Should Pregnant Women Risk Mood Meds?

Based on criteria such as the severity of depressive symptoms, past success with psychotherapy and the patient's desire to be on medication, the report provided guidance on evaluation and treatment options for women with depression who wish to conceive or who are already pregnant.

For instance, the report advises that it is safe for some women to taper off medication before or during pregnancy if their symptoms are mild and they respond well to psychotherapy. In women with a history of severe, recurrent depression, however, or those with suicidal symptoms, refraining from medication is not advised as they may become a danger to themselves and their baby.

"There are a lot of people who don't know this information," said Dr. Sudeepta Varma, a psychiatrist at the New York University Medical Center. "It might come as a surprise to some that it's necessary to treat patients [with drugs] when they're pregnant. I think there are clinicians that shy away from it."

Risks Of Depression May Outweight The Risks Of Medication

Though the prenatal risks of taking antidepressants are not fully known, the report stresses the potential negative impact of allowing depression to go untreated as a mitigating factor in the decision to medicate.

Depressed mothers are at increased risk of substance abuse, of poor compliance with prenatal care, and have poorer nutritional habits than mothers who are not depressed.

"You cannot separate the needs of the mother from the needs of her fetus," said Dr. Lucy Puryear, a reproductive psychiatrist and author of the book Understanding Your Moods When Your Expecting: Emotions, Mental Health, and Happiness—Before, During, and After Pregnancy. "To ignore the pregnant woman's mental health in order to 'protect' her baby causes distress to the pregnant mother and her family."

Some Oppose Antidepressant Use

Dr. Kimberly Yonkers, a psychiatrist at the Yale School of Medicine and lead author of the report, said there have been "a number of scares" regarding taking antidepressants during pregnancy.

"The majority of the literature has looked at the effects of depression on pregnancy... or looked at the effect of medication on pregnancy without considering the effect of the depressive symptoms themselves," she added.

But while some clinicians may sidestep the issue, certain groups strongly oppose using antidepressant medications during pregnancy.

"We're not in favor of women taking [antidepressants] when they're pregnant," said Amy Philo, co-founder of Children and Adults Against Drugging America (CHAADA) and "I don't know how people can logically believe that feeling sad when you're pregnant is going to cause [complications]."

Philo, who said she experienced suicidal and homicidal thoughts after being preemptively prescribed an antidepressant for post-partum depression, cited cardiac problems, fetal abnormalities, Sudden Infant Death Syndrome, and intra-uterine or neonatal death as potential risk factors of drug therapy.

"Definitely [antidepressants] can hurt the baby," Philo said. "We encourage people to get all the information that's out there and find support that is not drug oriented."

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