Tuesday, October 30, 2012

Antidepressants and Pregnancy: New Review finds a Risk

Pregnant women who are depressed are generally told that continuing their medication will be safe to take while pregnant with their baby. A mother who is too depressed won't be a good parent and take good care of herself, and the baby will also suffer. Not exactly.

But a new review of the scientific literature questions the assumption that depression is bad for a fetus, and concludes that antidepressants often confer more risk than benefit.

"There's clear and concerning evidence of risk with the use of these medications by pregnant women," says Adam Urato, obstetrician and chairman of the department of obstetrics and gynecology at MetroWest Medical Center in Framingham, Mass., and one of the authors of the paper published in the journal Human Reproduction.

Despite decades of antidepressant use, no one has ever done the kind of research that would definitively answer the safety question: following the pregnancies of two groups of depressed women, half on drugs such as Prozac, Paxil, Lexapro, Celexa and Zoloft, and half not.

The decision of whether to use these antidepressants during pregnancy should be between a woman and her doctor, says Shari Lusskin, an adjunct associate professor of psychiatry, obstetrics, gynecology and reproductive sciences at Mount Sinai School of Medicine in New York City.

Drug companies that make antidepressants declined to comment or did not return e-mailed requests. An industry group, the Pharmaceutical Research and Manufacturers of America, says the federal drug approval and review process is designed to guarantee drug safety.

But women who consistently relapse when they go off antidepressants should be confident that taking antidepressants is best for both them and their babies, she says.

"It's a dangerous message for women who are pregnant and depressed to say that antidepressants don't benefit them," says Yonkers. "To take someone who is stable (on medications) and tell them they shouldn't take it because of all the harm is ridiculous."

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