Consumers can find information on off-label uses for many drugs if they know where to look. Here’s one link: http://books.google.com/books?id=fhEFkBxEtH8C&pg=PA118&lpg=PA118&dq=%22off+l

In a previous blog, we noted that 1 out of 7 prescriptions is written off-label. Now prescription drugs have become so popular that 1 out of every 4 prescriptions written is off-label. That's a whopping 115 million off-label prescriptions a year.

Typical off-label conditions for which doctors prescribe common anti-depressants include Wellbutrin to treat chronic lower back pain, and Prozac and Zoloft to relieve the symptoms of menopause.

Off-label prescriptions are completely legal and your doctor will tell you, accurately, that they are a vital alternative for optimal patient care. However, there are still risks of side-effects with these medications - no matter what the reason is that they might be prescribed. So consumers need to actively engage in open discussion with their physicians regarding side effects of any medication they might be given.

A recent article shows that 15% or approximately 1 in 7 expectant mothers will experience depression at some level during their pregnancies. http://www.medicinenet.com/script/main/art.asp?articlekey=84213

For mild to moderate depression, treatments such as cognitive therapy may be effective, according to the article. The severity of the depression determines whether a doctor will prescribe anti-depressant medication such as an SSRI. The use of SSRIs in treating depression is common but certain ones such as Paxil have been found to have serious potential risks to the fetus, especially if the mother takes Paxil in the first trimester.

Paxil was more likely to be prescribed for conditions such as anxiety or panic than other SSRIs. Interestingly, babies whose mothers used an SSRI had a much higher rate of echocardiograms in the first year of life when compared to babies whose mothers took nothing.

Selective Serotonin Reuptake Inhibitors are a class of antidepressants used to treat depression, anxiety disorders and some personality disorders. The brain has neurotransmitters, chemicals that act as messengers. These neurotransmitters are made of serotonin, also known as 5-Hydroxytryptamine or 5-HT, chemicals that naturally occur in the human brain.

Two specific areas of the brain have serotonin concentrations, the midbrain and the hypothalamus. These areas regulate mood, hunger, sleep and aggression. The neurotransmitters are released at one point and absorb at another. This is how the chemical message is emitted and received in the body.

Chemical imbalances of serotonin in these areas cause a variety of mood disorders, particularly depression. SSRI medications prolong or inhibit the process by which serotonin is taken up by neurons, thereby maintaining chemical balance in brain. http://psychcentral.com/lib/2006/choosing-the-best-ssri Inhibiting means stopping or retarding a chemical reaction. SSRI medications treat depression by inhibiting the uptake of serotonin, thus making more available for better brain function. www.answers.com/topic/inhibitor?cat=health

Unfortunately, these medications have side effects. www.holisticonline.com/Remedies/Depression/dep_antidepressant-SSRI.htm Side effects can be perilous for an unborn baby by, for example, damaging the fetal heart.

Taking an antidepressant like Paxil may increase a pregnant woman’s risk of having a baby with a birth defect. Although some researchers suggest that the chances appear remote and confined to a few so-called “rare” defects, those defects can be substantial.

The findings appeared in The New England Journal of Medicine. www.nejm.org GlaxoSmithKline www.gsk.com claims that antidepressants are not a major cause of serious physical problems in newborns.

Here’s the problem with these studies: they didn’t include enough cases to adequately assess risks and they didn’t include information on how long women were taking antidepressants or at what doses.

“These are important papers, but they don’t close the questions of whether there are major effects” of these drugs on developing babies. That’s what Dr. Timothy Oberlander said. He’s a developmental pediatrician at the University of British Columbia www.ubc.ca who was not involved in the studies. “There are many more chapters in this story yet to be told.”

In both studies, researchers interviewed mothers of numerous infants with birth defects, including heart valve problems. They found that mothers who remembered being on antidepressants like Paxil while pregnant were at no higher risk for “most” defects than a control group of women who said they had not taken antidepressants. But they are at higher risk for some birth defects.

For example, the study led by Carol Louik of Boston University www.bu.edu found that use of Paxil was associated with an increased risk of a heart defect in a newborn.

Well, we haven’t posted for awhile due to our trial schedule but now we have some time. Here’s the latest.

Consumers need to be actively involved in decision making when their doctors prescribe medications for them. Don't be afraid to ask questions and challenge decisions made by your doctor. If the decisions are good ones, they will stand up to scrutiny.

A case in point is Lisa Collins. Her general practitioner prescribed Paxil for her six months before she became pregnant because she had irritable bowel syndrome and at times felt claustrophobic. This proved to be a catastrophic choice for her son Chase who was born with a serious heart defect, which required open-heart surgery. http://www.houstonpress.com/2006-09-14/news/baby-blues/ As noted in this article, Collins did not suffer from severe depression or any mental illness - yet her doctor chose Paxil as a suitable choice to treat her symptoms.

GlaxoSmithKline's expert witness in our Tobin trial in Cheyenne testified that general practitioners have insufficient training to take the detailed history required before prescribing Paxil. Consumers need to be alert for problems that the prescribing doctor does not heed.