photoLaw firms are drawing a bead on Zoloft and other popular antidepressants, shopping for women who have given birth to infants with serious birth defects.  Stories planted around the Web say various law firms are "reviewing claims," legal jargon for shopping for plaintiffs.

Zoloft is a selective serotonin reuptake inhibitor (SSRI), the same class of drug as Paxil. Studies have indicated such drugs may carry a slight risk of contributing to serious birth defects and Zoloft is especially vulnerable because it is so widely-used.

What's complicating the situation is that the risk occurs as early as the first trimester, when many women do not know they are pregnant. By the time the pregnancy becomes known, the damage may have been done.

Tapering off

There is then the problem of tapering off Zoloft when the pregnancy is discovered. The drug has a half-life of about one day – meaning that for every day that passes without taking the medication, the level in the blood falls by 50%.

If one stops taking the drug too rapidly, discontinuation syndrome may develop, with symptoms of weakness, anxiety, insomnia, muscle pain and lightheadedness.

Tapering off Zoloft should be done only under a doctor's supervision. Women who are clinically depressed then face the problem of finding another drug that effectively treats their depression without undue risk of birth defects.

The U.S. Food and Drug Administration (FDA) advises women who are pregnant or thinking about becoming pregnant should not stop any antidepressant without first consulting their physician and says the decision to continue medication or not should be made only after there has been careful consideration of the potential benefits and risks of the medication for each individual pregnant patient.

A 2006 study published in JAMA reported that women who stropped taking their meds during pregnancy were five times more likely to have a relapse of depression during the pregnancy than women who continued to take their medications.

No warning?

Law firms readying litigation against Zoloft are likely to argue that the drug's manufacturer, Pfizer, does not adequately warn women about the risk of birth defects, although in November 2006, the FDA added warnings about the risks, which include heart defects, persistent pulmonary hypertension in newborns (PPHN), lung defects, abdominal defects, cranial defects and other malformations.

In June 2007, studies found an association between the use of antidepressants like Zoloft early in the pregnancy and a risk of abnormal skull development, gastrointestinal abnormality and brain defects.

In September 2009, a study published in the British Medical Journal found that SSRI antidepressants like Zoloft increase the risk of heart defects when taken during the first trimester, a time when many women do not know they are pregnant.