By Peter C. Gøtzsche at Brownstone dot org.

On 23 August 2025, award-winning science journalist Robert Whitaker, founder of the evidence-based Mad in America website, published a very important article:

"Not even the unborn are safe from psychiatric harm: Medical organizations and the media dismiss the large body of research telling of fetal harm from exposure to antidepressants during pregnancy."

I summarize here Bob's detailed article, adding my own thoughts and explanations about the issues.

On July 21, the FDA convened a panel on antidepressants in pregnancy, with a focus on possible harms to the fetus from exposure to the drugs.

The panelists' brief presentations, and their plea for informed consent, did not sit well with medical organizations. They issued statements denouncing the panel as biased and misinformed; declared that the evidence showed that SSRIs and SNRIs are effective and safe treatments for prenatal depression; and claimed that the real concern was untreated depression. Major media echoed uncritically this flawed and erroneous expert consensus in their reporting on the panel.

The professional organizations betrayed the public's right to know. They were putting their guild interests - protecting their prescribing practices and belief in the efficacy and lack of harms of antidepressants - ahead of their duty to provide an honest basis for informed consent. As detailed below, they misled the media, and the media in turn misled the public, in both cases very seriously so.

One of the panelists, Michael Levin, concluded that since serotonin is important for embryonic development, "manipulating its use by cells with SSRIs is very, very likely to cause certain kinds of defects."

Animal experiments have proved him right. Fetal exposure to SSRIs leads to altered brain development, numerous risks to fetal health, and deficits in behavior after birth. At birth, fetal SSRI exposure in rodents is associated with low birth weight, persistent pulmonary hypertension, increased risk of cardiomyopathy, and increased postnatal mortality.

After birth, such exposure is associated with delayed motor development, reduced pain sensitivity, disrupted juvenile play, fear of new things, and a higher vulnerability of affective disorders (such as anhedonia-like behavior). These behaviors are regarded as signs of anxiety and depression in animals.

With the animal studies showing also an increased risk for miscarriage, pre-term birth, and congenital malformations, the first wave of studies in humans focused on these concerns, in addition to low birth weight and persistent pulmonary hypertension. This research produced an abundance of findings that the risk of such adverse events is elevated with fetal exposure to SSRIs in comparison to healthy controls.

A fair number of studies tell of how in utero exposure to SSRIs alters brain development in humans and lead to other harms. For example, a study by Kaiser Permanente of Northern California of 82,170 pregnant women showed that if the depression was treated with counseling, the risk of a pre-term delivery was reduced by 18%, whereas treatment with an antidepressant increased it by 31%. In both cases, there was a dose-response relationship.

Another harm is the neonatal abstinence syndrome, which is common, e.g. it occurred in 30% of 60 newborns exposed to SSRIs in utero. Researchers have published an extensive list of abstinence symptoms, which includes jitteriness, poor muscle tone, weak cry, abnormal crying, respiratory distress, seizure, abnormal behavior, sleep abnormalities, poor feeding, vomiting, uncoordinated sucking, and lethargy.

In a study using the World Health Organization's database for adverse drug effects, researchers classified 84% of the reported abstinence symptoms as serious.

The Doubt Industry at Work

The rodent studies, which were not confounded, clearly showed how fetal exposure to SSRIs regularly leads to maladaptive adult rodents. Correspondingly, in comparison wit...