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The Age – Victoria
November 25, 2015
A commonly-prescribed antidepressant may be implicated in the death of a day-old baby, a Victorian coroner has heard.
Sonja Jamsek was taking Lexapro during her pregnancy with baby Summer in 2010. Summer died 16 hours after birth at private Melbourne hospital Frances Perry House, and her cause of death remains unascertained and mysterious five years later.
On Wednesday the court heard evidence that at least one clinical study showed a link between Lexapro and pulmonary hypertension – raised blood pressure in the lungs which can sometimes become fatal.
A medical examination tendered to the court found pulmonary hypertension could not be excluded from the cause of death. Summer suffered internal bleeding, which can be caused by the disorder – but also by resuscitation efforts.
How significant the risks of pulmonary hypertension posed by Lexapro are remains unclear. The US Food and Drug Administration issued a warning note in 2006 noting one case study indicating the risk of PPHN, as it is known, was six times higher in women taking Lexapro.
But a second note issued by the same agency in 2011 said that new studies had produced conflicting findings on risk. The agency advised doctors it was premature to link Lexapro to PPHN.
Ms Jamsek’s doctor, Huon O’Sullivan, was aware she was taking Lexapro and warned her baby Summer may suffer from withdrawal symptoms, he told the court.
However he did not warn of any risk of pulmonary hypertension linked to Lexapro because he was unaware of such a link existing.
“I don’t know if I’m convinced that that’s proven,” Dr O’Sullivan told the court
“If there is an association then it’s very rare. I see my job as to not scare women inappropriately off medication that they are perhaps benefiting from and need.
“It’s a very difficult thing because to tell a woman that [Lexapro] might cause PPHN … And that’s not in my mind definite that it might then cause their baby to die. I think it’s a big leap. These are vulnerable women … There’s a very delicate line that needs to be travelled along.”
After three extensive days of testimony in the Melbourne coroner’s court, during which mother Sonja and Dr O’Sullivan were extensively examined and cross-examined, the cause of death and any possible blame remains unclear.
Ms Jamsek on Monday told the court about her concerns over a birth that she believed had gone badly wrong from the moment of Summer’s delivery, including erroneous health tests, a failure to worry the baby was not crying, and a failure to notice Summer’s blue colour.
On Wednesday Dr O’Sullivan was taken through his actions during Summer’s birth and asked to review photos and videos taken of the baby. He maintained, he told the court, that the baby showed all the signs of being a healthy baby while in his care.
The inquest continues.