Are Antidepressants Safe During Pregnancy?
Report Offers Guidelines for Treating Depression in Pregnant Women
WebMD News Archive
Miscarriage, Low Birth Weight, and Preterm Birth
SSRI use during pregnancy has also been linked in some studies to an
increased risk for miscarriage, low birth weight, and preterm delivery.
But once again, the report found no definitive link between the use of the
antidepressants and these pregnancy outcomes.
"Antidepressant use in pregnancy is well studied, but available research has
not yet adequately controlled for other factors that may influence birth
outcomes including maternal illness or behaviors that can adversely affect
pregnancy," the joint panel writes.
The report was published in both the American Psychiatric Association
journal General Hospital Psychiatry and the American College of
Obstetricians and Gynecology journal Obstetrics and Gynecology.
The joint panel concludes that a gradual reducing of antidepressant dosages
and stopping antidepressants altogether may be appropriate for women who hope
to become pregnant if they have had mild or no symptoms for six months or
The group also recommended that:
- Women who are already pregnant should not attempt antidepressant withdrawal
if they have severe depression.
- Psychiatrically stable women who want to stay on antidepressants during
pregnancy should consult with their psychiatrist and ob-gyn about the potential
risks and benefits.
- Women with recurrent depression or those who have symptoms despite drug
treatment may benefit from psychotherapy when available.
Psychiatrist Ariela Frieder, MD, who specializes in treating pregnant women
with depression at Montefiore Medical Center in New York City, tells WebMD that
her patients tend to be very concerned about how antidepressants will affect
their baby and much less aware of the dangers posed by untreated
Frieder was a practicing ob-gyn in her native Argentina before moving to New
York where she did her residency in psychiatry.
"Many women want to stop treatment abruptly and even stop on their own, but
this can be very risky," she says.
Jennifer Wu, MD, an ob-gyn who practices at New York's Lenox Hill Hospital,
"The old conventional wisdom was that pregnancy was a honeymoon period for
depression and that patients would be able to come off their medications and be
OK," she tells WebMD. "But we have learned that this is not true. It has become
more and more apparent that pregnancy is a vulnerable time for patients with a
history of depression."