HY 07/06: Pregnancy and Antidepressants

Discontinuing your medication may do more harm than good

You’re going to have a baby! This joyful news is mixed with a dose of uncertainty for women on antidepressant medication. While recent research links some antidepressants with birth defects and newborn withdrawal symptoms, other studies show that up to 60 percent of pregnant women who stop taking antidepressants suffer a relapse.

How do you balance your own health against your baby’s? It’s not an easy question for women who come into pregnancy with diagnosed depression or who become depressed during this time (an estimated 15 percent of all expectant mothers). “The raised levels of estrogen and progesterone during pregnancy lead to stable, positive emotions for many women, but not all,” says obstetrician Joseph DeFulvio, D.O., of Lehigh Valley Hospital and Health Network.

Should you stop your antidepressant? No, the experts say—because taking it is less risky than leaving your depression untreated.

“The effects of untreated depression during pregnancy can be profound,” says DeFulvio’s colleague, psychiatrist Rory Marraccini, M.D. “It raises the risk for spontaneous abortion, low birth weight and pre-eclampsia (a potentially fatal disorder of late pregnancy).”

These complications may stem partly from elevated levels of the stress hormone cortisol as well as from poor self-care. Depressed women are more likely to be careless about their diet and prenatal visits, and may even turn to alcohol or other substances harmful to the developing baby.

If you or someone you love is coping with depression and pregnancy, DeFulvio and Marraccini suggest:

If possible, talk with your psychiatrist and obstetrician or family doctor before conception about your therapy and prescription options. Get your depression under control before trying to conceive.

If you’re already pregnant and on an antidepressant, talk with your doctors about the pros and cons of your particular medication. If you plan to breastfeed, you may need a different drug. Some antidepressants are longer-acting than others and more likely to affect the baby.

If you become depressed during pregnancy, see a mental health professional. Counseling may resolve the problem; if not, starting an antidepressant at any time during pregnancy is safer than not treating your depression.

Want to Know More about the risks of antidepressants during pregnancy? Ask Our Expert or click here. For information on postpartum depression or referral to a psychiatrist specializing in pregnancy, call 610-402-CARE.