Antidepressants Linked to Newborn Problems
SSRI Use During Pregnancy Associated With Premature Birth, Other Health Problems for Babies
WebMD News Archive
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
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
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
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
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.