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Debate Over Antidepressants in Pregnancy Ongoing

SSRIs Linked to Worse Birth Outcomes? continued...

A study published last year also raised concerns that SSRI use during pregnancy may be associated with an increased risk for autism, but researcher Lisa A. Croen, PhD, says the findings are preliminary and more research is needed to confirm them.

“This was the first study to show this association, and it has to be replicated,” she says.

Domar agrees that for many women with major depression -- especially those who are suicidal -- treatment with SSRIs during pregnancy may be unavoidable.

“We don’t want every pregnant woman to stop taking her medication,” she says. “But for women with mild to moderate depression, there are very effective alternatives to these drugs.”

These alternatives include psychotherapy, especially cognitive behavioral therapy (CBT), a time-limited, goal-oriented type of talk therapy..

Yonkers says she uses CBT to treat women with mild-to-moderate depression who want to avoid taking antidepressants during pregnancy.

The 2009 joint panel report from the American Psychiatric Association and the American Congress of Obstetricians and Gynecologists concluded that many women can safely stop taking antidepressants during pregnancy, under the guidance of a doctor.

The exceptions include women with bipolar disorder, those who experience psychotic episodes, and those who are suicidal or have a history of suicide attempts.

The panel concluded that women with severe depression should not attempt to go off their antidepressants during pregnancy.

“We tried to drive home the point that this is not a one-size-fits-all disease,” Yonkers says. “My patients know their bodies and they know what they can contend with. What’s right for one woman may not be right for another.”

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