Antidepressants and Pregnancy


There isn’t a mother on earth who doesn't want to deliver a healthy child with the brightest of futures. To that end, mothers-to-be give up smoking, alcohol, aspirin and caffeine. Should they also give up their antidepressants?

The Risks

As with any recommendations for care during pregnancy, the primary goal is balancing the health and well-being of the mother with the health and safety of the child. Pregnant women are urged to consult with their physicians regarding the use of any medications during pregnancy. Physicians have to evaluate both patients - mother and child - and with their knowledge of outcomes, make the decision of what advice is best on a case by case basis.

Depression, and the emotions generated by it, can range from mild to severe. Pregnancy, and the hormones that are generated because of it, also heightens emotional levels. The combination of the two can create an emotional environment that is difficult for the pregnant mother to manage, and can have potential consequences for her child.

A pregnant mother with depression might lack the energy to take care of herself or the child. She might fail to seek prenatal care, not eat or sleep well or engage in activities - smoking, alcohol or drug consumption - that endanger both her own health and the baby's. The results of these behaviors could include miscarriage, premature delivery, low birth weight and disorders that result from the use of drugs or alcohol. There is also an increased risk of postpartum depression for the mother, and an increased risk of not being able to successfully establish a bond with the new baby.

Treatment Choices

Because testing drugs on pregnant women is considered unethical, scientists gather most of their information from statistical analyses of outcomes. On this basis, they have been able to determine the relative risks for certain anti-depressant drugs.

Tricyclic antidepressants (amitriptyline and nortriptyline), certain SSRIs (citalopram, fluoxetine and sertraline) and bupropion are all considered relatively safe, although studies have associated several of these drugs with a low risk of problems or defects for the baby.

A woman who is mildly depressed and has been symptom-free for at least six months may be able to forego any use of medicine during pregnancy. This should be done under the supervision of the woman's physician, preferably before becoming pregnant. However, this might also be attempted during the early stages of pregnancy.

Alternative activities - talking with a psychotherapist, practicing relaxation techniques such as meditation, yoga or tai chi, spending time outdoors, or getting more exercise - can often be sufficient to allow the mildly-depressed mother to remain symptom-free.

However, any pregnant woman with a history of severe depression, bipolar disorder or suicide attempts should stay on antidepressants under the close supervision of her physician.

Working together, a good doctor can assist a depressed woman through a healthy pregnancy and help her give birth to a healthy child.

Sources: WebMD and Mayo Clinic


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