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Antidepressants Linked to Newborn Problems

SSRI Use During Pregnancy Associated With Premature Birth, Other Health Problems for Babies

Treating Depression During Pregnancy an Ongoing Issue

The current study adds to the growing body of research devoted to helping decide whether pregnant women should take antidepressants during their pregnancy.

Previous studies have shown that the drugs lead to higher rates of NICU admissions because of withdrawal symptoms in newborns, and to higher rates of pulmonary hypertension -- high blood pressure in the arteries that serve the lungs. Last month, another Danish study showed that women taking Celexa and Zoloft early in pregnancy gave birth to babies with a slightly higher rate of a certain heart defect.

Despite such problems, Lockwood warns of the dire potential outcomes of avoiding medications in some women who suffer from depression. “We must always be focused on the mother’s health because the greatest risk of under-treating a depressed mother is suicide -- and that’s a really bad risk for any fetus to have,” he says.

Past studies have also shown higher rates of low birth weight and premature delivery as additional risks of being depressed while pregnant.

Although the exact mechanism is unclear, some animal studies have suggested that SSRIs might interfere with adequate blood flow to the uterus, thereby causing problems.

Pregnancy itself could cause onset of new depression or an exacerbation of pre-existing depression, says Lockwood. “Being pregnant can bring on a lot of different stresses for a woman -- financial worries, physical distress from feeling nauseous and exhausted -- it makes sense that there’s something about pregnancy in its essence that can trigger depression,” he says. Some theories suggest that fluctuations in certain hormone levels including progesterone and corticotropin-releasing hormone could also be part of the problem.

Strong Caution Against Discontinuing SSRI Use Among Severely Depressed Pregnant Women

“The number one thing is not to stop taking these meds if they work and if you will be depressed if you go off of them, especially if you will be severely depressed without them,” Lockwood says.

Pregnant women who are taking SSRIs should work closely with their obstetrician and psychiatrist to develop an optimal treatment plan that works for them on a case-by-case basis.

Treatment guidelines recommend that pregnant women experiencing psychotic episodes or bipolar disorder, or those who are suicidal or have been in the past should not be taken off antidepressants. Those with mild cases of depression or only a few symptoms for six months or longer can consider gradual reduction of doses or stopping drug treatment altogether, but only under close supervision of a doctor.

Behavioral therapy is another option that might work for some depressed women.

Lockwood says that women dealing with depression and mental health issues who are considering pregnancy should first attempt to get appropriate treatment, even if it requires going on antidepressant therapy.

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