Leapfrog - Should Pregnant Women Take Antidepressants?

This is what I tried to get leapfrogged on Helium to take the place of my earlier article on this subject. You can find the original posted down below. This new one was rejected. If you have comments or suggestions about the two articles and can help me figure out why it failed, please leave them here.

Thanks, Piper


Is it safe to take antidepressants through pregnancy?

It is a simple decision for a pregnant woman to forgo things like cold medicine, caffeine or alcohol in order to protect her baby from potentially harmful substances. The effects of those decisions are short term and not harmful to either mother or child. However, almost 20% of pregnant women experience clinical depression. Left untreated clinical depression can be deadly. Fortunately, there are several options available to treat depression, including psychotherapy, medications, bright light therapy and combinations of these. *[See note]

A study published in the April issue of Pharmacotherapy analyzes the choices available to patients and their doctors. This particular study evaluated the results of several other studies that focused on newer antidepressants, selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephiren reuptake inhibitors. While "information is available on the safety of antidepressant use during pregnancy, it is limited by the small size of most trials and by trial designs that often did not use mothers with depression as control subjects and could not, for ethical reasons, be randomized and double blinded." That paucity makes the decision whether or not to use medication to treat depression during pregnancy that much more difficult. Pregnant women "are subject to the same adverse consequences of depression as are non-pregnant women, including social withdrawal and even suicide."

Pregnant women frequently receive unsolicited and unwelcome advice; even from complete strangers. In addition, pregnant mothers often find themselves on the receiving end of harsh criticism for decisions that they make during their pregnancy. Some decisions can be debatable. For example, is it a good idea for her to take a vacation in the wilderness? In the case of major depression, however, the mother needs to be able to take care of herself and her child without suffering society's condemnation.

Untreated clinical depression during pregnancy has been associated with preeclampsia, miscarriages, and premature labor. "In addition, pregnant women with depression are less likely to attend regular obstetric visits and may have lower than normal weight gain, may lack compliance with prenatal care, and may be more likely to smoke, drink alcohol, or use cocaine."

While data about the gestational pharmacotherapy is sparse, most of the data is encouraging. For example, "preliminary evidence suggests that SSRI exposure in utero does not have significant long-term effects on cognition or behavior." In the end, society needs to realize that a clinically depressed mother-to-be is just like any mother who would do whatever it takes to save her child's life. It is for this reason that doctors and women should weigh all the factors to decide on an appropriate treatment plan. This includes acknowledging the fact that the life of both mother and child may depend on her decision.

http://www.pharmacotherapy.org

*Electoconvulsive therapy is another option, however, it is only used when other therapies have failed to provide relief.