Health & Pregnancy

Facing Depression During Pregnancy

Antidepressants Generally Safe

When the symptoms of depression warrant psychotherapy as well as antidepressant medication, the good news is that certain drugs can help treat depression with little to no risk to an unborn child.

"There is no evidence to suggest that taking antidepressants during pregnancy comes with a risk of congenital defects, and that's reassuring," says Hendrick. "But it is important to keep in mind that we cannot say for sure that antidepressants are 100% safe to take during pregnancy."

According to a study published in the American Journal of Psychiatry, women who took antidepressant drugs throughout their pregnancies -- both selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and tricyclic antidepressants -- had children with normal pre-school and early-school development.

Data also suggested that, on the other hand, depressed, untreated pregnant women and those suffering from long-term depression or multiple episodes of depression can have children with behavioral problems and delayed cognitive and language development.

Premature Labor?

A concern associated with medical treatment of depressed women during pregnancy is the possible increase risk of premature labor. A review of medical records showed women treated with SSRIs during pregnancy had a higher risk of delivering their babies early, before 36 weeks, according to a study published in the American Journal of Psychiatry.

But the women in this study who were treated with another class of antidepressants known as tricyclics had no increased risk of premature birth. Researchers stressed the risk associated with SSRIs is not overwhelming enough to warrant women not take antidepressants if their condition requires medication. Also reassuring is that the study showed no risk of birth defects associated with SSRIs.

Withdrawal Problems?

An additional concern is whether a newborn baby whose mother took antidepressants during pregnancy will suffer from symptoms of withdrawal.

"While the SSRIs, such as Zoloft, Prozac and Paxil, are unlikely to cause a major birth defect, several, including Prozac and Paxil, have been reported to increase the risk of withdrawal symptoms in the newly born child, especially if they are used in the third trimester," says C. Neill Epperson, MD, assistant professor of psychiatry and obstetrics/gynecology at Yale University School of Medicine.

Studies that assessed the risk of SSRIs taken during pregnancy showed that Paxil could cause withdrawal symptoms, such as jitteriness, vomiting, and irritability, in infants. But researchers noted the cause of the symptoms is not entirely clear: They were not able to say definitively whether the symptoms were a result of withdrawal, the toxicity of the drugs, or another unknown factor.