Researchers Find That For Women With Mild to Moderate Depression, Not Taking Antidepressants During Pregnancy May Provide the Best Outcome
This blog has discussed the potential risks posed to pregnant women by certain antidepressant medication. Those who take antidepressants, especially during the first trimester of pregnancy, have a higher risk of having a baby with a birth defect. Pregnant women with depression would be wise to talk to their doctors about how to proceed. However, as a recent review demonstrates, finding the right approach is not always easy.
In a review of over 100 studies published in the journal Human Reproduction, researchers from Tufts University School of Medicine and Boston IVF found that there was no conclusive evidence that taking antidepressant medication led to better birth outcomes than not taking the medication. In fact, many women with mild depression tended to avoid selective serotonin reuptake inhibitors (SSRIs) such as Celexa, Paxil, and Prozac. At the same time, many doctors are reluctant to take any woman with depression off of antidepressants, believing that it is better for the fetus to be exposed to the effects of antidepressants than to higher stress hormones and other physiological problems the woman could have without the medication.
However, the researchers and many experts note that while there is no evidence connecting depression to problems with delivery or birth defects, there is evidence connecting antidepressants to these problems. For instance, for those who take the medication while pregnant, the rate of miscarriage increases from 8% to 12 to 16%. Moreover, women who take medication while pregnant double their risk of having their babies prematurely, which can lead to health and developmental problems. Finally, the effects of antidepressants could be found in many newborns' behavior. One third of newborns exposed to antidepressants in the womb developed "newborn behavioral system," which consisted of jitters, difficulties with feeding, and ceaseless crying. Researchers note that this condition is rare in babies who have not been exposed to antidepressants. While it clears up after a short time, it is unknown whether the condition leads to long-term effects, though animal studies suggest that it can change brain chemistry.
Researchers also note that it is mainly women with mild to moderate depression who do not show any major benefit from staying on antidepressants. It is not necessarily the case for women with severe depression.
It is a situation that deserves a lot of careful consideration. If you are pregnant and have concerns about whether to stay on your antidepressant medications, you should talk to your doctor and determine whether your depression is mild enough to permit a break from antidepressants if you so chose. In any event, your physician has a responsibility to discuss all possible risks and benefits so that you can make an informed decision. If he or she fails to do so, and you have a child with a birth defect as a result of your taking antidepressants while pregnant, you would have grounds to sue your physician for medical malpractice.