A research team at UCLA studying early developmental exposure to the SSRI antidepressants Prozac and Lexapro (escitalopram) has found that although the two drugs are thought to work the same, they do not cause the same long-term changes in anxiety behavior. The researchers feel that with additional study, it may be possible to identify which antidepressants are safest for pregnant women and their babies.
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UCLA Study Finds SSRIs have Different Effects in Pregnant Women
About 15% of U.S. women suffer from anxiety and depressive disorders during pregnancy, and many are prescribed antidepressants from the selective serotonin reuptake inhibitor (SSRI) class. However, little is known about how these drugs may affect their unborn babies. This is an important question because approximately 5% of all babies born in the U.S. — over 200,000 each year — are exposed to antidepressants in the womb.
The UCLA research team studied the effects of Prozac and Lexapro in a mouse model that mimicked exposure during the 3rd trimester of human pregnancy. The mice that were exposed to Lexapro had permanent changes in serotonin neurotransmission and were less anxious as adults compared to mice exposed to Prozac, according to the study.
“This was quite surprising, since these medications belong to the same drug class and are believed to work by the same mechanism,” said Anne Andrews, the study’s lead author and a UCLA professor of psychiatry, chemistry and biochemistry. “The implications of these findings are that with additional investigation, it may be possible to identify specific antidepressants that are safer for pregnant women.”
SSRIs work by blocking the actions of serotonin transporters, which remove serotonin from the space between neurons. The researchers also studied mice that had been genetically engineered to have fewer serotonin transporters in the brain, so they were able to compare the effects of early exposure to SSRIs with the effects of the mice’s permanent reductions in serotonin transporter function.
In humans, genetic reductions in serotonin transporters are considered a risk factor for the development of anxiety and depressive mood disorders, particularly when combined with external stress factors. In fact, in the new study, the genetically engineered mice exhibited more anxiety as adults.
Based on the findings, the researchers theorized that early exposure to Lexapro may change the way serotonin neurons supply brain regions that control mood and anxiety behavior — a concept they plan to study in the future. The team also plans to look at other SSRI antidepressants including Paxil and Zoloft.
“Current antidepressant therapies are ineffective in treating anxiety and depression in large numbers of patients, and advances in predicting individual responses are hindered by difficulties associated with characterizing complex influences of genetic and environmental factors on serotonergic transmission in humans,” the study states. “Highly controlled animal models, such as those studied here, represent avenues by which to identify factors potentially influencing behavioral domains associated with emotion-related disorders.”