Latest News on Antidepressants During Pregnancy Is a Bummer

Health Check 13

If there's one thing that seems clear about the murky subject of antidepressants during pregnancy, it's that there has never been a definitive answer about the risks these medications may cause to unborn children -- and without a standard, treatment decisions will continue to be made on a case by case basis.

That's not terribly comforting, and neither are the latest medical opinions on the topic, which came up during the American Society of Reproduction conference that happened earlier this week in San Diego. According to leading doctors in the field, the results of "study after study" show that most popular antidepressants, seratonin reuptake inhibitors (SSRIs), are in fact associated with several dangerous pregnancy complications, such as premature birth and pre-eclampsia.

One professor of maternal-fetal medicine went so far as to call the practice of prescribing antidepressants during pregnancy "a large scale human experiment."

Doctors pointed to 40 studies that have linked taking SSRIs during pregnancy with causing birth complications, including new research that suggests that SSRIs can double the chance for autism in children, and pose a threat of lung and bowel diseases.

Of course, there's more to the story. As Jezebel reports,

Although the FDA issued warnings about taking SSRIs during pregnancy, a study published last year in the Obstetrics and Gynecology International found that for every study about the risks of SSRIs, there's another that negates it.

When Slate writer Jessica Grose's researched her own prenatal depression, she documented her findings from that same study:

The only risk that seems consistent among all of these drugs is for infants' withdrawal symptoms, which include jitteriness, irritability, respiratory problems, and in very rare cases, convulsions. However, the authors of the paper describe the majority of these symptoms as "mild and transient." This paper, which is an analysis of more than 100 other studies on SSRIs and pregnancy done over the course of the past 20 years, concludes that "the general benefit of treatment seems to outweigh the potential small risk of untoward effects on the embryo, fetus, or neonate."

Doctors will agree on one thing: they're not saying every pregnant woman should go off her medication, or downplay the seriousness of her depression. But some are suggesting that general practitioners are often too quick to prescribe a pill rather than suggesting alternative treatments such as cognitive behavior therapy:

You come in and you say I’m not feeling very well, I’m feeling lethargic, so the physician writes a prescription. (...) If you add up all the potential risks, a lot of people would say they are unacceptable.

Personally, I can see both sides of this. I absolutely believe that too many Americans are taking antidepressants -- it's impossible for me to look at the numbers (1 in 10! Usage has increased 400 percent since 2008!) and not be convinced that as a nation, we're taking far more pills than we need to be.

On the other hand, there are plenty of pregnant women who truly need these medications to protect their own health, and doctors need to be on their side for that. I can understand the difficulty in weighing risk, because I myself had to take a Class C drug (i.e., the classifcation that reads, "Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks") during pregnancy. It was scary, I wished I didn't have to, but it kept me healthy -- and my children, thank god, were perfectly fine.

I don't know if there's any sort of conclusion to reach from this latest news about SSRIs and pregnancy, only that it's important to talk to your doctor and be as informed as possible. As with most things in parenting, there's really no one right answer that works for everyone.

Are you surprised by the latest news on antidepressants? Does it change your mind at all about using them during pregnancy?


Image via ChrisHaysPhotography/Flickr

is it safe, pregnancy health, emotional health

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shesl... shesliketx

I was taking Prozac during my last pregnancy. My son was born at barely 34 weeks and spent a month in the Nicu because I had severe pre-eclampsia. I feel terrible

Liz Muia Frost

I took Paxil which is not one of the recommended SSRIs during pregnancy.  My daughter was born full-term and healthy.  We recently considered having another child but I was uncomfortable with my (lack of) options in treating my rather severe anxiety disorder.  My last pregnancy was miserable and if they took away my meds it would be worse the 2nd time.  So no baby.  :-/

nonmember avatar Sarah

I took Prozac my entire pregnancy with my first and Zoloft during my whole second pregnancy. My girls are perfectly healthy.

elle7777 elle7777

I'm not really surprised. They have prescribed various things (like Thalidomide!) and later found out oops, they cause birth defects. So whenever I was pregnant I pretty much bypassed taking any medication at all. If I was on anti-depressants and got pregnant I personally would continue taking them only as a last resort.

poppy... poppymuffin

Surprised? Use your brains people! It's not safe to take any drugs during pregnancy, so why would a psychiatric medication, which affects your brain chemistry be OK?

Pinkmani Pinkmani

Poppymuffin, you're totally right; drugs shouldn't be taken during pregnancy. But think about it this way: Some women discover they have depression/anxiety during their pregnancy. Even though I don't have children, I've been in that dark, dark place. And I personally, wouldn't want to get pregnant while I'm not mentally and physically healthy.

Liz Muia Frost

Oh, please.  There are many drugs that are safe during pregnancy.  http://www.webmd.com/baby/guide/taking-medicine-during-pregnancy

Melissa Mattner List

It's a little scary but I am on Lexapro. And both my doc and my OB have advised me that I'm ok. I really am.  I am on the lowest possible prescribed dose. I have very bad anxiety that has sometimes lead to depression and I'm doing my best to avoid prenatal and post partum depression. The benefits outweigh the risk.

Tracys2 Tracys2

This article doesn't mention the risks of having untreated depression during pregnancy. Yes, it's apparently much more than the risk of suicide, but since there are no drugs involved in failing to treat a disease, there are far fewer studies on that. The ones there are, led my OB and others to balance the risks of treating with the risks of not treating. There is no one good solution.


Many women also develop depression while pregnant, or depression they thought was gone for years/decades comes back.


It is possible that we could legislate that only physically- and mentally-healthy unmedicated people with no genetic risk factors should be allowed to procreate, but that isn't going to happen. I do like the fact that this study mentions therapy as an option. Many women aren't presented with that option, but it might help many. However, if a woman is at risk of suicide, or unable to take care of herself or her family while pregnant and depressed, something more may need done.

nonmember avatar Riley

I'm bipolar and because of the fact that my mood stabilizer has had known side effects on pregnancies, I can't give myself the option of having children. One, 9 months is way too long to be off of medication when you're bipolar...I mean the hormones alone...well, multiply that by 5 and that's where I would be. It's sad to think about it, but I'm only 21, maybe science will produce better--safer drugs for those with depression and bipolar disorder if they want to take it while they are pregnant.

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