11.3 Consequential Chemicals: Antidepressant Risks during Pregnancy

[00:00:00] Here, Adam tells us about some of the potential neurodevelopmental and fetal development risks associated with mothers taking SSRI antidepressants, an issue he's been outspoken about for 20 years.

[00:00:13] Dr. Urato is not trying to pill shame anybody.

[00:00:16] He's trying to provide compassionate and informed care so that his patients can make the best possible decisions based on the true scientific evidence.

[00:00:29] He outlines this evidence starting with basic common sense scientific principles, to basic science studies, on to animal studies and later human studies, and most recently MRI studies of children of exposed mothers, revealing changes in brain tissue and differences in connectivity compared to controls.

[00:00:51] His stance is not that all pregnant women should stop taking their antidepressants, but rather that they have all the relevant information at their disposal to make the best possible choice for them.

[00:01:04] He talks a little bit about the misinformation that is taught in training, including my psychiatric training, that SSRIs are completely safe during pregnancy.

[00:01:14] And this topic leads into another discussion about lithium, specifically using low doses as an antidepressant monotherapy, which is not FDA approved but has the best evidence of any drug in reducing the worst outcome in depression, suicide, and may be significantly safer than SSRI antidepressants, especially at low doses during pregnancy.

[00:01:40] Adam discusses the vicious cycle of profitability with so many bad actors promoting bad information because it benefits them and continues to benefit them.

[00:01:51] Hope you enjoyed this part of our talk.

[00:01:52] Thanks for listening.

[00:01:56] Somebody get this guy some help.

[00:01:59] You know, one of the saddest things that I've seen in my field is in 1987, Ronald Kessler was at Harvard.

[00:02:13] He was quoted as saying that mental illness does not exist in children.

[00:02:20] It's really a neurodevelopmental, but more of an adolescent developmental condition.

[00:02:25] Now that is excluding things like intellectual disability or trauma based reactions to things.

[00:02:31] But when we talk about bipolar disorder, we talk about schizophrenia.

[00:02:35] These are things that it's almost mandated that people go through puberty in order to, I think, develop their conscious subconscious relationship or limbic system frontal lobe relationship.

[00:02:48] And with that comes mental illness.

[00:02:50] And with that comes mental illness.

[00:02:53] But there's a really telling stat in 1987, point two percent of Medicaid insured youths were on any psychiatric medication.

[00:03:03] And as of 2018, that number is almost 20 percent.

[00:03:08] We are over medicating the crap out of our kids.

[00:03:12] And who knows what kind of impact that's going to have in the long term?

[00:03:17] As you were talking about children being exposed, because during pregnancy, those rates now of antidepressant use, depending on where you look, which population, it's between about five to 10 percent, which is a sizable percentage of the population of developing babies being exposed to antidepressants during pregnancy.

[00:03:38] And when you lump in other medications, mental health medications, but also other medications, the number of exposed babies being exposed to medication and to polypharmacy to a number of different medications has really risen over the past few decades.

[00:03:55] Yeah. So one of the other kind of big hot button issues that you've been involved with for the last 10 years, I think your chemicals have consequences, which I hope you don't have a patent on because I use that with my patients all the time.

[00:04:08] After I heard you say that it's just so good.

[00:04:11] I'm always like, if I can get a point across with the fewest amount of words with a patient, they're almost always going to retain that better than some lengthy explanation where they're going to get lost in the weeds.

[00:04:23] I love the sarcasm that you use.

[00:04:25] It really speaks to me.

[00:04:26] You talked about a woman going to her doctor back when there was the chemical imbalance theory of low serotonin and all we have to do is raise your serotonin levels and you won't be depressed anymore.

[00:04:38] And basically the doctor saying, we're going to give you this powerful serotonergic drug that is going to correct this imbalance in your brain.

[00:04:47] And then the woman says, I'm thinking about getting pregnant.

[00:04:50] Is this going to have an impact on my baby?

[00:04:52] And the doctor knowing that it crosses the placenta and high percentages says, no, this powerful brain drug, it's not going to affect the developing brain of your fetus.

[00:05:04] Tell us a little bit more about your experiences and your history of working on this problem and the outcomes of antidepressant use during pregnancy.

[00:05:15] Yeah, I've been outspoken on this now.

[00:05:17] I think coming up for about 20 years, I've been speaking out about antidepressants and pregnancy.

[00:05:23] I think to sort of lead into the topic, what I would say is my key focus is on providing pregnant women and the public with compassionate care.

[00:05:34] You want to have compassionate care for pregnant women and women with depression.

[00:05:39] They need compassionate care.

[00:05:41] They need good care.

[00:05:42] They shouldn't be ignored.

[00:05:45] They shouldn't be pill shamed.

[00:05:47] And my message is actually none of that.

[00:05:49] I'm not trying to tell people to ignore depressed pregnant women or pill shame or any of that.

[00:05:55] Pregnant women need good compassionate care, but a big part of good compassionate care is giving women the right information.

[00:06:04] And that's just basic medicine, providing women with the risks, benefits, alternatives, therapeutic options for anything.

[00:06:13] So that is providing good compassionate care.

[00:06:16] The central question that patients ask me every day, do these medications, the antidepressants, in particular, the SSRI antidepressants, do they affect the developing baby?

[00:06:28] And I think that your example there was a good one, which is that there's a scientific consensus at this point that the answer to that question is yes, these medications do affect the developing baby.

[00:06:42] But it's information that's not getting out necessarily to patients in the public.

[00:06:46] I have patients who come in regularly on these medications.

[00:06:50] They'll be on Prozac, they'll be on Zoloft, and they'll tell me that the only counseling that they get shot was that these don't affect the baby.

[00:06:58] And that's just not supported by the scientific information that we have.

[00:07:04] If you look just from a common sense standpoint, it's what you said, Ethan, which is that we're telling pregnant women that have depression or anxiety, look, we're going to give you these powerful

[00:07:16] chemicals, these SSRIs that are going to go into your brain and have significant profound effects on your brain chemistry that are going to cure your depression.

[00:07:26] That's what they're telling them.

[00:07:28] We're telling them in a non-OB setting.

[00:07:32] Then when they ask the question in the OB setting, and when I use the example, I say you're telling women this in one room, and then you go to the next room and she's pregnant and she asks, do they affect the baby?

[00:07:42] And you're saying, no, there's no effect on the baby.

[00:07:45] It doesn't make any sense.

[00:07:46] If it's a chemical that goes into the brain, it's going to have chemical effects.

[00:07:52] That's what chemicals do.

[00:07:53] Chemicals have consequences.

[00:07:54] It's going to go into the brain and it's going to cause effects.

[00:07:57] So from a common sense standpoint, we know that.

[00:08:00] Then we say, OK, but let's test it or study it.

[00:08:04] If you study the effect of SSRI antidepressants on neurons, you see effects.

[00:08:10] These studies have been done again and again.

[00:08:12] SSRIs affect neurons.

[00:08:14] They affect brain cells.

[00:08:16] So we've got common sense, number one.

[00:08:19] Number two is we've got basic science studies.

[00:08:23] Then you say, OK, let's take it a step further.

[00:08:25] Let's look at the animal studies.

[00:08:27] If you take pregnant animals and you randomize them, whether it's

[00:08:30] rats or mice or rabbits, if you randomize them into an SSRI exposed group

[00:08:37] and a non-SSRI group, you see changes in the developing babies.

[00:08:43] And so that's the animal data.

[00:08:45] Then the last step of this, I think we're up to step four now, is the human studies.

[00:08:50] We do human studies and we also see effects of the SSRI antidepressants

[00:08:56] on the developing babies.

[00:08:58] As far as the pregnancy goes, there's fairly good data showing impact,

[00:09:03] increases in preterm birth, effects on low birth weight, increases in preeclampsia,

[00:09:10] increases in postpartum hemorrhage.

[00:09:13] The FDA just added that to the label, the increase in postpartum hemorrhage

[00:09:16] with antidepressant use in pregnancy.

[00:09:18] And then what's really profound, the huge difference that we see is

[00:09:24] with a condition called for neonatal adaptation or newborn withdrawal syndrome

[00:09:29] or neonatal abstinence syndrome.

[00:09:32] What it is, is when these babies come out and the mom has been using

[00:09:36] antidepressants during pregnancy, we see a lot more difficulty

[00:09:40] during the newborn period.

[00:09:41] Things like jitteriness, trouble feeding, odd sort of motor movements,

[00:09:47] things like that.

[00:09:48] And we see that depending on which study you look at, those rates

[00:09:51] can be as high as I think up to date, which is the online textbook,

[00:09:56] quotes it as high as 80% plus.

[00:09:58] Most studies are not that high, but we do see significant effects

[00:10:01] from these medications on the developing babies.

[00:10:05] So the issue again, to step back and sort of from the summary to say,

[00:10:09] you know, what are we trying to answer here?

[00:10:11] We're trying to answer, do these medications, do the SSRI antidepressants

[00:10:16] affect the developing baby?

[00:10:18] There's a general scientific consensus.

[00:10:20] Yes, that they do.

[00:10:22] Then the second part of that is should pregnant women and the public be aware

[00:10:25] of this? The answer to that one is yes as well.

[00:10:29] And the reasons they're not, we can get into further about, you know,

[00:10:33] how, how the control of information is out there on these subjects.

[00:10:36] Yeah. First, just to add a little bit more substance, when you talk

[00:10:41] about the animal studies, of course, animals are not humans, right?

[00:10:44] Therefore those are not reliable studies.

[00:10:47] And I'm being sarcastic, of course.

[00:10:48] But as you've mentioned before, you can't do the studies that you do in animals

[00:10:54] on pregnant women because it's unethical.

[00:10:58] That's the roundabout that the pharmaceutical industry tries to put us

[00:11:01] on that path, that never ending circle where you can never actually get

[00:11:05] to the truth because the animal studies can't be replicated in humans.

[00:11:10] But animals are not like humans, but they are anyway.

[00:11:14] So a couple of things that you see in those rats or mice,

[00:11:17] I know that they are less interested in copulation, less interested in sex.

[00:11:22] Can you talk just a little bit about the swim test as well?

[00:11:26] Yeah, we see. So these studies have been done again and again and again.

[00:11:31] When I used to lecture on this, I used to say there's going to be

[00:11:33] a movement like save the rats, stop exposing them during development

[00:11:38] to the SSR antidepressants because we already know from study after study

[00:11:42] that these are having effects.

[00:11:44] So as you were saying, they'll show these rats or mice grow up or come of age

[00:11:49] that they'll have different copulatory behavior in terms of the swim tests

[00:11:54] or maze tests, they'll behave differently in those testing scenarios.

[00:12:00] And then things like how they socialize will be different

[00:12:05] in terms of how they get along.

[00:12:07] People have referred to these as autistic-like behaviors

[00:12:10] or abnormalities in socialization.

[00:12:13] What's happening again from a very

[00:12:18] scientific or basic science perspective, you've got to come back to the chemical.

[00:12:23] You've got a rat brain or human brain trying to develop,

[00:12:27] trying to wire itself for a human brain.

[00:12:30] There's about 100 billion neurons, I think, and there's 100 trillion connections.

[00:12:35] So the human developing fetal brain needs to do all that wiring.

[00:12:41] And serotonin is a cell signaling molecule.

[00:12:45] It's telling the neurons where to go, how to connect, that sort of thing.

[00:12:49] When you add an SSRI antidepressant throughout development,

[00:12:52] you're going to alter those kind of connections

[00:12:55] that are so crucial to the formation of the brain.

[00:12:58] This is just basic science.

[00:13:00] Like what is the chemical effect in the brain,

[00:13:04] whether it's a rat or whether it's a human?

[00:13:06] So then you're going to get some effects and then you're going to see that

[00:13:09] when you do these studies in the rat or mice or rabbit offspring

[00:13:15] with their behavior, with their socialization, with their copulatory behavior,

[00:13:20] with how they behave when they're forced to swim.

[00:13:23] They're going to behave differently than unexposed

[00:13:27] because they've been subjected to a chemical

[00:13:31] that's altered the formation of their brain during that crucial time period.

[00:13:35] Hey, you triggered an idea for me.

[00:13:37] Maybe we're going about this all wrong.

[00:13:39] Maybe we need to be petitioning PETA

[00:13:42] and PETA will lead the charge on, you know, animals

[00:13:46] not being allowed to take antidepressants when they are pregnant.

[00:13:52] Yeah, well, no, this is something that I used to say, you know,

[00:13:54] half joking is that there needed to be a movement

[00:13:57] because we don't really need more pregnant rats

[00:14:02] and mice and rabbits to be given antidepressants

[00:14:06] to see if they're having effects on development, because we know that.

[00:14:09] We've got so much data.

[00:14:12] There are so many animal studies showing this.

[00:14:15] And it just makes common sense.

[00:14:17] If serotonin is a crucial cell signaling molecule

[00:14:22] and crucial for brain development, if that's a true statement, which it is,

[00:14:27] serotonin is a crucial cell signaling molecule,

[00:14:29] it's crucial for brain development.

[00:14:31] And if SSRI antidepressants alter the serotonin system, which is true,

[00:14:37] then we know there's going to be effects on brain development.

[00:14:41] And then we do these studies, numerous ones on animals that have shown these.

[00:14:46] It should come as no surprise that we see effects on brain development.

[00:14:50] When we do them in humans, we also see these effects.

[00:14:53] For years, it was just trying to study how the kids were doing.

[00:14:57] For example, if you do EEG studies, electroencephalographic studies

[00:15:02] like you do for patients that are having seizures on babies

[00:15:06] who have been exposed to antidepressants versus unexposed.

[00:15:09] It's a significant difference.

[00:15:12] The brain waveforms in the EEG are different than the exposed babies.

[00:15:17] It's becoming more certain now that we're using MRI.

[00:15:22] There's now, by my last count, about 10 MRI studies

[00:15:26] that have shown the impact of SSRI antidepressants on the developing fetal brain.

[00:15:33] They do these studies on babies or even further along than babies, on children.

[00:15:38] And they can show effects.

[00:15:40] The group that was exposed to SSRIs in pregnancy,

[00:15:43] their brains on MRI and on functional MRI,

[00:15:47] which looks at connectivity and activity in the brain,

[00:15:50] look different than the unexposed brains do.

[00:15:53] I tweeted about this, by the way, for people that are interested.

[00:15:56] I think the tweet is from April 17th, 2023, where I was up to nine.

[00:16:01] I collected them all in one place.

[00:16:03] There have been a couple of additional MRI studies, but they're out there.

[00:16:07] I mean, this evidence is out there.

[00:16:09] Yeah, I thought it was one study MRI wise,

[00:16:11] but that's a lot of evidence, a lot of data.

[00:16:14] One of the craziest things that I have seen in my field

[00:16:18] is that I'm seeing a patient who's suicidal.

[00:16:22] What is the first line treatment?

[00:16:24] What I'm supposed to do is prescribe them a drug

[00:16:28] that puts them at increased risk of killing themselves

[00:16:32] in the first two weeks of treatment.

[00:16:34] When I have another drug that has much better proven evidence

[00:16:40] and I can use it at relatively low doses,

[00:16:43] the only drug outside of clozapine, which is a very, very difficult

[00:16:47] to use antipsychotic that reduces the risk of suicide in lithium.

[00:16:53] Yet, huh, lithium, it's a very cheap, old, unpatentable medicine.

[00:17:00] That always blew my mind that I was supposed to give somebody

[00:17:04] something that could tip them over the edge.

[00:17:07] And then the pharmaceutical industry will say, yes,

[00:17:10] if you give SSRIs to bipolar patients, then they may have

[00:17:14] that manic like reaction or they may have a suicidal reaction,

[00:17:18] but they act like it's this obvious thing that I'm diagnosing

[00:17:21] that I can tell that an 18, 19, 20 year old person

[00:17:25] when the average age of onset is 22 and males, 27 and females,

[00:17:29] that I'm somehow supposed to know who's going to have

[00:17:32] what reaction to the SSRI.

[00:17:35] I think you're raising a very important point there.

[00:17:37] And you also raised this earlier in our conversation

[00:17:40] about using the suicide, playing the suicide card in this debate.

[00:17:45] Again, my discussion about this and trying to raise awareness

[00:17:51] is to try to properly counsel patients and get them

[00:17:54] the right information about therapeutic options.

[00:17:58] It's not to again, to ignore depression in pregnancy.

[00:18:03] It's not to pill shame.

[00:18:05] And it's just to provide the proper information

[00:18:08] and then allow patients to make the best decision for themselves.

[00:18:12] I'm taking care of friends, neighbors, so I'm not trying to pill shame them.

[00:18:17] I'm certainly not trying to have them worsening or committing suicide.

[00:18:21] I do think that sort of suicide card gets played.

[00:18:24] But maybe you can answer this better than I can.

[00:18:27] It doesn't look like the data is clear, though, in that direction.

[00:18:31] In fact, I think people have looked at this and says

[00:18:34] it does look like it may be causative,

[00:18:36] certainly in young people, increased risk of suicide with the SSR antidepressants.

[00:18:42] And I believe there's an FDA warning on that for young people,

[00:18:45] for children then into the younger ages.

[00:18:48] And there's some concern even beyond that in adults

[00:18:50] about actually causing suicide with the initiation of these drugs.

[00:18:55] I always tell my patients that there is this black box warning for adolescents,

[00:19:01] but also that the drug that is given to you doesn't know when you turn 18.

[00:19:06] There's not some switch that goes off in your brain

[00:19:09] that makes you not at risk of that any longer.

[00:19:12] David Healy talks about concerns about some of these episodes of mass violence

[00:19:18] in what honestly tends to be 18, 19, 20, 21 year olds

[00:19:24] who a lot of them have history of psychiatric treatment.

[00:19:27] There have been all kinds of court cases.

[00:19:29] I mean, I know you've done your own expert litigation on antidepressants

[00:19:34] and David Healy has done a lot of work testifying in some of those huge court cases

[00:19:40] from a very, again, basic explanation of what happens.

[00:19:44] If you have somebody who's already very depressed,

[00:19:49] SSRIs really they have much better impact on anxiety than they do depression,

[00:19:54] at least what we used to call depression with slowed movements,

[00:19:59] slowed expressions, not talking a whole lot, not doing a whole lot,

[00:20:04] but internally ruminating very negative self-talk.

[00:20:07] But if you have a depressed person thinking about killing themselves

[00:20:12] and then you give them a drug that reduces that anxiety that may have

[00:20:16] actually been protecting them from engaging in any sort of ass, in essence,

[00:20:21] kind of numbs them, which is a known effect of SSRIs can be useful for somebody

[00:20:27] who has a pure form of anxiety, severe anxiety like OCD.

[00:20:31] But if you have somebody who's biologically or classically depressed,

[00:20:35] like we used to diagnose them on the manic depression spectrum

[00:20:39] and you take away that anxiety, that can push them over the edge

[00:20:43] to impulsively engage in that behavior.

[00:20:46] It's something that drives me crazy because people see the amount of lithium

[00:20:50] that I use even again at low doses.

[00:20:53] And you're talking about a fraction of the risks that are associated with high dose.

[00:20:58] Even the low doses have such an incredible impact on reducing the risk of suicide.

[00:21:04] And this is data that has been around for a hundred years medically.

[00:21:08] We're talking about thousands of years in ancient cultures.

[00:21:11] I did want to know if you know anything about the risks

[00:21:15] of the pregnant mother taking low doses of lithium to manage their condition.

[00:21:21] Yeah, I don't know if that dosing has been studied.

[00:21:24] We're always taught to avoid it because of the cardiac defects,

[00:21:28] because of lithium's effect on the heart.

[00:21:30] Occasionally I have taken care of some moms who are on lithium

[00:21:34] during the course of their pregnancy.

[00:21:35] We make sure we evaluate the fetal heart, get a fetal echocardiogram

[00:21:39] typically with a pediatric cardiologist to take a close look,

[00:21:42] make sure that heart is normal because of those concerns.

[00:21:45] But I'm not aware of the data looking at low dose.

[00:21:49] It may be out there, but I'm not aware of it.

[00:21:51] I can certainly send you some of the things that I have.

[00:21:54] Some of the really interesting stuff lately is its impact in COVID as an antiviral.

[00:21:59] We noticed that bipolar patients on lithium,

[00:22:02] they're not having these horrible outcomes.

[00:22:05] There was a Spanish COVID study only had 28 patients in it,

[00:22:09] all bipolar and all admitted to the hospital with COVID.

[00:22:13] 14 of them were on lithium, 14 weren't.

[00:22:16] The outcomes were much better in the lithium group.

[00:22:18] This is not a big enough study to draw widespread conclusions from.

[00:22:22] But the interesting thing is they measured 18 different cytokines.

[00:22:27] Now, we have known effects in HIV, HSV and several other viruses.

[00:22:32] But what it looks like it does in COVID or to the immune system

[00:22:36] is it keeps it within the guardrails.

[00:22:38] All 18 of those cytokines in the lithium treated group

[00:22:41] versus the non-lithium treated group were reduced.

[00:22:45] All of them were out of the hospital within a week

[00:22:48] versus the other group had two deaths, had several ICU admissions.

[00:22:52] The average stay much longer than a week.

[00:22:55] To me, it's like, well, golly, shouldn't we be investigating this with large studies?

[00:23:01] Why is this not a more accepted treatment?

[00:23:03] Why is this not even FDA approved for what we call now

[00:23:07] unipolar depression or major depressive disorder?

[00:23:11] And if you and I are both starting a lithium company, then

[00:23:15] one of us has to do the studies for the FDA approval

[00:23:18] for major depressive disorder.

[00:23:20] And the other one of us can then just completely profit off of it.

[00:23:23] And I could use your study and say, yeah, it's effective.

[00:23:27] And now Adams spent millions of dollars to gain the FDA approval.

[00:23:31] But you're not as likely to get that money back on the tail end.

[00:23:36] This gets, though, to, I think, an important question, which is that

[00:23:39] the answers that we generate about things, why we're using,

[00:23:42] what drugs we're using or what answers we give to medical questions

[00:23:47] and what information gets out to the public on them,

[00:23:50] whether it's about psychiatric treatments that you're talking about

[00:23:53] or about lithium or about the effects of antidepressants in pregnancy.

[00:23:57] There's a scientific answer to a lot of these questions.

[00:24:00] But then there's also a commercial answer.

[00:24:04] And so this is the problem and a big issue I try to focus on,

[00:24:09] which is how patients and how the public get information about things.

[00:24:14] And the problem is that, for example, if you ask a basic question,

[00:24:19] do SSRI antidepressants affect the development of the baby?

[00:24:22] You'd say there's a scientific answer to that.

[00:24:24] And there's general agreement that the scientific answer is yes.

[00:24:28] It's a chemical that's running into the mom, it's running into the baby.

[00:24:31] And chemicals have consequences and there are effects.

[00:24:34] So that's the scientific answer.

[00:24:37] But that answer that the medication does affect the baby,

[00:24:41] that doesn't help to sell the drugs.

[00:24:44] And so the commercial answer to that question is actually no,

[00:24:49] is actually to sort of money the waters and try to make that answer

[00:24:54] seem much more complex than it is and actually try to make some people

[00:24:58] or many people believe that the answers know that it doesn't affect the baby.

[00:25:02] The reason that's the right answer from a commercial

[00:25:05] standpoint is that's going to lead to more sales of the drug,

[00:25:08] more young women using it and more young women using it during pregnancy.

[00:25:13] So what you end up with is the public has trouble

[00:25:18] getting proper information on these things.

[00:25:21] I'm circling back from your example about what treatments work,

[00:25:24] whether it's lithium or whether it's something else,

[00:25:27] because the public is having trouble getting the right information on these things

[00:25:31] because there's a commercial incentive to come up with certain answers

[00:25:37] that's not necessarily the right information.

[00:25:40] So you'd say whatever the product is, I'm using antidepressants here.

[00:25:43] We're trying to ask a question,

[00:25:45] do the antidepressants affect the developing baby?

[00:25:49] The scientific answer for anybody who reads this literature

[00:25:52] or thinks about it for any amount of time is yes, it's a chemical.

[00:25:56] It affects the serotonin system.

[00:25:57] It's running into the baby

[00:25:59] who needs the serotonin system working in a certain way to develop.

[00:26:02] So that scientific answer is yes.

[00:26:04] But the commercial answer to that question, do they affect the baby?

[00:26:08] The commercial answer is actually no, because that answer will lead

[00:26:13] to more young women being on the drug, more young women staying on the drug.

[00:26:18] The pharmaceutical industry, the last thing they want are young women,

[00:26:21] a significant proportion of users of these medications,

[00:26:24] staying off these medications because of their concerns

[00:26:27] about getting pregnant on them or for that matter,

[00:26:30] coming off of them during pregnancy and not resuming them.

[00:26:34] And so the commercial answer basically to the question is no,

[00:26:39] they don't affect the developing baby.

[00:26:40] So then you ask the question, what answer gets out to the public?

[00:26:44] And the answer that typically gets out to the public is the commercial answer

[00:26:48] because so many of the people providing information,

[00:26:51] whether it's the key opinion leaders or whether it's the commercial media

[00:26:56] or the professional medical societies are funded by the industry,

[00:27:01] are funded by the pharmaceutical industry.

[00:27:04] And so that commercial answer is the answer that tends to get out to the public.

[00:27:09] The journalists here have done a very poor job

[00:27:12] of actually informing the public, unfortunately.

[00:27:15] Corporate media does basically what you'd expect corporate media to do,

[00:27:21] which is to cover things with the commercial answer to these questions,

[00:27:26] cover things in such a way that are going to increase sales and profits.

[00:27:30] And we should have a lot more health journalists.

[00:27:32] We've got in some places 10 percent or more of pregnant women

[00:27:36] taking these medications.

[00:27:37] They appear to be having significant impacts on the fetal brain.

[00:27:41] You would expect that you'd have more media, more journalist coverage

[00:27:45] of these studies or of this area.

[00:27:48] But it's just not there because it doesn't produce

[00:27:51] a commercially lucrative effect showing harmful effects of medications.

[00:27:56] So what ends up happening is the public ends up

[00:27:58] poorly informed about a lot of these things.

[00:28:01] Yeah, it's disheartening how misinformed the American public is about these things.

[00:28:07] What about the risk of SSRI antidepressant use in breastfeeding?

[00:28:12] The concerns about SSRI antidepressant use in breastfeeding

[00:28:17] is that every mom baby pair functions differently when it comes to breastfeeding.

[00:28:23] For the most part, it looks like most babies do OK.

[00:28:27] Not a lot appears to get into the breast milk.

[00:28:29] But there have been case reports of moms using medications during breastfeeding

[00:28:34] and the breastfeeding babies being exposed and having high levels in the blood.

[00:28:40] And what's probably going on there is that the way the mom metabolizes

[00:28:45] the drug and concentrated in her breast milk, that particular mom

[00:28:49] and the way that baby suckles and gets the breast milk and metabolizes

[00:28:55] the drug, the way that pair is working for some reasons,

[00:28:58] leading to a higher level in the baby's blood.

[00:29:01] And then you can see effects, somnolence.

[00:29:04] Or I think there are some reports of seizures.

[00:29:06] So while for the most part, it seems OK, you can have a particular mom

[00:29:11] baby dyad where there are problems with medication used during breastfeeding.

[00:29:16] I would encourage you to look at some low dose lithium information,

[00:29:20] because I've heard that the risk of Epstein anomaly.

[00:29:24] And I was going to ask you if you'd have actually seen any is a lot lower

[00:29:28] than what the literature states.

[00:29:31] And also the risk of removing lithium from somebody's regimen.

[00:29:36] It's got a seven to 10 time protective effect.

[00:29:39] Removing it has close to 20 time negative effect on increasing the risk of suicide.

[00:29:45] I'm interested to email me the papers.

[00:29:49] Somebody get this guy some help.

[00:29:59] Thanks for listening.

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[00:30:49] If seeking medical advice, diagnosis or treatment, or put more simply,

[00:30:52] you need help like this guy, call your own doctor.