Antidepressants and a Healthy Pregnancy
Many women who are currently taking an antidepressant (with good results) wonder how safe the medication will be for their unborn baby, and how they will get through their pregnancy should they decide to discontinue the drug. Although this is a subject you should definitely have an open, honest discussion with your doctors about, it can be very comforting for you to be fully informed about depression and pregnancy. Historically pregnancy hormones were thought to protect women from depression, but unfortunately science has proven this to be untrue. It's critical to take appropriate care of your depression during your pregnancy so you can avoid putting your own health-as well as your baby's health-at risk.
The Consequences of Leaving Your Depression Untreated During Pregnancy
Women who have suffered from depression for any length of time cannot simply decide arbitrarily to discontinue their antidepressant medication. A mom-to-be who is depressed will not have the required energy to take good care of herself and her unborn baby. A depressed woman may not seek prenatal care, eat healthy foods, or take good care of her body, and can even turn to drugs and alcohol in an attempt to ease the symptoms of depression. Allowing your depression to go untreated can result in risks such as premature birth or low birth weight for your baby, developmental problems for the baby, and a greatly increased risk of severe postpartum depression. Some studies have shown that babies who have a depressed mom following delivery are more likely to experience difficulties and delays in their cognitive, social and psychological development.
If You Currently Take an Antidepressant While Pregnant
Should you decide to discontinue your antidepressant while pregnant, it is extremely important that you don't go cold turkey. Discuss your decision with your doctor, as suddenly quitting such medications can cause withdrawal symptoms, some mild, some quite severe. After weighing the risks and benefits you may decide to continue taking your antidepressants during your pregnancy. Studies have shown that babies born to women who take antidepressants while pregnant may experience small delays in reaching developmental milestones, but the results have not been judged clinically significant just yet. An example of the delay in reaching milestones was shown in one study which showed that children born to women taking antidepressants sat up approximately sixteen days later, and walked about a month later. In the grand scheme of things, such minor developmental delays may be an acceptable trade-off for the woman who has done well on her medication and is very hesitant to stop taking it.
What are the Risks When Pregnant?
Overall the risk of problems for babies of mothers who take antidepressants during their pregnancy are low, however certain antidepressant medications have been shown to cause more health problems than others. Specifically, Celexa has been associated with newborn lung problems (rarely) as well as certain birth defects which affect the brain, skull and abdominal organs. Prozac has shown few effects on unborn babies, however Paxil is one antidepressant that you should avoid during pregnancy, as it can cause serious birth defects. Zoloft has been associated with septal heart defects, but is considered relatively safe while Nardil should be avoided during pregnancy as it can cause high blood pressure which triggers a stroke in pregnant moms. Finally, Wellbutrin is considered one of the safest antidepressants to use during pregnancy, with no established risks. The class of antidepressants known as SSRIs which include Prozac, Paxil, Celexa, Zoloft, Cymbalta and Effexor should be avoided (especially Paxil) unless your doctor feels the benefits for you far outweigh the risks to your baby. A 2006 study showed SSRIs were associated with a small increase in the risk of a miscarriage, and nearly one third of newborns whose mothers were treated with SSRIs in the third trimester had tremors, convulsions, irritability and increased crying, although these symptoms were relative short-lived (one to four days).
Your level of depression will likely determine whether you will stay on your antidepressants or discontinue them while pregnant. A woman with severe depression symptoms will likely not do well discontinuing her medication, while a woman with milder symptoms may be able to cope during her pregnancy without her antidepressant medication.