home
RSS
Antidepressants during pregnancy can be tricky
October 31st, 2012
11:53 AM ET

Antidepressants during pregnancy can be tricky

For years, pregnant women who suffer from depression have been told it's safer for them and their unborn child to continue taking antidepressants during pregnancy.

Now a new study is challenging that advice, suggesting the opposite is true and advocating against most women taking these drugs. If the depression is severe, however, the benefits might outweigh the risks, so it's best to check with your psychiatrist or physician.

Experts say about 13% of women take an antidepressant at some point during their pregnancy. Many drugs are called SSRIs, or selective serotonin reuptake inhibitors.

Taking these medicines while pregnant, however, may raise safety concerns, according to a review of existing research published Wednesday in the journal Human Reproduction.

Study findings
"There is clear consistent evidence of risk with the use of these drugs by pregnant women and we know there is a range of pregnancy complications that are associated with the use of these drugs in pregnancy," says study author Dr. Adam Urato, chairman of the Department of Obstetrics and Gynecology at Metrowest Medical Center in Framingham, Massachusetts.

"Those include miscarriage, preterm birth (delivering the baby early), newborn behavioral syndrome (poor newborn adaptation) - and there is a big issue about the possible long-term effects of these drugs," he says.

Counterpoint
But others are concerned this review does not address the risks of not treating women with severe depression, which can be equally important.

"Yes, there are issues with using antidepressants during pregnancy, but they (the study authors) are not putting this in any sort of context," says Dr. Jennifer Payne, director of the Women's Mood Disorders Center at Johns Hopkins School of Medicine in Baltimore. "They didn't even give a nod to (the fact that) there may be cases when you need to use antidepressants during pregnancy, and I find that irresponsible."

"Many women who are depressed don't sleep and don't eat properly," Payne says. "Women who are depressed during pregnancy are less likely to see their doctors for routine prenatal care."

Treatment during pregnancy also helps protect mothers from developing postpartum depression after the baby is born. Waiting to begin treatment until after delivery, "you're going to run the risk of letting mom slide into postpartum depression when perhaps you could have prevented this if you'd started treatment earlier," explains Dr. Marla Wald, a psychiatrist at Duke University Medical Center who specializes in perinatal and women's mental health.

The study authors also reviewed several studies that suggest use of SSRIs does not increase infertile women's chances of conceiving. More research is needed on the topic, they say.

The American Psychiatric Association and the American College of Obstetricians and Gynecologists issued a joint report in 2009 to address the concerns about the risks of antidepressants on the health of pregnant women and their babies.

According to the report, studies show pregnant women who take antidepressants have a slightly increased risk of miscarriage and may deliver their babies early, before 37 weeks of gestation. The report also says when pregnant women take antidepressants, 15% to 30% have babies with neurobehavioral problems such as irritability or risk for seizures. These symptoms usually go away in about two weeks, according to the APA and ACOG.

Another concern, according to the report, is persistent pulmonary hypertension, a type of high blood pressure that affects the arteries in the lungs and the right side of the heart, although the risks are very small. The jury is still out about the possibility of long-term effects of SSRIs on children, according to the APA/ACOG report, but lack of treatment for very depressed moms increases the risk of early developmental issues.

Depression levels differ
But the authors of the new study point out that the majority of women on SSRIs are not severely depressed, instead suffering only mild to moderate symptoms.

And in this group, "There is really no conclusive evidence that SSRIs are better than placebo," says study author Dr. Alice Domar, executive director of the Domar Center for Mind/Body Health at Boston IVF. "I don't want women to stay on this medication thinking it's as safe as a sugar pill because it's not."

The takeaway
Domar says that other treatments such as cognitive behavioral therapy are as good or better than SSRIs for those with mild to moderate depression. She says other options also being investigated include exercise, mindfulness based therapy, yoga, acupuncture and light box therapy.

But Wald wants to reassure women with severe depression who find that only SSRIs work as opposed to alternative therapies that they aren't doing anything wrong.

"I don't want women to be scared by this paper because fundamentally there is not enough being done for this population," she says. "I would be concerned if this information was viewed as saying there was too much treatment going on for these women, particularly too much medication treatment."

And she adds that each woman is different and needs to be evaluated by a psychiatrist or trained professional to determine if antidepressants are the best treatment option.

"They should make the best individual decision they can and not succumb to cultural pressures - make the best individual decision they can for themselves and their whole family, for all of their children," says Wald.


« Previous entry
soundoff (295 Responses)
  1. RebfZisse

    cialis daily use side effects http://rcialisgl.com/ cialis online 2nd day shipping

    May 15, 2021 at 12:49 | Report abuse | Reply
  2. storno brzinol

    I've been surfing online more than three hours today, yet I never found any interesting article like yours. It’s pretty worth enough for me. In my view, if all web owners and bloggers made good content as you did, the web will be a lot more useful than ever before.

    http://www.stornobrzinol.com/

    May 15, 2021 at 17:34 | Report abuse | Reply
  3. brimonidine

    buy brimonidine brimonidine

    May 16, 2021 at 05:27 | Report abuse | Reply
  4. LbsoZisse

    cialis 20mg uk http://ucialisdas.com/ cialis online nz

    May 16, 2021 at 21:15 | Report abuse | Reply
  5. JebgEncox

    Levitra with Dapoxetine http://pharmacylo.com/ Celebrex

    May 17, 2021 at 11:14 | Report abuse | Reply
  6. GtnbCrulk

    canadian viagra https://jokviagra.com/ cost of viagra at costco

    May 17, 2021 at 12:50 | Report abuse | Reply
  7. RebfZisse

    cialis without perscription canada pharmacy http://rcialisgl.com/ buy black cialis

    May 17, 2021 at 15:56 | Report abuse | Reply
  8. LbsoZisse

    cialis professional review https://ucialisdas.com/ cialis free canada

    May 17, 2021 at 20:58 | Report abuse | Reply
  9. JebgEncox

    online pharmacy pain medicine canadian pharmacy no prescription needed Cardura

    May 18, 2021 at 02:26 | Report abuse | Reply
  10. LebnEncox

    motion sickness [url=http://xlnpharmacy.com/ ]Reglan[/url] hq pharmacy online 365

    May 18, 2021 at 13:33 | Report abuse | Reply
  11. Frances Rethman

    This website was... how do you say it? Relevant!! Finally I have found something which helped me. Thanks a lot!

    https://extraproxies.com/how-to-get-free-traffic-for-both-videos-and-websites/

    May 18, 2021 at 21:20 | Report abuse | Reply
  12. GtnbCrulk

    cheap viagra online https://jokviagra.com/ viagra uses

    May 19, 2021 at 07:26 | Report abuse | Reply
  13. FmrfEncox

    cialis 20mg online https://cialisee.com/ – max cialis dose 200 mg cialis

    May 19, 2021 at 19:51 | Report abuse | Reply
  14. LebnEncox

    corner drug store https://xlnpharmacy.com/ Lanoxin

    May 20, 2021 at 00:55 | Report abuse | Reply
  15. AnooEncox

    contraindicaciones viagra diabetes http://llviagra.com/ gebrauchsanleitung fГјr viagra

    May 20, 2021 at 03:39 | Report abuse | Reply
  16. BbshMile

    india pharmacy viagra http://loxviagra.com/ – viagra challenge viagra com free sample

    May 20, 2021 at 18:12 | Report abuse | Reply
  17. cyclosporine

    cyclosporine eye drops cyclosporine lab tube

    May 20, 2021 at 23:08 | Report abuse | Reply
  18. RebfZisse

    really really cheap cialis https://rcialisgl.com/ cialis free trial offer

    May 21, 2021 at 13:21 | Report abuse | Reply
  19. JebgEncox

    cvs pharmacy online https://pharmacylo.com/ mexican pharmacy what to buy

    May 22, 2021 at 13:43 | Report abuse | Reply
  20. LbsoZisse

    canada cialis for sale http://ucialisdas.com/ cheapest cialis tadalafil 20 mg

    May 22, 2021 at 22:12 | Report abuse | Reply
  21. FmrfEncox

    cialis 10 mg http://cialisee.com/ – cialis 20 mg sell where can i get cialis overnite

    May 23, 2021 at 06:59 | Report abuse | Reply
  22. JebgEncox

    online pharmacy viagra http://pharmacylo.com/ canadian prescriptions online

    May 23, 2021 at 07:48 | Report abuse | Reply
  23. BbshMile

    roman viagra review https://loxviagra.com/ – is viagra covered by insurance how often can i take viagra

    May 23, 2021 at 14:00 | Report abuse | Reply
  24. AnooEncox

    how much viagra works https://llviagra.com/ quantas horas antes tem que tomar o viagra

    May 23, 2021 at 14:38 | Report abuse | Reply
  25. RebfZisse

    cialis online without a prescription https://rcialisgl.com/ cialis australia express shipping

    May 23, 2021 at 15:07 | Report abuse | Reply
  26. LbsoZisse

    cialis 20mg overnight http://ucialisdas.com/ cheap cialis with dapoxetine

    May 23, 2021 at 18:21 | Report abuse | Reply
  27. LebnEncox

    peoples pharmacy no prescription pharmacy paypal online pharmacy same day delivery

    May 23, 2021 at 21:47 | Report abuse | Reply
  28. Tritreviewifind

    buy tadalis side effects of tadalafil buy generic cialis online with mastercard https://tadacipetadalafil.com/

    May 24, 2021 at 08:43 | Report abuse | Reply
  29. brimonidine

    brimonidine generic buy generic brimonidine

    May 25, 2021 at 04:41 | Report abuse | Reply
  30. CrulkAsd

    cialis 20mg pills https://cialisjla.com/ – genericcialis cialis 20 mg soft

    May 25, 2021 at 08:29 | Report abuse | Reply
  31. EncoxGtv

    do canadian pharmacies sell generic viagra Imitrex Viagra Professional

    May 25, 2021 at 08:46 | Report abuse | Reply
  32. Duplex Villas for sale in Hyderabad

    392289 457161Xanax (Alprazolam) is used to treat anxiety disorders and panic attacks. Alprazolam is in a class of 765642

    May 25, 2021 at 09:03 | Report abuse | Reply
  33. ZisseVed

    generic cialis reviews forum https://krocialis.com/ – cialis online lexapro and cialis

    May 25, 2021 at 18:31 | Report abuse | Reply
  34. EncoxGtv

    canada drugs online prescription drugs become illegal when __________. american rx pharmacy

    May 26, 2021 at 02:50 | Report abuse | Reply
  35. Soosteemocush

    tadalafil drug side effects of tadalafil what is tadalafil buy generic cialis online with mastercard https://cttadalafil.com/

    May 26, 2021 at 14:34 | Report abuse | Reply
  36. Zisseloh

    cialis super active real online store https://rcialisgl.com/ – liquid cialis research chemicals i need cialis

    May 26, 2021 at 14:44 | Report abuse | Reply
  37. EncoxDev

    universities in canada pharmacy pharmaceutical online pharmacy tech in canada

    May 26, 2021 at 16:42 | Report abuse | Reply
  38. Tritreviewifind

    generic cialis tadalafil https://tadalafilol.com/ – cheap cialis pills for sale tadalafil online with out prescription lowest price cialis tadalafil price walmart

    May 26, 2021 at 18:03 | Report abuse | Reply
  39. ZisseVed

    viagra levitra cialis which works better? https://krocialis.com/ – free sample of cialis india pharmacy cialis

    May 26, 2021 at 19:54 | Report abuse | Reply
  40. MileSwa

    cialis extra https://ckacialis.com/ – real cialis sublingual generic cialis online

    May 26, 2021 at 22:57 | Report abuse | Reply
  41. EncoxHtf

    cialis generika paypal https://cialishav.com/ – 30 day free trial cialis buy cialis on line

    May 27, 2021 at 11:46 | Report abuse | Reply
  42. EncoxAni

    canadian pharmacy reviews https://pharmacyken.com/ – order drugs from canada legal cheapest pharmacy to fill prescriptions without insurance

    May 27, 2021 at 18:58 | Report abuse | Reply
  43. EncoxDev

    Amoxil med store pharmacy fort worth pharmacy rx one legitimate

    May 28, 2021 at 08:38 | Report abuse | Reply
  44. EncoxAni

    walmart pharmacy viagra https://pharmacyken.com/ – prescription prices comparison pharmacy store in india

    May 28, 2021 at 23:06 | Report abuse | Reply
  45. EncoxHtf

    cialis in canada https://cialishav.com/ – black cialis mexico best price on cialis

    May 29, 2021 at 03:50 | Report abuse | Reply
  46. MileSwa

    cialis 5mg tablets https://ckacialis.com/ – rx party cialis cialis no prescription

    May 29, 2021 at 10:59 | Report abuse | Reply
  47. Zisseloh

    cialis without insurance https://rcialisgl.com/ – free cialis sample canada how to dose cialis

    May 31, 2021 at 01:40 | Report abuse | Reply
  48. CrulkAsd

    generic cialis 20mg tablets viagra c20 cialis cialis buy australia online

    May 31, 2021 at 05:27 | Report abuse | Reply
  49. EncoxGtv

    online pharmacy technician schools Lisinopril safe canadian pharmacies online

    May 31, 2021 at 05:33 | Report abuse | Reply
  50. ZisseVed

    what dosage of cialis should i take cialis reviews what works better cialis or viagra

    May 31, 2021 at 12:38 | Report abuse | Reply
1 2 3 4 5 6

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

« Previous entry
Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.