft is Linked To Heart Defects and Circulatory Issues in Newborns (Zoloft er knyttet til hjertefeil og sirkulasjonsproblemer hos nyfødte)
injurylawyer-news.com 4.9.2012
Zoloft was introduced in the United States in 1991 and is one of the most popular medications prescribed to treat depression, obsessive-compulsive disorders, panic disorders, and anxiety disorders. Studies subsequent to its release have underlined the potential for side effects, especially for pregnant women and the risk of birth defects from Zoloft.

Serious side effects can result when taking antidepressants while pregnant. Selective serotonin reuptake inhibitors (SSRIs) are particularly notable among antidepressants as serotonin plays a role in the formation of cardiac tissue. Zoloft is an SSRI antidepressant that has been linked to heart defects and circulatory issues in babies born to mothers who were taking the drug during their pregnancy. (...)

Antipsychotics in Pregnancy Up Diabetes Risk (Antipsykotika under svangerskapet øker diabetesrisiko)
medpagetoday.com 2.7.2012
Kvinner som tok antipsykotiske medikamenter under svangerskapet - også de legemidlene som antas å ha mindre potensial for uønskede metabolske effekter - hadde økt risiko for å utvikle diabetes og å føde små spedbarn, ifølge forskerne. (Women who took antipsychotic drugs during pregnancy -- including those drugs thought to have less potential for unwanted metabolic effects -- were at increased risk for developing diabetes and giving birth to small infants, researchers said.)

Analyse av nasjonale svenske fødsel- og helseregisterdata viste at risikoen for svangerskapsdiabete hos mødre i forhold til de som ikke tok antipsykotiske medisiner var nesten fordoblet, ifølge Robert Boden, MD, PhD, ved Uppsala Universitet i Uppsala, Sverige, og kolleger. (Analysis of Swedish national birth and health registry data showed that, relative to mothers-to-be not taking antipsychotic drugs, the risk of gestational diabetes was nearly doubled, according to Robert Bodén, MD, PhD, of Uppsala University in Uppsala, Sweden, and colleagues.)

Forskerne fant også at visse antipsykotika var forbundet med uvanlig store hoder hos nyfødte etter justering for mors karakteristika som status for røyking, ifølge juliutgaven av Archives of General Psychiatry. (...) (The researchers also found that certain antipsychotics were associated with unusually large heads in newborns, after adjusting for maternal characteristics such as smoking status, they reported in the July issue of Archives of General Psychiatry.)

– Screening for livmorhalskreft kan gi alvorlige bivirkninger
nrk.no 28.4.2012
En norsk professor i helseledelse mener at kvinner får for dårlig informasjon når de testes for kreft i livmorhalsen.

Screening for livmorhalskreft kan føre til senabort og for tidlig fødsel. Få kvinner blir informert om dette, hevder helseprofessor. Men Kreftregisteret mener at screeningen er viktig.

Internasjonalt er livmorhalskreft den tredje største kreftformen som rammer kvinner, og den vanligste kreftsykdommen hos kvinner under 35 år.

Sykdommen er spesielt et folkehelseproblem blant dem som har mange seksualpartnere i fattige land med dårlig helsevesen.

Hos oss er problemet mindre omfattende. Likevel rammes rundt 300 kvinner i Norge hvert år, og 100 dør på grunn av sykdommen. Kreften skyldes infeksjon med HPV-virus. (...)

Men screeningen har flere og til dels alvorlige bivirkninger, ifølge Ivar Sønbø Kristiansen. Han er professor i helseledelse og helseøkonomi ved Universitetet i Oslo, og gjesteforsker ved Stanford-universitet i USA. (...)

– Men inngrepet kan også føre til senabort og for tidlige fødsler ved fremtidige svangerskap. Dette står det ingenting om verken på screeningprogrammets nettside eller i invitasjonsbrevet som Kreftregisteret sender ut til norske kvinner, påpeker Kristiansen.

Over halvparten av kvinnene som får utført konisering er under 35 år, og for dem kan senere svangerskap være aktuelt. (...)

Avviser kritikken
Det er besynderlig å påstå at frykten mot livmorhalskreft er skapt av screeningprogrammet, mener direktør Giske Ursin i Kreftregisteret.

– Kristiansen burde lære seg litt mer om livmorhalskreft, sier direktøren for Kreftregisteret, professor Giske Ursin.

– På verdensbasis er dette den tredje viktigste årsaken til kreftdød, og i en del fattige land er dette kreftformen flest kvinner dør av. (...)

Birth defects more common in IVF babies: study
reuters.com 19.4.2012
(Reuters Health) - Babies conceived through certain fertility treatment techniques are about one-third more likely to have a birth defect than babies conceived without any extra help from technology, according to a new review of several dozen studies.

The report "confirms what most people accepted anyway, that, yes, there is an increased risk in congenital abnormality associated with assisted reproductive technology," said Dr. William Buckett, a professor at McGill University, who was not involved in the study. (...)

(Anm: In vitro-fertilisering (IVF) (prøverørsbefruktning) (no.wikipedia.org).)

Hormoneksponering in utero gir økt helserisiko
Tidsskr Nor Legeforen 2012; 132:645 (17.4.2012)
Dietylstilbøstrol gitt under svangerskapet gir økt sykdomsrisiko hos jentebarn. Det viser en studie med oppfølgingstid på rundt 50 år.

Gjennom flere tiår før 1970 ble mange millioner kvinner behandlet med dietylstilbøstrol for å hindre tidligabort. Denne praksisen tok slutt etter at det ble påvist betydelig økt risiko for vaginalt adenokarsinom hos disse kvinnenes jentebarn. Originalstudien er blitt stående som en klassiker innen kreftepidemiologi (1).

Nå foreligger det en oppfølgingsstudie med 4 653 eksponerte og 1 927 ueksponerte jentebarn. Observasjonstiden var opptil 55 år for enkelte utfall (2). Alle mål for reproduktiv helse ga høyere hasardratio etter dietylstilbøstroleksponering in utero: infertilitet, ektopisk svangerskap, spontan- og senabort, preeklampsi, prematur fødsel og perinatal død. Eksponerte kvinner hadde tidligere menopause og høyere forekomst av cervikal cancer in situ (CIN2+) og brystkreft etter fylte 40 år.

Forklaringen på den ekstra høye tilleggsrisikoen for prematur fødsel er mest sannsynlig at dietylstilbøstroleksponerte kvinner har en medfødt stump og kort portio, noe som øker forekomsten av spontanabort, senabort og prematur fødsel. En tid var det vanlig å anlegge forebyggende cerclage når disse kvinnene ble gravide.

For enkelte av analysene ble dietylstilbøstroleksponerte kvinner stratifisert i dem som hadde og dem som ikke hadde tegn på vaginale epitelcelleforandringer. Begrunnelsen var at slike celleforandringer ble oppfattet som en biologisk markør for dosestørrelse og tidspunkt for dietylstilbøstrolbehandling i svangerskapet. Resultatene viste gjennomgående økt risiko for alle studerte utfall. Studien viser betydningen av gode eksponeringsdata og lang oppfølgingstid av forventede og uventede utfall. (...)

Psychiatric Medication For Children? Important New Book Gives Pause
boston.com 14.4.2012
Two things most stood out for me in Kaitlin Bell Barnett's new book Dosed: The Medication Generation Grows Up. The first is the stories of women struggling to get off of SSRI's, started in early adolescence, when they decide to get pregnant. The second is Bell Barnett's review of the literature regarding sexual dysfunction as a side effect of SSRIs in adolescence.

The book as a whole has much to say that is very important. As I write in my blurb for the cover:

Dosed is a fascinating, well-researched, and very important book. After reading it, I hope that no parent, pediatrician or psychiatrist will give psychiatric medication to a child or adolescent without very careful consideration of the potential long-term consequences. Bell Barnett shows that these medications are often not a ‘quick fix,’ but rather have deep, lasting impact, not only on physical and emotional health, but also on a person’s core sense of self.

Bell Barnett is a journalist who was herself started on SSRIs as a teenager. Her book intertwines in depth interviews with people who were started on psychiatric medication in childhood and are now young adults, with a journalistic study of the history of psychiatric medication use in children. I could probably write several posts covering all the important issues she addresses, but have chosen to focus on these two.

I first learned of the emerging evidence that SSRIs may cause long term sexual dysfunction last fall when I attended a talk by Robert Whitaker, author of the controversial book about psychiatric illness and medication Anatomy of an Epidemic. I was so alarmed about this data that I wanted to immediately write a blog post about it. But shortly after that talk I received the galleys of Bell Barnett's book. I discovered that she has a through review of the rather scant literature on the subject along with some very poignant stories, so I decided to wait until her book came out. I recommend that anyone who is concerned about this issue (as anyone who takes or prescribes these drugs should be) read her book. The subject is covered in the chapter entitled "Side Effects." Here are a few sample quotes.

A comprehensive review of the literature conducted in 2004 found just one clinical trial that reported erectile dysfunction in a teenager; most clinical guidelines and reviews of SSRIs didn't mention sexual side effects at all.

This is pretty shocking since, as the authors of the study cited above noted, anywhere from 30-40 percent of adults experience some kind of SSRI induced problems with libido, arousal, or orgasm. (...)

Disse medisinene er trygge
dagbladet.no 27.3.2012
Antidepressiver øker ikke risikoen for fosterskader eller for tidlig fødsel, viser ny norsk studie. (...)

Ved bruk av alle legemidler vil gravide, leger og farmasøyter være ekstra forsiktige fordi eventuelle bivirkninger også går utover et lite liv i magen til mor.

Professor i farmasi ved Universitetet i Oslo, Hedvig Marie Egeland Nordeng, mener den nye mor/barn-studien kan hjelpe mange kvinner som lider av depresjoner.

- Studien er så viktig fordi usikkerheten og engstelsen ved å måtte bruke antidepressiva i svangerskapet er så stor. Avgjørelsen om å bruke disse medikamentene er ikke lett, og denne studien vil bidra til å bedre kunnskapsgrunnlaget for slike avgjørelser, påpeker hun. (...)

Pregnancy Outcome After Exposure to Antidepressants and the Role of Maternal Depression: Results From the Norwegian Mother and Child Cohort Study
Nordeng H, van Gelder MM, Spigset O, Koren G, Einarson A, Eberhard-Gran M.
J Clin Psychopharmacol. 2012 Apr;32(2):186-194.
ABSTRACT: Results of previous studies on the safety of antidepressants during pregnancy have been conflicting. The primary objective of this study was to investigate whether first-trimester exposure to antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), was associated with increased risk of congenital malformations. The secondary objective was to examine the effects of exposure to antidepressants during pregnancy on birth weight and gestational age.We included 63,395 women from the Norwegian Mother and Child Cohort Study. The women had completed 2 self-administered questionnaires at gestational weeks 17 and 30 on medication use and medical, sociodemographic, and psychological factors. Data on pregnancy outcome were retrieved from the Medical Birth Registry of Norway.Of the 63,395 women, 699 (1.1%) reported using antidepressants during pregnancy, most frequently SSRIs (0.9%). Exposure to SSRIs during the first trimester was not associated with increased risk of congenital malformations in general (adjusted odds ratio [OR], 1.22; 95% confidence interval [CI], 0.81-1.84) or cardiovascular malformations (adjusted OR, 1.51; 95% CI, 0.67-3.43). Exposure to antidepressants during pregnancy was not associated with increased risk of preterm birth (adjusted OR, 1.21; 95% CI, 0.87-1.69) or low birth weight (adjusted OR, 0.62; 95% CI, 0.33-1.16).This study does not suggest a strongly increased risk of malformations, preterm birth, or low birth weight following prenatal exposure to antidepressants. Without adjustments for level of maternal depression and various sociodemographic and lifestyle factors, antidepressant use during pregnancy would wrongly have been associated with an increased risk of preterm birth. (...)

Antidepressiva og svangerskap
fhi.no 19.3.2012
Over en prosent av gravide i den norske mor- og barnstudien (MoBa) brukte medisiner mot depresjon i svangerskapet. For noen gravide er slik behandling nødvendig, men er dette trygt for fosteret? I en ny delstudie fra MoBa er det ikke vist noen økt risiko for medfødte fosterskader, for tidlig fødsel eller lav fødselsvekt etter bruk av antidepressiva.

Nesten 700 av over 63 000 deltakere i denne MoBa-studien brukte medikamenter mot depresjon mens de var gravide. Litt over 1000 kvinner brukte slike medisiner de siste seks måneder før svangerskapet, men sluttet når de ble gravide. Samlet sett fant man ingen økning av fosterskader, lav fødselsvekt eller for tidlig fødsel etter bruk av antidepressiva. Flere typer antidepressiva var benyttet, men moderne antidepressiva (SSRI) var de klart mest brukte. Ingen av enkeltmedisinene ga økt risiko for uheldige effekter i svangerskapet. Heller ikke tidsrommet for når legemidlene ble brukt så ut til å ha noen betydning. (...)

Pregnant Women on Antidepressants Less Likely to Breastfeed (Mindre sannsynlig at gravide kvinner på antidepressiva gir brystmelk)
health.ucsd.edu 8.3.2012
Researchers Say Results Show Need for Additional Breastfeeding Support and Education

Researchers at the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a statewide non-profit organization based at the University of California, San Diego School of Medicine, have found women exposed to certain antidepressants during pregnancy were significantly less likely to breastfeed their babies compared to unexposed women. The results of the study were recently published online in The Journal of Human Lactation.

The study uses data obtained by counselors at the CTIS Pregnancy Health Information Line, a toll-free service offering evidence-based clinical information about exposures during pregnancy and breastfeeding. It focused on 466 pregnant women who contacted the CTIS Pregnancy Health Information Line over a ten year period with questions about a wide variety of exposures and, after being counseled, agreed to participate in a follow-up study of their pregnancy outcome.

The study specifically examines breastfeeding choices of women exposed to selective serotonin reuptake inhibitor (SSRI) antidepressants at the time of delivery, compared to those who discontinued use of antidepressants earlier in pregnancy, as well as to those women who report not taking antidepressants at all. The results showed women exposed to an SSRI anytime in pregnancy were about 60 percent less likely to initiate breastfeeding than women who took no antidepressant. (...)

– Det er bra det fødes flere barn med Downs i Norge
nrk.no 19.12.2011
I Sverige og Danmark velges barn som Ludvik bort, men i Norge opplever flere foreldre å få barn med Downs syndrom.

Det har vært en økning av antall barn som fødes med Downs syndrom i Norge. I våre naboland er det en nedgang. Der velges slike barn bort under graviditeten. (...)

Antall foreldre som får barn med Downs syndrom øker i Norge. På 1980-tallet ble det årlig født 40-60 barn med Downs syndrom, mens fra 1999 til 2009 ble det årlig født 60-80 barn med Downs syndrom.

Leder av foreningen Ups and Downs Telemark Mette Witemeyer er glad det fødes flere barn med Downs syndom i Norge enn i våre naboland. (...)

Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: Drug Safety Communication - Use During Pregnancy and Potential Risk of Persistent Pulmonary Hypertension of the Newborn
fda.gov 12.12.2011
Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); Viibryd (vilazodone) (...)

ISSUE: FDA notified healthcare professionals and the public on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women during pregnancy and the potential risk of a rare heart and lung condition known as P ersistent Pulmonary Hypertension of the Newborn (PPHN). The initial Public Health Advisory in July 2006 on this potential risk was based on a single published study. Since then, there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.
FDA has reviewed the additional new study results and has concluded that, given the conflicting results from different studies, it is premature to reach any conclusion about a possible link between SSRI use in pregnancy and PPHN. FDA will update the SSRI drug labels to reflect the new data and the conflicting results.

BACKGROUND: SSRIs are marketed under various brand and generic drug names, and are used to treat depression and other psychiatric disorders. There are no adequate and well-controlled studies of SSRIs in pregnant women.

PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with PPHN may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage, and even death.

RECOMMENDATION: FDA advises health care professionals not to alter their current clinical practice of treating depression during pregnancy. See the Data Summary in the FDA Drug Safety Communication for additional information. (...)

(Anm: FDA Drug Safety Communication: Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies. (fda.gov 12.12.2011).)

Pfizer sued by parents claiming Zoloft use caused birth defects
madisonrecord.com 30.11.2011
The ingestion of Zoloft during pregnancy led eight different couples to parent children born with various birth defects, according to a recently filed lawsuit that name the drug's manufacturer as a defendant. (...)

Bivirkninger om lykkepiller blev skjult
b.dk 27.10.2011
Medicinalfirmaer politianmeldes for at tie om døde babyer

Medicinalfirmaer har skjult, at kvinder risikerer aborter, dødfødte babyer og misdannede børn, hvis de spiser lykkepiller under graviditeten. (...)

Producenterne blev i juni pålagt at advare om bivirkningerne efter, at det var kommet frem, at myndighederne havde fået 51 indberetninger om alvorlige bivirkninger ved lykkepiller fra danske gravide. Herunder 12 indberetninger om aborter og fosterdød og fire om døde babyer. (...)

Det er jo ganske alvorlige bivirkninger, som de skulle fortælle om - bl.a. at gravide risikerede misdannede babyer og at abortere?

- Ja, når vi advarer er det jo alvorligt. Derfor har vi krævet, at de trækker de pakninger tilbage, hvor advarslen ikke står på indlægssedlen, siger afdelingschef Anne-Marie Vangsted til B.T.

Foreningen for den danske medicinalbranche LIF er særdeles fåmælte om sagen.

- Ingen kommentarer, skriver kommunikationschef Lars Bech Pedersen i en sms. (...)

Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: a retrospective cohort study
BMJ 2011; 343:d5931 (18 October)
(...) Objective To examine a reported association between use of angiotensin converting enzyme (ACE) inhibitors during the first trimester and risk of malformations in offspring. (...)

Conclusions Maternal use of ACE inhibitors in the first trimester has a risk profile similar to the use of other antihypertensives regarding malformations in live born offspring. The apparent increased risk of malformations associated with use of ACE inhibitors (and other antihypertensives) in the first trimester is likely due to the underlying hypertension rather than the medications. (...)

(Anm: Editorial. Fetal risk from ACE inhibitors in the first trimester. BMJ 2011; 343:d6667 (18 October).)

Mom Says Taking Zoloft Killed Her Newborn (Mor sier Zoloft tok livet av hennes nyfødte)
courthousenews.com 4.10.2011
CLEVELAND (CN) - Parents claim the anti-depressant Zoloft caused their newborn son to die of anencephaly - lack of a great part of his brain - 18 hours after he was born, and that Pfizer, the world's biggest drug company, covered up studies that documented the fatal side effect.

Susan and James Hodge sued Pfizer and Cardinal Health in the Cuyahoga Court of Common Pleas.

Anencephaly is a fatal neural tube defect, "generally described as the absence of a large part of the brain and skull," according to the complaint.

Zoloft is an antidepressant in the class of selective serotonin reuptake inhibitors. (...)

Women and Depression - Full Disclosure of Drug Risks Required
chicago-land.injuryboard.com 22.8.2011
Women who find themselves at crossroads in their life in terms of career and family often find themselves depressed and looking for help which often leads to the use of antidepressants. In fact, women between the ages of 25 and 44 incur a higher rate of depression than any other group with some estimating that 1 in 10 women in America are taking antidepressants. The most widely prescribed antidepressants belong to a class of medication known as selective serotonin reuptake inhibitors (SSRIs), and include such well known antidepressants such as Prozac, Zoloft and Paxil.

Although SSRIs have been known to help some when combined with therapy and exercise, women of this age have the added complexity of potentially risking the health of a yet unborn child with the use of SSRIs. And the awful truth is that most women don’t know of these risks.

It is imperative that women in this age group get full disclosure of the risk of fetal birth defects In order to do a proper risk-benefit analysis of whether SSRI’s are an appropriate answer for their symptoms. (...)

Paroxetine is associated with malformation during pregnancy (Paroxetine (Seroxat; Paxil) er knyttet til misdannelser under svangerskapet)
BMJ 2011; 343:d5060 (10 August)
In their clinical review of the diagnosis and management of premenstrual disorders O’Brien and colleagues state1: “Obviously, some patients may become pregnant while taking SSRIs [selective serotonin reuptake inhibitors] and these drugs have not been shown to be teratogenic” with a reference to an article reviewing the adverse effects of SSRIs in pregnancy.2 This is incorrect and is inconsistent not only with the reference provided but also with both the label (black box warning and the pregnancy category D labelling) and the wider literature. Tuccori et al in fact state:

“Paroxetine has been associated with significant risks of major malformation, particularly cardiac defects, when used during pregnancy.

“Significant associations between maternal exposure to SSRIs and both persistent pulmonary hypertension of the newborn and a self-limiting neonatal behavioral syndrome have been reported in a number of recent original studies and meta-analyses.”2

They correctly conclude: “The available evidence suggests that SSRIs and other serotonergic/noradrenergic antidepressants should be used with caution during pregnancy, with careful follow-up of infants exposed to these agents in utero.”

Evidence shows SSRIs to be teratogenic in early pregnancy.3 Concerns about the effects on child development are emerging with a recent signal of a potential link with autistic spectrum disorder.4 5 This is important information for clinicians and patients to be aware of when use is in women of reproductive age. Women need to be warned of these potential adverse events when these medicines are prescribed. (...)

Genetics May Affect Fetal Susceptibility to SSRIs' Pulmonary Effects
familypracticenews.com 8.8.2011
(...) Previous studies have determined that maternal use of this class of drugs has a variety of deleterious effects on the infant, including low birth weight, prematurity, and a type of withdrawal syndrome characterized by irritability and jitteriness.

"But interestingly, there is also a link with respiratory distress, which tends to be more like a TTN [transient tachypnea of the newborn]-type respiratory distress, and also, there have been case reports of primary pulmonary hypertension," he noted.

The pathogenesis of these pulmonary abnormalities is unclear. "We do know that serotonin itself is a very powerful vasoconstrictor, but it has differential effects in different tissues," Dr. Lim explained.

Preclinically, serotonin impairs lung fluid resorption, suggesting that SSRI-exposed infants may be unable to reabsorb lung fluid after birth; one SSRI has been found to increase arterial smooth muscle cell proliferation. (...)

Results were based on 23 women taking SSRIs (predominantly fluoxetine) and 32 control women. They were 33 years old, on average. Only a single woman in each group smoked during pregnancy. Those in the SSRI group had higher scores for depression.

At delivery, the gestational age was significantly younger in the SSRI-exposed group (39.0 vs. 40.0 weeks). Additionally, the SSRI-exposed infants had a smaller head circumference (34.1 vs. 35.0 cm) and poorer Apgar scores at 1 minute (7.5 vs. 8.4).

Infants in the SSRI-exposed group also were more likely to have respiratory distress (30% vs. 3%) and jitteriness (39% vs. 3%).

"These are all things that have been previously documented, so basically, these kids are behaving the way that we expect from previous studies," commented Dr. Lim.
When it came to fetal right pulmonary artery parameters, there were no significant differences between SSRI-exposed and SSRI-nonexposed groups, or between morning and afternoon within the exposed group, in terms of pulsatility index, resistance index (a measure of blood flow impedance in the artery), peak systolic velocity, diameter, area, and flow.

However, within the SSRI-exposed group, fetal right pulmonary artery flow was higher for infants who experienced respiratory distress in the neonatal period than for those who did not, with a value of approximately 280 mL/min vs. 175 mL/min (P = .03).

Dr. Lim reported no relevant financial disclosures. (...)

(Anm: What controls blood flow in the brain? (…) In a paper published on June 25 in Neuron, Yale University scientists present the strongest evidence yet that smooth muscle cells surrounding blood vessels in the brain are the only cells capable of contracting to control blood vessel diameter and thus regulate blood flow. This basic anatomical understanding may also have important implications for phenomena observed in stroke and migraines. (medicalnewstoday.com 24.6.2015).)

Antidepressant Use During Pregnancy Linked to Higher Risk of Autism (Bruk av antidepressiva under svangerskapet linket til høyere risiko for autisme)
healthland.time.com 5.7.2011 (Time)
Children whose mothers use antidepressants during pregnancy may be more likely to develop autism than kids whose mothers do not, say researchers in California.

In a study involving data on more than 1,800 children — fewer than 300 of whom had an autism spectrum disorder (ASD) — and their mothers, the scientists found that women who were prescribed drugs to treat depression in the year before giving birth were twice as likely to have children with an ASD, compared with women who did not take antidepressants. The risk was even greater for women who were prescribed the drugs in the first trimester: their children were nearly four times more likely to develop autism or a related disorder.

The study focused on one type of antidepressant, selective serotonin reuptake inhibitors (SSRIs), a class of drug that includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). These antidepressants work by increasing available levels of the neurotransmitter serotonin surrounding nerve cells in the brain, which helps boost mood. (...)

(Anm: Antidepressant Use During Pregnancy and Childhood Autism Spectrum Disorders (Bruk av antidepressiva under svangerskapet og autisme). Arch Gen Psychiatry 2011 (Published online July 4).)

Can an increased risk of autism be linked to Paxil? (Kan en øket risiko for autisme linkes til Seroxat (paroxetine)?)
central-pennsylvania.injuryboard.com 15.3.2012
Late last year, a study was published in the Archives of General Psychiatry that suggests a possible link between autism spectrum disorders (ASDs) and maternal use of antidepressant medications during pregnancy. The study—although inconclusive as to a causal link between the two—has gotten quite a bit of attention for the advances it makes in furthering our understanding of what causes ASDs.

The study was aimed at determining whether prenatal exposure to antidepressant medications can be associated with an increased risk of ASD. It was a relatively small study, involving only about 300 children with ASD and 1500 randomly selected children without ASD. The authors concluded that the results suggest that exposure to SSRIs—especially during the first trimester—may “modestly increase the risk of ASD.” The researchers also underscored the need for further studies on this issue, particularly given this study’s small size. (...)

More Evidence SSRIs in Pregnancy Boost Birth Defect Risk
medscape.com 28.6.2011
June 28, 2011 — A study from Finland provides more evidence that exposure to selective serotonin reuptake inhibitors (SSRIs) in the first trimester of pregnancy increases the risk for major congenital anomalies, particularly cardiac defects.

In the study, use of fluoxetine in early pregnancy was associated with about a 2-fold increased risk for isolated ventricular septal defects, whereas paroxetine was associated with more than a 4-fold increased risk for right ventricular outflow tract defects. (...)

Some small risks to antidepressants in pregnancy
reuters.com 24.6.2011
(Reuters Health) - Two antidepressants appear to be associated with a small risk of birth defects, according to a new analysis based on national data from Finland.
Specifically, the researchers found that women taking fluoxetine (Prozac) and paroxetine (Paxil) were slightly more likely to give birth to babies with specific types of heart defects. (...)

The data have so far been somewhat conflicting, although some studies have already linked SSRIs to higher-than-average, though small, risks of certain birth defects. One study of nearly half a million Danish children found an increased risk of heart defects among those whose mothers had used SSRIs such as fluoxetine (Prozac), but also sertraline (Zoloft) and citalopram (Celexa).

Last year, a study among 12,700 U.S. infants found that mothers who used bupropion (Wellbutrin) during early pregnancy had more than double the risk of heart defects known as left outflow tract defects, compared with infants whose mothers had not used the drug.

During the latest study, Malm and her colleagues reviewed national data collected about 635,583 births that occurred between 1996 and 2006.

They found that mothers who took fluoxetine during early pregnancy were more likely to give birth to babies with isolated ventricular septal defects, in which they have a hole between the left and right sides of the heart. Babies whose mothers took paroxetine in early pregnancy were more likely to be born with right ventricular outflow tract defects, which affect the flow of blood from the heart's right chambers to the rest of the body.

Specifically, among 10,000 babies born to women who didn't take SSRIs, 7 developed a right ventricular outflow tract defect. But among the same number of babies born to women taking paroxetine, 31 had the heart defect. (...)

Birth Even a Few Weeks Early May Raise Odds for ADHD
news.yahoo.com 21.4.2011
TUESDAY, April 19 (HealthDay News) -- The risk that children will develop attention-deficit/hyperactivity disorder (ADHD) rises with every week they are born short of full term, a new study suggests.

Earlier studies have shown an association between a too-early birth and the increased risk for ADHD. This study adds to that data by looking at the risk based on how preterm the delivery is, the Swedish researchers say.

"Our study is the first to report that the risk for ADHD is 40 to 60 percent higher in babies born moderately preterm," said lead researcher Dr. Anders Hjern, an adjunct professor of pediatric epidemiology at the Center for Health Equity Studies at the Karolinska Institutet in Stockholm.

"Even in babies born in the early term period -- at 37-38 weeks -- the risk is 20 percent higher," he added.

This underlines the fact that preterm birth carries significant risks and needs to be given more attention in neonatal care, and in follow-up within health care systems, Hjern said. (...)

The Long-Term Effects of In Utero Exposures — The DES Story
NEJM 2011 (April 20)
It has been 40 years since the Journal published a seminal article by Herbst et al. (1971;284:878-81) noting the association of in utero exposure to a synthetic nonsteroidal estrogen, diethylstilbestrol (DES), and the development of a rare clear-cell adenocarcinoma (CCA) of the vagina in young women 15 to 22 years later. The identification of an in utero exposure that caused alterations to the anatomical and histologic structure of the female genital tract, infertility, and malignant transformation has changed medical thinking about both the embryologic development of the genital tract and the mechanism of carcinogenesis. (...)

Premature birth tied to increased risk of ADHD
(Reuters Health) - The earlier babies are born, the more likely they are to later get a prescription for ADHD medication, according to a new study from Sweden.
reuters.com 19.4.2011
Researchers found that babies born as little as three weeks before their due dates had an elevated risk for attention deficit hyperactivity disorder (ADHD).

The findings suggest that mothers considering scheduling cesarean births a few weeks early reconsider and deliver as close to term as possible, the authors say.

People with ADHD have trouble paying attention or controlling impulsive behaviors, and can be treated with behavioral therapy or medication.

The condition is diagnosed in about three to five percent of school-aged children in the United States.

In the new study, the researchers analyzed a Swedish database of more than a million children aged 6 to 19 years; 7,506 of them had received a prescription for ADHD medication. (...)

Psoriasismedisin kan gi misdannelser hos fosteret
dagensmedisin.no 14.3.2011
Foster kan bli misdannet hvis gravide behandles med legemiddelet acitretin (Neotigason).

Det er Statens legemiddelverk som advarer om dette medikamentet, som blant annet brukes til å behandle alvorlig psoriasis.

Legemiddelverket har derfor innført strengere regler for utlevering av legemidler som inneholder acitretin (Neotigason) til fertile kvinner. (...)

Paxil Birth Defects: When Important Data Is Allegedly Pushed through the Cracks
lawyersandsettlements.com 6.3.2011
Philadelphia, PA: With a pivotal Paxil side effects trial set to start in May, a focus will be placed on what Paxil manufacturer GlaxoSmithKline knew about the risk and potential for heart defects in newborns with Paxil use during the first trimester, and an alleged failure to disclose such risks to the medical community and the population at large. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no) - Antidepressiva (SSRI) (mintankesmie.no).)

Acitretin (Neotigason) – strengere regler for fertile kvinner
legemiddelverket.no 13.3.2011
Det er innført strengere regler for utlevering av legemidler som inneholder acitretin (Neotigason) til fertile kvinner. Årsaken til dette er at det kan oppstå misdannelser hos fosteret hvis graviditet oppstår under behandling. Acitretin brukes blant annet til å behandle alvorlig psoriasis.

Tilstrekkelig mengde Neotigason for kun 30 dagers behandling kan nå utleveres og reseptene er kun gyldig i syv dager etter utstedelse. Bruk hos fertile kvinner krever særlig aktsomhet fordi sannsynligheten for misdannelser hos fosteret er svært stor hvis graviditet oppstår under behandling, også ved kortvarig behandling. Risikoen vedvarer i lang tid etter at behandlingen er avsluttet. Sikker prevensjon skal derfor benyttes i to år etter behandlingsslutt. (...)

FDA: Cleft Palate Risk With Seizure Drug in Pregnancy
medpagetoday.com 4.3.2011
Clinicians should be extra cautious about prescribing the epilepsy drug topiramate (Topamax) to women of childbearing age because of a risk of cleft palates and lips in their offspring should they become pregnant, the FDA warned Friday.

"The benefits and the risks of topiramate should be carefully weighed when prescribing this drug for women of childbearing age, particularly when topiramate is considered for a condition not usually associated with permanent injury or death. Appropriate alternative treatment should be considered," the FDA urged.
Topiramate also is approved to prevent migraine headaches, but not to relieve the pain of migraines.

The drug's labeling will be changed to strengthen an existing warning about use during pregnancy. Topiramate had previously been designated as Class C for risk during pregnancy, reflecting a lack of human data.

Based on a new review of clinical information, topiramate will now be labeled as Class D, the FDA said. (...)

CDC Links Prescription Painkillers in Pregnancy to Birth Defects (CDC linker reseptbelagte smertestillende midler i svangerskapet til fødselsdefekter)
news.yahoo.com 2.3.2011
WEDNESDAY, March 2 (HealthDay News) -- Moms-to-be who take prescription opioid painkillers such as codeine, hydrocodone or oxycodone (Oxycontin) may increase the risk of birth defects in their newborns, according to a new U.S. government report.

Taking these types of analgesics just prior to pregnancy or in the early stages of pregnancy was linked to a modest risk of congenital heart defects in an ongoing population study, according to the U.S. Centers for Disease Control and Prevention.

The risk for spina bifida, hydrocephaly, congenital glaucoma and gastroschisis was also heightened, the report said.

"Women who are pregnant, or thinking about becoming pregnant, should know there are risks associated with using prescription painkillers," said CDC Director Dr. Thomas R. Frieden, in an agency news release. "They should only take medications that are essential, in consultation with their health care provider." (...)

(Anm: Prescriptions for hydrocodone plummet after US tightens prescribing rules. Prescriptions for combination analgesics containing the opiate hydrocodone have fallen by 22% since the US government imposed tougher prescribing rules in 2014, a study has found.1 Hydrocodone bitartrate, which is often formulated with a non-opioid analgesic such as paracetamol, is one of the most commonly misused prescription opioids in the United States. BMJ 2016;352:i549 (Published 27 January 2016).)

Risks: Pain Drugs May Lead to Birth Defects (Risikoer: Smertestillende legemidler kan føre til fødselsdefekter)
nytimes.com 17.3.2011
Women who take codeine, oxycodone and other opioid pain drugs early in pregnancy may be exposing their babies to a higher risk of birth defects, a new government study suggests.

Though the overall numbers were small, babies whose mothers took opioids were considerably more likely than others to have congenital problems, including a potentially fatal syndrome in which the left part of the heart does not develop completely; spina bifida, in which the backbone and spinal canal do not close; and gastroschisis, in which the intestines stick out of the body.

The study, from the Centers for Disease Control and Prevention, was one of the largest to examine the effects of opioid use during pregnancy. It appeared last month in The American Journal of Obstetrics & Gynecology.

It used data from the National Birth Defects Prevention Study about mothers in 10 states who gave birth from 1997 to 2005. Information was drawn from hourlong computer-assisted telephone interviews with the mothers. (...)

2010 a Year for Paxil Birth Defects Plaintiffs to Remember (2010 et år å huske for saksøkere av fødseldefekter forårsaket av Seroxat)
lawyersandsettlements.com 25.12.2010
Dallas, TX: Plaintiffs who filed lawsuits alleging Paxil side effects such as Paxil birth defects and PPHN (persistent pulmonary hypertension of the newborn) may look back on 2010 as a year to remember. Hundreds of Paxil lawsuits were reportedly settled and a million-dollar award handed out in at least one other lawsuit. For plaintiffs who still have Paxil lawsuits pending, 2010 might be a year that provides them with hope that they will receive either a settlement or an award. (...)

Barn med lav fødselsvekt mer psykisk syke
dagbladet.no 20.12.2010
Angstlidelser og ADHD vanligst.

Barn med lav fødselsvekt har større risiko for psykisk sykdom i 20-årene enn jevngamle med normal fødselsvekt, ifølge en studie utført ved NTNU.

Blant de undersøkte for tidlig fødte barna med lav fødselsvekt hadde én av tre fått en diagnose som omfattet en psykisk lidelse ved 20 års alder.

Hos jevngamle som hadde hatt normal fødselsvekt, var dette tilfelle for under én av ti. Hos personer som ble født til termin, men med lav fødselsvekt, forekom psykisk sykdom hos hver fjerde da de var 20 år gamle, skriver Dagens Medisin. (...)

The Bad Daddy Factor
miller-mccune.com 10.12.2010
Drinking, smoking, taking prescription meds or failing to eat a balanced diet can influence the health of men’s future children. (...)

Drugs can also interfere with sperm transport. A 2009 study revealed that a standard dose of paroxetine — the active drug in the antidepressant marketed as Paxil — causes a fivefold increase in the number of men who show evidence of “sperm fragmentation,” which can increase the chances of miscarriage. Researchers have known that certain antidepressants can influence ejaculatory response; it turns out that they seem to slow the transportation of sperm through the male reproductive system, causing the cells to age prematurely. “Sperm are being damaged because they’re not traveling properly through the body,” says Peter Schlegel, who led the study and is a urologist at New York’s Weill Cornell Medical College. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Letters suggest Schering knew of birth defect problems with drug
thelocal.de/society/ 21.11.2010
Documents dating back to the late 1960s have emerged which suggest that the then pharmaceutical firm Schering, now part of Bayer, knew about birth defect problems with one of its drugs earlier than admitted.

Der Spiegel reported on Sunday that letters written by scientists in the UK and Germany indicate that concern was being raised about the pregnancy test drug Duogynon in 1967 – yet it was still being prescribed until at least 1975.

André Sommer from Pfronten, Bavaria, is suing Bayer for the defects he suffered after his mother took the drug while pregnant with him in 1975. He was born with severe problems with his bladder and sexual organs.

His case will be heard by the Berlin District Court next week, and will include the documents which have recently come to light in which doctors wrote to each other about problems they had observed.

“The seeming relation between the increase in birth defects and the sale of the pregnancy test is pretty alarming,” one scientist wrote on November 1967. (...)

- Paracetamol kan skade guttefostre
vg.no 8.11.2010
Kvinner som spiser hodepinetabletter med paracetamol under graviditet, risikerer å føde gutter med misdannet kjønnsorgan.

47.000 danske kvinner har deltatt i en undersøkelse i regi av universitetet i Aarhus. Resultatet presenteres i siste utgave av tidsskriftet Epidemiology. (...)

- Guttene vil sannsynligvis ha nedsatt sædkvalitet resten av livet. I tillegg kommer de guttene som ikke har medfødte misdannelser, men som vi likevel mistenker vil få nedsatt sædkvalitet på grunn av paracetamol, sier Morten Søndergaard Jensen ved universitetet i Aarhus.

Rundt halvparten av kvinnene som deltok i undersøkelsen tok piller med paracetamol under graviditeten. (...)

(Anm: Maternal Use of Acetaminophen, Ibuprofen, and Acetylsalicylic Acid During Pregnancy and Risk of Cryptorchidism. Epidemiology2010;21(6):779-785 (November).)

Paxil Plaintiff Settles Birth Defects Lawsuit (Seroxat-saksøker forliker fødselsdefekt-søksmålsøksmål)
lawyersandsettlements.com 20.10.2010
Watertown, SD: A woman who recently settled her Paxil birth defects lawsuit ended a legal ordeal that began with the 2004 death of her newborn son. The woman's Paxil lawsuit alleged her son suffered from Paxil birth defects, including persistent pulmonary hypertension of the newborn (PPHN). (...)

READ MORE [ PAXIL ARTICLES ] (...)

Glaxo To Settle Paxil Birth Defect Cases, Noted Attorney Jim Fitzgerald Offers Insight
thenewsfactory.com 23.8.2010
CHEYENNE, WY (AttorneyNewswire.com) — August 23, 2010 — Eleven percent of American women are on antidepressants, such as Paxil. Use by pregnant women has risen a lot, even though Paxil has been linked to birth defects. The unborn babies of women who take it may be at risk of heart malformations, and other birth defects.

The Archives of Pediatric & Adolescent Medicine reported that 30 percent of babies with prenatal antidepressant exposure showed symptoms of withdrawal such as tremors, breathing problems, stomach problems, sleep issues, rapid heartbeat, irritability and profuse sweating. But even more worrisome are birth defects. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

Paxil Birth Defects Lawyers (Seroxat, fødselsdefekter, advokater)
lawyersandsettlements.com 15.8.2010
Recent studies have found that women who take Paxil during certain times in their pregnancy are more likely to give birth to babies experiencing Paxil side effects than women who take other antidepressants or women who do not take any antidepressants during pregnancy. These Paxil side effects can be life-threatening and include serious health problems such as Paxil heart defects. Now, some women are investigating filing their own Paxil lawsuit, alleging the company did not properly warn them about the risks associated with taking the antidepressant during pregnancy. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

Plaintiffs Hoping for More Paxil Birth Defects Settlements (Saksøker håper på flere flere forlik i saker om fødselsdefekter utløst av Seroxat (Paxil))
lawyersandsettlements.com 5.7.2010
Boston, MA: Although very little information has been released concerning the settlement of Paxil birth defects lawsuits, news reports indicate that approximately 190 cases have been settled while another 100 are in various stages of settlement.

At issue in the lawsuits is whether or not Paxil caused the birth defects of infants whose mothers took the antidepressant while pregnant. Scientific studies concerning the link between Paxil and other selective serotonin reuptake inhibitors (SSRIs) to birth defects have returned mixed results. Further studies have suggested a link between SSRIs and behavioral problems, withdrawal symptoms and developmental delays.

GlaxoSmithKline, however, has defended its drug and its own actions regarding Paxil. A spokeswoman for GlaxoSmithKline, Sarah Alspach, said in an e-mail statement that the company agreed to settle to avoid the costs and uncertainties of ongoing litigation

"GSK believes it acted properly and responsibly in conducting its clinical trial program for Paxil, in marketing the medicine, in monitoring its safety once it was approved for use and in updating pregnancy information in the medicine's label as new information became available," Alspach wrote, as published in the Legal Intelligencer on 6/23/10.

Plaintiffs, however, disagree. They argue that GlaxoSmithKline failed to adequately warn physicians and patients about the risks of birth defects when babies are exposed to Paxil prior to birth. They allege those birth defects include Persistent Pulmonary Hypertension of the Newborn (PPHN) and atrial or septal defects—holes in the heart. (...)

(Anm: Babies with drug withdrawal syndrome more likely to be readmitted (medicalnewstoday.com 1.10.2015).)

Paxil Can Cause Heart Defect in Newborns
lawyersandsettlements.com 21.6.2010
Montreal, Canada: There are many side effects associated with the antidepressant Paxil, but certainly one of the scariest is the risk of heart defects in newborns whose mothers took the drug. (...)

The study revealed that combining two different medications designed to combat depression could double the risk of miscarriage.

"These results, which suggest an overall class effect of selective serotonin re-uptake inhibitors, are highly robust given the large number of users studied," Dr. Anick Berard, who led the study, told the news source. "Physicians who have patients of child-bearing age taking antidepressants or have pregnant patients who require antidepressant therapy early in pregnancy discuss the risks and benefits with them."

It is estimated that more than one expectant mother in 30 takes an antidepressant with selective serotonin re-uptake inhibitors, meaning there are a number of pregnant woman whose children may suffer a heart defect.

[ READ MORE PAXIL ARTICLES ] (...)

Antidepressants Associated With Miscarriage Researchers find antidepressant use during pregnancy may increase risk of spontaneous abortion
modernmedicine.com 1.6.2010
TUESDAY, June 1 (HealthDay News) -- Use of antidepressants during pregnancy, particularly paroxetine, venlafaxine, or a combination of different antidepressant classes, may increase the risk of miscarriage by 68 percent, according to research published online May 31 in CMAJ, the journal of the Canadian Medical Association. (...)

(Anm: Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 2010 (Published online ahead of print May 31, 2010).)

Antidepressants during pregnancy increase risk of sponaneous abortion, study finds (Antidepressiva i løpet av svangerskapet øker risikoen for spontanaborter, ifølge studie)
latimes.com 31.5.2010
(...) In the new study, Dr. Anick Berard, director of the University of Montreal's Research Unit on Medications and Pregnancy at University Hospital Center Sainte-Justine used information from the Quebec Pregnancy Registry to identify 5,124 women who had a spontaneous abortions between 1998 and 2003 -- before warnings about the risks of the drugs became more common -- and compared them with about 10 times that many carefully matched women who did not have abortions. A separate database provided information about prescriptions the women had filled.

The researchers reported in the Canadian Medical Assn. Journal that 5.5% of the women who had spontaneous abortions had taken antidepressants, compared with 2.7% of those who did not have a spontaneous abortion. Controlling for other factors, that amounted to a 68% increase in risk. The biggest effects were found with paroxetine (brand names Paxil and Seroxat) and venlafaxine (Effexor) or when combinations of drugs from different families were used. (...)

Miscarriage Linked to SSRI Use (Insidermedicine Video) (Interview with Dr. Anick Berard, PhD, University of Montreal) (Video)
insidermedicine.ca 31.5.2010
Use of antidepressants during pregnancy, particularly the agents paroxetine and venlafaxine as well as combinations of drugs, may increase the risk of miscarriage, according to research published in the latest issue of the Canadian Medical Association Journal. (...)

Researchers out of the University of Montreal used the Quebec Pregnancy Registry to obtain data on 5,124 women who had experienced a clinically-detected spontaneous abortion. For each case, the investigators randomly selected 10 controls also from the Registry who did not experience a spontaneous abortion at or before the same gestational age as the cases. Cases and controls were compared with regard to antidepressant use.

Overall, 5.5% of the women who had experienced a spontaneous abortion had filled at least one prescription for antidepressants during their pregnancy, compared with 2.7% of matched controls. After adjusting for potential confounders, use of antidepressants was associated with a 68% increased risk for spontaneous abortion. Looking at specific antidepressants revealed that the risk increased by 61% with use of SSRIs, by 2.11 times with use of SNRIs, and by 3.51 times with combined use of antidepressants. In particular, paroxetine was associated with a 75% increased risk for spontaneous abortion and venlafaxine a 2.11-fold increased risk.

Today’s research identifies miscarriage as another potential risk of antidepressants that should be discussed with patients who are pregnant or planning to become pregnant. (...)

(Anm: Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 2010 (Published online ahead of print May 31, 2010).)

Antidepressiva medel kopplas till förhöjd risk för missfall
dagensmedicin.se 1.6.2010
Användning av antidepressiva läkemedel under graviditeten kan förhindra återfall i depression som kan vara farliga för både mamman och barnet. Men det är omdebatterat om behandlingen ökar risken för missfall. De flesta tidigare studier av antidepressiv medicinering under graviditet har heller inte varit utformade för specifikt studera missfallsrisk, enligt kanadensiska forskare bakom en ny studie. (...)

(Anm: Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ 2010 (Published online ahead of print May 31, 2010).)

Antidepressants Linked to Miscarriages (Antidepressiva linket spontspontanaborter)
newyorkcity.injuryboard.com 31.5.2010
Researchers at the University of Montreal have linked use of antidepressants by pregnant women to miscarriages.

The study found that pregnant women taking antidepressant prescription medications for depression and anxiety, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and the older tricyclics, are at increased risk for miscarriages than those who do not use antidepressants.

Researchers documented that patients taking SSRIs paroxetine marketed by GlaxoSmithKline as Paxil and venlafaxine marketed by Pfizer as Effexor were at the greatest risk. Risk also increased with higher drug dosage.

According to an article by HealthDay featured in U.S. News & World Report, antidepressants may increase miscarriage risk by 68%.

"These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied," writes senior author Dr. Anick Bérard, from the University of Montreal and the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine.

Antidepressant use during pregnancy is quite common, in 2003 about 13% of women took an antidepressant at some point during their pregnancy, says a Time article. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

A pregnant question (Et gravid spørsmål)
sciencenews.org 5.6.2010
Drugs known as SSRIs can fight depression during pregnancy but may also have a lasting effect on a developing baby's brain. (...)

Over the past few years, a handful of studies have found that mice and rats exposed to antidepressants shortly before birth or just afterward grow up anxious and depressed. Other animal studies link early exposure to SSRIs to improved decision-making and spatial-learning abilities. Though many of the documented reactions fall within the normal range of behavior, the drugs can influence how an animal experiences and relates to its surroundings, says Judith Homberg of Radboud University in Nijmegen, the Netherlands.

No one knows for sure if people experience the same risks or benefits over the long haul, but a new study shows that children exposed to antidepressants in the womb are more likely to appear sad or withdrawn at age 3 than those whose moms didn’t take the drugs.

Though the mechanism underlying such changes is still unknown, a picture is beginning to emerge. In the February Trends in Pharmacological Sciences, Homberg and her colleagues outline research in animals linking exposure to SSRIs during early development to faulty brain organization and abnormalities. And recent studies in fruit flies support a theory that sensitivity to serotonin can be set early in life.(...)

SSRI Antidepressant Use Found to Affect Birth Weight
lawyersandsettlements.com 25.5.2010
Melbourne, AUSTRALIA: A small but damning study originating in Australia suggests that SSRI side effects are eight times more prevalent in newborns whose mothers have taken antidepressants during pregnancy. A recent report from the UK also warned of increased incidents of babies born to mothers taking selective serotonin reuptake inhibitor (SSRI) antidepressants exhibiting birth defects such as persistent pulmonary hypertension (PPHN) at birth.(...)

Paxil Birth Defects vs. Mother's Health
lawyersandsettlements.com 22.5.2010
(...) The European Medicines Agency (EMA) in the UK recently released a study showing that the potential for heart defects in newborns increases slightly when women use SSRI antidepressants during pregnancy. The EMA has advised doctors to carefully weigh the pros and the cons when prescribing the medication to their patients.

According to the EMA, recent studies show that SSRIs may cause birth defects in five out of 1000 newborns, as compared with two out of 1000 births among mothers who did not take antidepressants in any form. (...)

Doctors Warn of the Risk of Lexapro Birth Defects
lawyersandsettlements.com 16.5.2010
Washington, DC: Women experiencing postpartum and prenatal depression have been known to use popular antidepressants like Lexapro or Zoloft to treat their psychosis. However, a number of doctors have come out against the prescription of these medications for pregnant women due to their increased risk of newborn birth defects. (...)

Hundreds of Lawsuits Claim Paxil Causes Birth Defects
parentdish.com 11.3.2010
The makers of the antidepressant drug Paxil are facing an increasing number of lawsuits alleging the medication causes birth defects, and one family has already won a settlement of $2.5 million, online investigative news site The Public Record reports. (...)

Number Of Paxil-Related Birth Defect Cases Soar
pubrecord.org 7.3.2010
Since Paxil came on the market in 1992, there have been three separate types of failure to warn lawsuits filed against GlaxoSmithKline over Paxil; birth defects, suicide, and addiction. (...)

New Study: SSRI Side Effects May Cause Lactation Problems in New Moms
lawyersandsettlements.com 21.2.2010
Charlotte, NC: Researchers studying the potency of SSRI birth defects have found a potential link between the medication and a delay in the production of breast milk in new mothers. (...)

[ READ MORE SSRI ARTICLES ] (...)

Evelyn Pringle: Paxil Birth Defect Litigation
scoop.co.nz 18.2.2010
GlaxoSmithKline has paid out close to $1 billion to resolve lawsuits involving Paxil since the drug came on the market in 1992, according to a December 14, 2009 Bloomberg report. But the billion dollars does not cover the more than 600 Paxil birth defect cases currently pending in multi-litigation in Pennsylvania.

Glaxo has settled about 10 birth defect cases, according to Sean Tracey, a Houston attorney who represented the family of a child victim in the first jury trial that decided in favor of the plaintiff on October 13, 2009, Bloomberg reports. The settlements in those lawsuits averaged about $4 million, people familiar with the cases told the new service. (...)

Studies Confirm Paxil Causes Birth Defects (Studier bekrefter at Seroxat forårsaker fødselsdefekter)
oklahomacity.injuryboard.com 30.1.2010
Since 2005 there have been a number of studies which concluded that Paxil increases the risk of certain birth defects. What follows is a concise summary of some of the most significant publications. A complete reference list is available form our office by request. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

No Easy Answers for Physicians Caring for Pregnant Women With Depression
JAMA. 2009;302(22):2413-2420 (December 9)
(...) Recent data suggest that use of SSRIs, which are now the most commonly used antidepressants, during pregnancy may contribute to an increased risk of such outcomes as septal heart defects, preterm delivery, low 5-minute Apgar score, and admission to a neonatal intensive care unit. These new findings add to a complex body of evidence that has linked both antidepressant use and gestational depression with poor fetal growth, premature delivery, and short-term behavioral changes in the neonate, according to a recent review and guidelines by the APA and ACOG (Yonkers KA et al. Gen Hosp Psychiatry. 2009;31[5]:403-413). (...)

New Test Could Have Predicted Paxil Side Effects
lawyersandsettlements.com 3.12.2009
Washington, D.C.: Scientists at the University of North Carolina at Chapel Hill and the University of California San Francisco have created an experimental method that could accurately predict a chemical's interaction with the human body, in a move that could help prevent future drug complications like Paxil birth defects.

The new method is a computational technique that compares how similar the structures of all identified drugs are to human cells and diseases. The move allows scientists to examine how medications will interact with the body without dangerous animal or human trials. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Many pregnant women take drugs harmful to baby
reuters.com 27.11.2009
NEW YORK (Reuters Health) - With the help of their doctors, women planning to become pregnant should take an inventory of the medications they take, researchers from Canada advise.

In a study, they found that many pregnant women still take medications long known to cause birth defects. (...)

The investigators call on doctors caring for women of childbearing age to conduct a thorough medication review prior to a planned pregnancy, or as soon as an unplanned pregnancy is recognized.

SOURCE: BJOG: An International Journal of Obstetrics and Gynecology, December 2009. (...)

Prenatal SSRIs Linked to Problems in Newborns
medpscape.com 7.10.2009
October 7, 2009 — Infants of mothers who took selective serotonin reuptake inhibitors (SSRIs) during pregnancy are at greater risk for preterm birth, a low 5-minute Apgar score, and admission to the neonatal intensive care unit (NICU), according to a report in the October issue of the Archives of Pediatrics & Adolescent Medicine. (...)

Dr. Lund told Medscape Psychiatry that his group's most important findings were that prenatal exposure to SSRIs was associated with increased risk for preterm delivery, low 5-minute Apgar score, and increased chance of NICU admission (which was not explained by either Apgar score or gestational age). The researchers found no association between prenatal SSRI exposure and birth weight or head circumference after controlling for confounders. (...)

Christina Chambers, PhD, MPH, told Medscape Psychiatry that this study is "consistent with many previous studies that have shown...a doubling of risk for preterm delivery and increased NICU admission, including our study first reporting these findings for fluoxetine back in 1996." (...)

(Anm: Selective Serotonin Reuptake Inhibitor Exposure In Utero and Pregnancy Outcomes. Arch Pediatr Adolesc Med. 2009;163(10):949-954. (October).)

Antidepressant Use and Preterm Birth
Am J Psychiatry 166:1189-a (October 2009) (American Psychiatric Association)
To the Editor: I would like to congratulate Katherine L. Wisner, M.D., et al. for their important study, published in the May 2009 issue of the Journal, on depression and antidepressant treatment in pregnant women (1). However, I have several concerns with the article. (...)

Many of these differences between the two groups (e.g., African American race, low socioeconomic status, prior preterm birth) are risk factors for preterm birth, which must be controlled for. In the article, it does not appear that this was the case. Even without controlling for all of these factors, based on Table 4, it seems that only the continuous SSRI group had a statistically significant increase in the rate of preterm birth (a rate ratio of 5.43), with a confidence interval that did not cross 1.00.

These results are dramatic and join the accumulating evidence that now links SSRI use to preterm birth (2, 3). Pregnant women and their providers should be made aware of the growing evidence that supports an association between SSRI use and preterm birth. (...)

Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs
NEJM 360:1597-1605 (April 16)
(...) Conclusions In utero exposure to valproate, as compared with other commonly used antiepileptic drugs, is associated with an increased risk of impaired cognitive function at 3 years of age. This finding supports a recommendation that valproate not be used as a first-choice drug in women of childbearing potential. (...)

Which Drug for the Pregnant Woman with Epilepsy?
NEJM 2009;360:1667-1669 (April 16)
Approximately 25,000 children are born in the United States each year to mothers with epilepsy.1 Most of these women need to continue taking medication during pregnancy, since uncontrolled seizures may be harmful to the women as well as to the fetuses.2 The challenge to physicians is to prescribe a treatment that is effective in controlling seizures but has minimal associated risks. (...)

IQ low in toddlers whose mothers took valproate
reuters.com 16.4.2009
BOSTON (Reuters) - Children born to women who took the epilepsy drug valproate while pregnant had lower IQs at least up to age 3 than the children of women who took rival epilepsy drugs, researchers reported on Wednesday.

The findings add to evidence that the pill is harmful to unborn children. It is sold by Sanofi-Aventis as Epilim and as Depakine in the United States by Abbott Laboratories.

"This finding supports a recommendation that valproate not be used as a first-choice drug in women of childbearing potential," Kimford Meador of Emory University in Atlanta and colleagues wrote in the New England Journal of Medicine. (...)

Paxil Birth Defects – The Never-Ending Vigil
lawyersandsettlements.com 22.3.2009
Springhill, FL : Kristine's son was born without incident – a healthy baby boy. He is now 4 years old and was recently diagnosed with a condition that could kill him if his parent's aren't vigilant. It turns out he was born with this condition, and Kristine wonders if the Paxil she took while pregnant could have contributed – could it be a Paxil birth defect? (...)

Paxil isn't the only drug that has been linked with birth defects. The SSRIs Prozac by Eli Lilly, Zoloft by Pfizer, and Celexa and Lexapro sold by Forest Laboratories, along with various generic versions of the drugs are also controversial. And the closely-related class of SNRI antidepressants, which include Wyeth's Effexor and Lilly's Cymbalta, also carry birth defects warnings.

Just what are the birth defects? The published studies so far, and they are few, highlight the risk for persistent pulmonary hypertension (PPHN), and this is what the package warnings refer to.

However, in 2007, a study published in the New England Journal of Medicine showed that the use of antidepressants in the first 3 months of pregnancy more than doubles the risk of and craniosynostosis (premature closure of the connections between the bones of the skull before brain growth is complete), omphalocele (the child's abdomen does not close properly allowing intestines and other organs to protrude outside the body), and anencephaly (birth without forebrain). (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Drugs for preterm labor linked to complications
reuters.com 6.3.2009
NEW YORK (Reuters Health) - Pregnant women given drugs to prevent the baby being born too soon may run the risk of having serious complications, a large study conducted in Belgium and The Netherlands suggests.

The choice of first-line drugs to avert preterm labor is controversial "because of inconclusive information on the relative safety of the various agents," Dr. Roel de Heus at University Medical Center Utrecht and associates explain in the British Medical Journal.

Most clinical trials of these drugs have been restricted to women with low-risk pregnancies and therefore don't reflect real-world situations. (...)

Birth Injury Lawyers Show True Effects of Associated Drugs
bestsyndication.com 11.2.2009
Birth injury lawyers are trying to gain awareness about certain pharmaceutical drugs that cause severe birth complications when taken by women who are pregnant. The fact of the matter is that birth injury lawyers want to make known that these drugs did not have warnings as to the negative effects of taking the drug while pregnant. A common drug in this category is Paxil, manufactured by GlaxoSmithKline. Paxil is a very common drug used by women and teenagers battling depression and other types of mood behaviors. Paxil was heavily advertised to women and teenagers because their studies showed that these demographics incurred the most problems with depression. (...)

SSRI Birth Defects: Had I Known Then What I Know Now
lawyersandsettlements.com 29.1.2009
Fresno, CAWhen Jodie found out she was pregnant she was taking the antidepressant Zoloft. One of the first things she did was ask her doctors if it was safe for her to continue taking the drug. They told her that the benefits outweigh the risks. But her daughter was born prematurely, and with a permanent hole in her spine. Jodie wonders if that could be an SSRI birth defect. (...)

Obama Administration Quickly Halts Effect of Bush Administration Pending
norfolk.injuryboard.com 21.1.2009
One of the first official acts of the Obama administration was to halt the effect of any “last minute” Bush administration “corporate protection” regulations that would wipe out consumer rights to pursue state court lawsuits. The Bush Administration has famously wiped out and "preempted" each of the 50 states civil justice remedies in a wide array of fields, including select regulations involving medications, prescriptions, railroad matters, food and drug issues, and the list goes on. This is also known as complete immunity preemption. (...)

. One of the pending rules is a Food and Drug Administration (FDA) labeling requirement for prescription drugs for pregnancy and lactation. Kimberly’s daughter Kenndyl died from complications arising from a congenital heart defect Kimberly believes was caused from her taking Paxil during part of her pregnancy. Neither Kimberly nor her doctor knew that taking Paxil during pregnancy is associated with an increased risk of birth defects, but the manufacturer of Paxil, GlaxoSmithKline (“GSK”) did. The FDA rule could prevent people harmed by prescription drugs while pregnant or breastfeeding from seeking justice in the courts. Kenndyl was just two weeks old. (...)

SSRI Birth Defects" The Only High Risk Factor I had Was Being on Effexor"
lawyersandsettlements.com 15.1.2009
Regina, SA : Pam was told by both her family doctor and her obstetrician that the antidepressant she was taking, namely effexor, was safe for her to continue taking through her pregnancy. But within hours of her son being born, he had been admitted to the natal intensive care unit, suffering from seizures and breathing difficulties. (...)

"My son had a smooth delivery but within 5 hours of being born he began to have agitation seizures and trouble breathing," Pam said. "I was told he was showing withdrawal symptoms. He was put into neo natal intensive care for 10 days. He was suffering from tremors and having difficulty getting enough oxygen. They had him on different stabilizing medications and oxygen and continued to monitor him, and he had another seizure 5 days later. He came home 10 days later. (...)

Birth Defects and SSRIs—How's a Mother to Know?
lawyersandsettlements.com 23.12.2008
Houston, TX: In 2006, Elissa's doctor prescribed Cymbalta to help with her depression. Shortly after starting on the antidepressant Elissa became pregnant. On her doctor's advice she continued taking Cymbalta. But it soon became apparent her baby was developing life-threatening defects.

"I had my first ultrasound at 3 months," Elissa said. "That's when I found out something wasn't right. The doctor explained that my baby appeared to have a heart defect, a hole in her heart. Shortly after Elissa's baby girl was born, prematurely, the infant had to undergo heart surgery to repair the damage that could have been induced by the antidepressant. But Elissa was not aware of the association between SSRIs—or selective serotonin reuptake inhibitors—and birth defects. (...)

One Baby's Heart Defect, Courtesy of the SSRI Lexapro
lawyersandsettlements.com 15.12.2008
Bernie, MO: Ann has a healthy girl, and she was born with absolutely no health problems whatsoever. But Ann suffered from depression after her baby's birth, so her doctor put her on the antidepressant lexapro. Then Ann found out she was pregnant. But she stopped taking this SSRI as soon as she found out her son was born with a heart defect. (...)

Paxil Birth Defect Warnings too Late For Two Little Boys
lawyersandsettlements.com 10.12.2008
Hendersonville, N.C: April has 3 children; 2 were born with complications, quite possibly Paxil-related birth defects. April had taken the selective serotonin re-uptake inhibitor (SSRI) Paxil, also known as paroxetine, during both pregnancies.

"Christian, my first son, was born 4 weeks early, and his brother Jordon was born 6 weeks early – both babies were premature," April said. Christian was born in January 1998, and he was born with a heart murmur – or a whole in his heart. "I was suffering from depression when I became pregnant with Christian. I asked my doctor if it was safe to take the antidepressant while I was pregnant and he assured me that yes, it was totally safe. The doctors found my son's heart murmur within a day or two of his birth." (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

Fødselsvekten avgjør din helse
nrk.no 20.6.2008
Forskning viser at det er en klar sammenheng mellom fødselsvekt og sykdom senere i livet. (...)

Leveren viktig
Leverens blodgjennomstrømning hos foster er viktig fordi leveren er sentral i reguleringen av fosterets vekst.

Studien viser at dårlig gjennomstrømning senker fødselsvekten og påvirker risikoen for sykdom senere i livet.

– Redusert morkakeblod til leveren gir en mindre lever og i neste omgang redusert vekst og muligvis en varig endret metabolsk funksjon. (...)

Graviditetsstudier av läkemedel efterfrågas
lakemedelsvarlden.se 17.6.2008
Det råder en stor brist på läkemedelsstudier när det gäller behandling av tropiska infektionssjukdomar hos gravida. Detta varnar thailändska forskare för i en artikel i Plos Medicine. (...)

(Anm: New Medicines for Tropical Diseases in Pregnancy: Catch-22. PLoS Med 5(6): e133 doi:10.1371/journal.pmed.0050133 (17.6.20089).)

SSRIs Linked to Premature Birth
lawyersandsettlements.com 7.6.2008
Washington, DC: A recent study has linked the use of SSRIs (selective serotonin reuptake inhibitors) while pregnant to an increased risk of premature births. Meanwhile a different study suggests that SSRIs may not be effective at treating some forms of depression. Women who have used SSRIs while pregnant and had babies with serious health problems are now filing lawsuits against the makers of SSRIs, alleging their babies were harmed by the antidepressants. (...)

FDA proposes new drug label system (FDA foreslår nytt system for pakningsvedlegg)
usatoday.com 29.5.2008
Women and their doctors may soon have better information about the safety of drugs taken during pregnancy and breastfeeding.

The Food and Drug Administration on Wednesday proposed replacing a 30-year-old system for classifying drugs in favor of labels that provide far more detailed information about a medication's risks and benefits.

Women need much better guidance, says Sandra Kweder, deputy director of the agency's office of new drugs. Women take an average of three to five medications during pregnancy. More than 90% of nursing mothers take medication during the first week after delivery. (...)

Birth defect risk doubles in U.S. pre-term babies
reuters.com 21.5.2008
WASHINGTON (Reuters) - Premature babies born in the United States are more than twice as likely to have a major birth defect than full-term infants, with the risk even higher among very pre-term babies, researchers said on Wednesday.
The researchers tracked nearly 7 million babies born between 1995 and 2000 in 13 states, accounting for about 30 percent of U.S. births, to better understand the relationship between birth defects and pre-term birth. (...)

Fetal Cocaine Exposure has Lasting Effects
ivanhoe.com 14.4.2008
(Ivanhoe Newswire) -- Cocaine abuse by young women of childbearing age is a growing problem. Now, a new study done on monkeys indicates babies exposed to cocaine in the womb may have long lasting brain changes -- especially males.

The research showed adult male monkeys who were exposed to cocaine in the womb appear to have altered function in dopamine receptors in their brains. Dopamine is similar to adrenaline. It affects brain processes that control movement, emotional response and ability to experience pleasure and pain. There are five known dopamine receptors. In humans, changes in them are associated with vulnerability to drug abuse.

Though the monkeys in the study experienced fetal cocaine exposure, they had no contact with the drug after birth. When the research team studied them at age 13, they found the male monkeys exposed to the drug in the womb yawned twice as much in a 30-minute period as the males who were not exposed. (...)

(Anm: Functional brain organization of newborns altered by prenatal cocaine exposure. A new study by UNC researchers, based on MRI brain scans of 152 infants, found disruptions in functional connectivity within part of the amygdala-prefrontal network - a pathway thought to play an important role in arousal regulation. (medicalnewstoday.com 10.4.2015).)

Positive screening for autism in ex-preterm infants: prevalence and risk factors
Pediatrics. 2008 Apr;121(4):758-65
OBJECTIVE: The survival of very low birth weight infants has increased markedly in recent years. Unfortunately, the prevalence of significant and lifelong motor, cognitive, and behavioral dysfunction has remained a major problem confronting these children. (...)

RESULTS: Twenty-six percent of ex-preterm infants had a positive result on the autism screening tool. Abnormal scores correlated highly with internalizing behavioral problems on the Child Behavior Checklist and socialization and communication deficits on the Vineland Scales. Lower birth weight, gestational age, male gender, chorioamnionitis, acute intrapartum hemorrhage, illness severity on admission, and abnormal MRI studies were significantly associated with an abnormal autism screening score. CONCLUSIONS: Early autistic behaviors seem to be an underrecognized feature of very low birth weight infants. The results from this study suggest that early screening for signs of autism may be warranted in this high-risk population followed by definitive autism testing in those with positive screening results. (...)

Tidlig fødsel øker dødeligheten
vg.no 27.3.2008
Dødeligheten blant tidligfødte er mye høyere enn blant vanlige barn, viser en ny omfattende studie ved Universitetet i Bergen. (...)

Risikoen for jenter er litt lavere, sier professor Rolv Skjærven ved Institutt for samfunnsmedisinske fag i Bergen til Bergens Tidende.

Studien er det første av sitt slag i verden og vekker oppsikt. Flere prestisjetunge medisinske tidsskrifter har publisert resultatene. (...)

(Anm: Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth. JAMA. 2008 Mar 26;299(12):1477-8.)

(Anm: – Mange ekstremt tidligfødte får alvorlige problemer Hvert femte barn barn født innen uke 28 har allerede i toårsalderen så alvorlige atferdsproblemer at det påvirker hverdagen, viser ny svensk forskning. (nrk.no 9.2.2015).)

Tidlig fødsel øker dødeligheten
vg.no 27.3.2008
Dødeligheten blant tidligfødte er mye høyere enn blant vanlige barn, viser en ny omfattende studie ved Universitetet i Bergen. (...)

Risikoen for jenter er litt lavere, sier professor Rolv Skjærven ved Institutt for samfunnsmedisinske fag i Bergen til Bergens Tidende.

Studien er det første av sitt slag i verden og vekker oppsikt. Flere prestisjetunge medisinske tidsskrifter har publisert resultatene. (...)

Professor: Vi får flere retarderede børn
berlingske.dk 8.3.2008
For tidlige fødsler, indavl og kemiske stoffer kan ifølge professor være nogle af årsagerne til, at der tilsyneladende bliver født flere og flere børn med hjerneskader. Børn, der er så mentalt retardererde, at de har svært ved at begå sig fagligt eller socialt. (...)

Ifølge en ny undersøgelse fra Undervisningsministeriet er antallet af skoleelever i vidtgående specialundervisning steget med 48 procent på ti år, således at det i dag er oppe på over 11.000 elever.

Men hvorfor er der tilsyneladende flere børn, der har svært ved at læse, svært ved at regne, svært ved at forstå og svært ved at fungere sammen med andre børn? Er det fordi, forældre og lærere er blevet bedre til at få øje på problembørn, er det fordi, skoler og myndigheder er blevet bedre til at hjælpe problembørn, er det fordi, der bliver stillet flere diagnoser som ADHD, eller er det fordi, der er blevet flere småt begavede børn med indlæringsproblemer?

Det spørgsmål stiller professor og børneneurolog Peter Uldall fra Rigshospitalet i morgen eftermiddag i et foredrag på Københavns Kommunehospital i anledning af, at det i den kommende uge er Hjerneuge i Danmark og flere andre lande. (...)

Risiko for hørselsskade ved lav fødselsvekt
(VG Nett) Lav fødselsvekt øker risikoen for at barnet kan få alvorlig hørselskade, viser ny norsk studie. (...)

- Vår studie viser at sensorinevralt hørselstap henger sammen med lav fødselsvekt, sier Bo Engdahl, forsker ved divisjon for psykisk helse, Nasjonalt folkehelseinstitutt. Resultatene er nylig publisert i tidsskriftet Paediatric and Perinatal Epidemiology. (...)

Increase in use of selective serotonin reuptake inhibitors in pregnancy during the last decade, a population-based cohort study from The Netherlands
Br J Clin Pharmacol. 2007 Oct 22; [Epub ahead of print]
(...) Conclusion There has been a significant increase in the use of SSRIs among pregnant women in the Netherlands over the last 10 years, parallel with the increase in exposure in women of fertile age. In light of the recent warnings about the use of SSRIs in pregnancy, healthcare professionals should be careful in prescribing SSRIs to women planning a pregnancy. (...)

Flere børn fødes med misdannelser
netdoktor.com 17.9.2007
De røde lamper blinker, når talen falder på misdannelser i kønsorganerne og urinvejene. Her har videnskaben nemlig en begrundet mistanke om, at en væsentlig del af forklaringen på stigningen skal ses i udefrakommende påvirkninger. Hormonforstyrrende stoffer, der allerede i fostertilstanden griber ind og påvirker primært drengefostrenes udvikling negativt. (...)

Paxil and Birth Defects: I Blamed Myself for Too Long
lawyersandsettlements.com 20.6.2007
Batavia, IL: "I took Paxil for two months before I knew I was pregnant," says Shae Conlin. "My daughter lived for one hour until she passed away in my husband's arms." (...)

Increasing use of antidepressants in pregnancy
American Journal of Obstetrics and Gynecology 2007;196(6):544.e1-544.e5 (June 2007)
(...) Results
During the study period, 8.7% of women giving birth had exposure to any antidepressant; 6.2% had exposure to a selective serotonin reuptake inhibitor. Maternal age > 25 years (P < .0001), white race (P < .0001), and education > 12 years (P = .008) were significant predictors of antidepressant exposure. The proportion of pregnancies with antidepressant use increased from 5.7% of pregnancies in 1999 to 13.4% of pregnancies in 2003 (p<.0001). The increase was mostly accounted for by increases in selective serotonin reuptake inhibitor exposures.

Conclusion
There is an urgent need for further studies that better quantify the fetal consequences of exposure to antidepressants. (...)

Tidobling av fødsler med alvorlig misdannelse
vg.no 11.6.2007
Antallet tilfeller av barn født med deler av innvollene utenpå kroppen øker dramatisk.

- Økningen skjer over hele verden og er spesielt sterk blant yngre kvinner, sier overlege ved Nasjonalt senter for fostermedisin (NSFM), Anne Brantberg til Adresseavisen.

Hun forsvarte fredag sin doktorgrad der hun tar for seg defekter i bukveggen og på ulike nivåer i fordøyelseskanalen, som spiserør, tolvfingertarm og endetarm.

Mens forekomsten av diagnosen gastrochise, det vil si «åpen bukvegg», på 60-tallet i Norge var ca. ett barn av 20.000, var forekomsten i Brantbergs materiale hele ett av 2.000.

Ingen kjenner årsaken til at antallet barn som fødes med innvollene på utsiden av magen øker, og en rekke internasjonale forskningsmiljøer jobber med å løse gåten. (...)

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