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Part 1: “Life was amazing”

“Please don’t forget about me”: Antidepressants and birth defects



“Life was amazing.” That is how Amery Schultz recalls life with his wife Christiane – before she began taking Wyeth’s blockbuster drug Effexor while pregnant. Since then, their lives have changed in ways they never could have imagined. Amery and Christiane were born in the same hospital, just a month apart. They weren’t childhood sweethearts, but they grew up together in the same small town in British Columbia. Christiane remembers her adolescence as a rocky time. “At school I was being bullied really bad, and my parents weren’t helping.” At 14 she left home and moved in with her older sister. “She wanted me to have fun, so she pushed me to go partying. I was drugged and assaulted a couple of times, and she wouldn’t help me.” Christiane turned to her old friend Amery for consolation, and when she got married for the first time at the age of 21, Amery was the best man at the wedding – at Christiane’s behest. Part I: “Please don’t forget about me”: Antidepressants and birth defects Part II: A gigantic uncontrolled experiment Part III: I was Absolutely Distraught Part IV: Patient safety is our highest concern

Toxic effects of the antidepressant drug

“I was drunk on my wedding day cause I didn’t want to get married,” Christiane says. “But my dad said he paid for the wedding so I had to go through with it, so I did.” Christiane secretly wished she were getting married to Amery instead, but she was afraid to tell him. It wasn’t until years later that she found out that Amery felt exactly the same way. Christiane’s first marriage was not a happy one. She was living in a strange city, far away from friends and family, feeling trapped in a marriage she remembers as abusive. She left her husband and returned to her hometown, but he followed her and she agreed to go back to him and give their marriage another try, with the aid of counseling. “He beat me up on the way home from anger management class,” Christiane recalls. Christiane remained in the marriage, got pregnant, and gave birth to a daughter. “She brought me so much joy,” Christiane remembers. But after filling out a ten-item questionnaire in a doctor’s office, Christiane was diagnosed with post-partum depression by a doctor who prescribed antidepressant medication for her. Christiane says she doesn’t know what kind of medication she was initially prescribed. She was not offered any counseling or prescribing information, just a blister packet of pills. Certainly no one ever asked her if she was depressed because she felt trapped in an abusive marriage. Christiane complained to her doctor about the toxic effects of the antidepressant drug she was prescribed, so her doctor tried another drug, which didn’t help either. Christiane left her first husband and returned to her hometown, where she and Amery finally got married and began making plans to have a family together.

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Thus begins a tale of iatrogenic harm

Christiane told her doctor that she wanted to stop taking antidepressants, but he admonished her she would need to keep taking them for the rest of her life. “We’re going to put you on Effexor, because it’s safer,” he assured her. Thus begins a tale of iatrogenic harm that beggars belief. Christiane and Amery went through seven pregnancies together. Again and again, she was assured by her doctors that Effexor was safe for pregnant women. Her first pregnancy ended in a miscarriage, with no known cause. No one suspected at the time that Effexor may have played a role. During her second pregnancy Christiane complained to her doctor about the effects the drug was having on her. His response was to increase the dose, and when she complained again, he had her placed in the psychiatric ward. “If you don’t go,” he warned her, “Your daughter is going to be taken away.” Christiane spent two weeks in the psych ward. After that, she was careful not to complain anymore about the effects Effexor was having on her. “I didn’t say anything,” she explains. “I was too scared to.” The second pregnancy resulted in the birth of their son Cole, who had difficulty breathing. He survived, but has a heart murmur which persists to this day. The third pregnancy resulted with the birth of their son Jacob, who was a full-term baby but was born weighing only five pounds. He suffered from primary pulmonary hypertension of the newborn, or PPHN, a condition caused by an overgrowth of the smooth muscle cells lining the arterioles in the lungs. This creates resistance against blood flow through the lungs and can lead to heart failure. The death rate for this condition can be as high as 15%. Jacob flatlined right away and had to be resuscitated.

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Jacob spent the first ten days of his life in the NICU. “He was very jittery,” Christiane remembers, just like one of her nephews who had been born addicted to cocaine. Jacob survived, but he never did catch up with other boys in terms of growth. At the age of thirteen, he is in the second or third percentile for his height and weight – about the size of an average seven-year-old. Like his brother Cole, he has a persistent heart murmur, and in addition Jacob’s doctors have diagnosed him with dysautonomia, or failure to regulate the autonomic functions of his body. He has seizure-like episodes in which his diaphragm goes into spasms and he stops breathing. He also suffers from sleep apnea, severe night terrors, sleep-walking, and encopresis, or failure to control his bowel movements, and soils his pants on a regular basis. In addition he has learning disabilities, emotional problems, and episodes of rage. The fourth pregnancy resulted in the birth of their son Andrew, who also needed to be resuscitated at birth. He was born with a heart murmur which fortunately subsided after his first birthday. Today he suffers from mild learning disabilities, dyslexia, and sleep disturbances. The fifth pregnancy was difficult. Christiane suffered from heart palpitations and tremors. When their son Matthew was born, Christiane knew right away something had gone terribly wrong. “They put him on me and I was angry because he was blue, and they said he was fine and I said “No he’s not! He looks like an eggplant!” The nurses gave Matthew some oxygen and his color returned to normal, but he soon began making odd sounds and turning blue again. Amery walked out of the room and called the nursing station and said “We need some help!” The nurse became angry and told Amery “You can’t be out here. Get the baby back in the room!” “Well, we need somebody to come look at the baby!” Amery replied. “We’ll get there as soon as we can,” the nurse responded. “You’re scaring the other parents, so get back in the room!”


About fifteen minutes later a nurse came in to check on Matthew, who by then was turning purple. The nurses started CPR and tried to intubate Matthew. “It was chaos,” Christiane recalls. The efforts to revive Matthew were not successful. The autopsy report noted the findings were consistent with a diagnosis of pulmonary hypertension caused by venlafaxine toxicity. This was the first suggestion the Schultzes had that this drug could be the source of these problems. Christiane decided to kick the Effexor. The doctors were of no help. “I became my own compounding pharmacist,” Amery recalls. He was opening up capsules of Effexor and removing individual grains, to help wean his wife off the drug, milligram by milligram. Christiane suffered from worsening depression, myoclonic twitching, brain zaps, and suicidality. Sometimes Amery had to lock her in her room while he took the kids on an outing. “It was Hell,” Amery recalls. Christiane’s sixth pregnancy occurred while she was in the process of withdrawing from Effexor. This one ended in a miscarriage at eighteen weeks.

Could Effexor be the cause of his heart defects?

Christiane’s seventh and final pregnancy resulted in the birth of their son Daniel, who was born with multiple heart defects, including atrial and ventricular septal defects, along with a rare condition known as transposition of the great arteries, in which the aorta is connected to the right ventricle, and the pulmonary arteries are connected to the left – the exact opposite of how things are arranged in a normal heart. Daniel was conceived one year after Christiane kicked Effexor completely. Could Effexor be the cause of his heart defects? In an email Amery wrote, “I am personally of the belief that either Effexor has had a genotoxic effect on my wife’s eggs, or there is/was a significant build-up of venlafaxine in her fatty tissue leading to the effect, or thirdly that the Effexor which did wreak havoc on her endocrine system for a very long time caused the defect, or some combination of the three,” but he admits he doesn’t know for certain. Next: Part 2: A gigantic uncontrolled experiment

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Patrick D Hahn -- Bio and Archives

Patrick D Hahn is the author of Prescription for Sorrow: Antidepressants, Suicide, and Violence (Samizdat Health Writer’s Cooperative) and Madness and Genetic Determinism: Is Mental Illness in Our Genes? (Palgrave MacMillan). Dr. Hahn is an Affiliate Professor of Biology at Loyola University Maryland.



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