Radically Genuine Podcast with Dr. Roger McFillin 217. The Harms of SSRI's During Pregnancy Debate w/ Dr. Adam Urato and Dr. Robert Chen
Jan 29, 2026
Dr. Robert Chen, psychiatry researcher focused on biomarkers and therapeutics, and Dr. Adam Urato, maternal-fetal medicine physician and FDA panel expert, debate SSRI use in pregnancy. They tackle serotonin’s role in fetal brain development, how SSRIs cross the placenta, limits of the evidence, newborn risks, informed consent failures, and the need for clearer patient conversations.
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Serotonin, SSRIs And Fetal Exposure
- Serotonin is crucial for fetal development and SSRIs disrupt serotonin while crossing the placenta.
- Those three facts together make fetal impact plausible and demand rigorous examination.
Prioritize True Informed Consent
- Provide patients clear, balanced informed consent covering risks, benefits, and alternatives before starting or continuing SSRIs in pregnancy.
- Engage patients in shared decision-making and revisit choices as pregnancy progresses.
Consistent Associations Across Cohorts
- Multiple human datasets show associations between prenatal SSRI exposure and adverse outcomes like preterm birth, low birth weight, and later neurodevelopmental issues.
- These consistent signals across locations raise concern beyond mere statistical noise.