Antidepressant Use During Pregnancy Linked to Heart Defects in Babies

• SSRIs penetrate the placenta and fetal blood — According to the researchers, SSRIs and their byproducts can cross the placental barrier, moving through maternal blood and into fetal circulation. This raises the risk of heart toxicity during key developmental stages.

• To investigate further, they used human pluripotent stem cell models — These are a gold standard for studying human tissue development in the lab. They used two systems — 2D cardiomyocytes (heart muscle cells grown in a dish) and 3D cardiac organoids (miniature heart-like structures that better mimic early heart formation).

Compared to animal testing, these models offer far greater accuracy because they reflect real human cell behavior — eliminating errors caused by species differences.

• The aim was to assess the effects of three widely used SSRIs — These include fluoxetine, sertraline, and paroxetine. Aside from evaluating the short-term effects, the researchers also studied long-term disruptions by exposing cells during the heart’s earliest formation stages, a method designed to mimic real-world fetal exposure during the first trimester.

• Sertraline was the most toxic of the three drugs tested — Its estimated lethal concentration 50 (LC50) was around 7.5 to 7.8 μM — much lower than paroxetine and fluoxetine, which were closer to 33 μM. This means sertraline was more damaging to developing heart cells at lower doses.

• At the core of their findings was a consistent pattern — All three SSRIs impaired oxidative metabolism, the process by which cells convert oxygen into energy. After just five days of exposure to real-world concentrations — levels known to circulate in the blood of pregnant women taking these medications — heart cells showed elevated levels of reactive oxygen species (ROS).

Excessive ROS is a hallmark of oxidative stress and signals that the cells are being pushed beyond their metabolic limits, damaging proteins, DNA, and cellular membranes in the process.

• Adenosine triphosphate (ATP) production dropped significantly as well — ATP provides the energy that cells need to function — it powers the contraction of heart muscle cells, electrical signaling, and cellular repair. In SSRI-treated cardiomyocytes, ATP levels dropped sharply after several days of exposure, suggesting that the mitochondria — which are responsible for ATP production — were failing to perform under the strain of these drugs.

Although these effects didn’t show up right away, they became clear over time, indicating that long-term exposure, even at therapeutic levels, stresses the heart cells.

• Major depression affects up to 3% of seniors — The study also notes that 8% to 16% experience significant depressive symptoms even if they don’t meet the full criteria for major depression.⁶ Late-life depression is frequently dismissed as a natural part of aging, when in reality it carries major risks — including cognitive decline, difficulty recovering from illness, increased health care costs, and a higher likelihood of premature death.

• Older patients often end up with much higher blood levels of SSRIs — This happens even when taking the same dose as younger people. For example, steady-state plasma levels of paroxetine and citalopram in seniors were reported to be about two to four times higher than in younger individuals. This is because liver metabolism and kidney excretion — key steps in drug clearance — slow down with age.

• SSRIs also have direct effects on the blood vessels — SSRIs interfere with calcium channels in blood vessel walls, impairing a key defense mechanism in the circulatory system known as myogenic constriction. Normally, this mechanism helps arteries tighten in response to pressure, ensuring stable blood flow. But in older adults, SSRIs disrupt this response, making blood vessels less able to constrict when needed.

• SSRIs also promote artery-clogging diseases like atherosclerosis — The paper cites multiple studies showing that these drugs activate the inner lining of the blood vessels (endothelium) and encourage white blood cells to stick to it — early steps in plaque buildup.

Platelet function — important for blood clotting — also changes under the influence of SSRIs. Since serotonin plays a role in platelet activity, and SSRIs alter serotonin levels, they affect how platelets behave.

• SSRIs affect the heart itself — One type of SSRI called fluoxetine disrupts heart rhythm by blocking sodium and calcium channels. This can lead to arrhythmias like atrial fibrillation or dangerous slow heart rates, especially in those with existing heart failure.

• Taking SSRIs is associated with a higher risk of brain changes that could lead to autism — An animal study published in the journal Brain, Behavior, and Immunity found that SSRIs interact with inflammation in the mother’s body, producing a reaction that affects the maternal-fetal interface (MFI), which includes the decidua (a mucous membrane lining the uterus) and placenta, and ultimately the fetus’ developing brain.^7,8

• Offspring of female mice that were given SSRIs had behavioral changes in adulthood — The adult offsprings exhibited behavioral changes like lessened communication and low interest in social interactions — similar to the behavior of people with autism.

• The use of SSRIs during pregnancy has been tied to other significant health effects — A systematic review and meta-analysis found women who received SSRIs during pregnancy had a significantly higher risk of developing preterm birth than women in the control group.⁹ They’ve also been linked with an increased risk of neonatal seizures in newborns,¹⁰ as well as a higher risk of postpartum hemorrhage in women.¹¹

• Feed your cells with the energy they need — If your cells aren’t making enough energy, everything else starts falling apart, including your brain function. Your diet has a significant role not just in your physical but also your emotional well-being. That’s why I always recommend increasing your intake of easy-to-digest carbohydrates like ripe fruit. You need at least 200 to 250 grams of carbs per day if you’re an adult, more if you’re active.

In addition, minimize or eliminate seed oils high in linoleic acid (LA), processed foods, and snacks like nuts and seeds that are rich in polyunsaturated fats (PUFs). These block mitochondrial function and create toxic byproducts that worsen fatigue and brain fog. Choose healthy saturated fats that help your cells make energy, such as grass fed butter, ghee, or tallow.

• Address your nutrient deficiencies — Magnesium is one example — in fact, depressed individuals are found to have lower magnesium levels in the blood, brain and cerebral spinal fluid.^12,13 B vitamins also play an important role in brain health and cognition, and being deficient in some of these vitamins leads to mental issues. For example, B3 deficiency is associated with anxiety, aggression, and paranoia, while being B1 deficient leads to irritability, confusion, and disturbed sleep.¹⁴

• Get enough exercise — Being physically active works as a natural antidepressant and may help prevent prenatal depression.¹⁵ If you’re pregnant, consider doing gentle, low-intensity exercises, like yoga or walking outdoors.

• Spend time outdoors — Spending time under the sun helps uplift your mood. Sun exposure allows you to reap the benefits of vitamin D, and having optimal amounts of this nutrient has been associated with a lower risk of depression.¹⁶ I recommend a range between 60 and 80 ng/mL; make sure to get tested regularly to know that you’re optimizing your levels. However, there are some precautions to take before you expose yourself to sunlight.

For example, if you’ve been on a high-LA diet, avoid peak sun exposure until you’ve removed seed oils and other processed foods from your diet for at least four to six months. LA embeds into your skin and oxidizes with UV exposure, increasing your risk of sunburn and DNA damage.

Instead, go outside in the early morning or late afternoon, when the sun’s rays aren’t as intense. I recommend reading “The Fast-Track Path to Clearing Vegetable Oils from Your Skin” for more strategies to help speed up this process.

• Get enough high-quality sleep — Optimizing your circadian clock helps trigger brain chemicals that stabilize your mood and energy. Spend time outside every morning for at least 15 minutes of natural sunlight within 30 minutes of waking, then sleep in total darkness at night. In the evening, avoid all blue light sources, and maintain a bedtime routine that helps you get seven to nine hours of sleep nightly.

• Reduce chronic stress — Finding ways to lower your stress daily. Some effective methods include deep breathing exercises, meditation, or even spending time in nature. I also recommend the Emotional Freedom Techniques (EFT), a form of psychological acupressure that takes inspiration from the same energy meridians used in acupuncture. Below is a video from EFT practitioner Julie Schiffman on how to ease depression using this helpful tool.