Antidepressants and Clubfoot Birth Defect
Congenital clubfoot (congenital talipes equinovarus) is a deformity of the leg and foot that is present at birth. When an infant is born with clubfoot, the bones, joints, muscles and blood vessels in their leg and foot are abnormal. Clubfoot can affect one or both feet. The foot is generally turned inward and downward and the calf muscles of the affected foot are often underdeveloped. Clubfoot can range from mild to severe and if not treated properly will cause pain and/or disability with walking and moving later in life.
The treatment of clubfoot deformity usually begins soon after birth. Because an infant’s joints and bones are so flexible, treatment can be successful. There are both surgical and non-surgical methods to treating clubfoot. These include:
- The Ponseti method or Ponseti technique: This method, named after its creator, Dr. Ignacio Ponseti, consists of casting, bracing and stretching the foot or feet. A series of casts and braces are used to manipulate the affected foot into a correct position. A series of stretching exercises and special shoes then maintain the position of the treated foot or feet. This method is very time-consuming and demands patience as full correction of the clubfoot may take up to two years.
- Clubfoot surgery: In severe cases of clubfoot, surgery may be necessary. During surgery, which usually occurs within the first year of life, an orthopedic surgeon will lengthen the tendons of the affected foot or feet. This allows the foot to be manipulated into a more normal position. A brace is often required after surgery and is worn for about a year.
The cause of clubfoot is not known. There are studies, however, that have linked the congenital deformity with the use of Selective Serotonin Reuptake Inhibitors (SSRIs) while pregnant. Some studies suggest that babies are more likely to be born with clubfoot if their mothers took antidepressants while pregnant. Some mothers who took certain antidepressants like Effexor, Pristiq, Celexa, Lexapro, and Zoloft, have reported that they have had babies born with clubfoot.
The authors of a July 2007 article in the New England Journal of Medicine showed concern over the higher occurrence of clubfoot in infants whose mothers took SSRIs while pregnant. Researchers stated that the association between certain antidepressants and higher incidence of congenital clubfoot “warrants further exploration.”
A study conducted by the Institute of Reproductive Toxicology at the University of Ulm, Germany, also found a connection between the ingestion of SSRIs during pregnancy and a higher rate of congenital clubfoot birth defect.
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