While pregnancy has potential to be a joyous and exciting time for women, for those suffering with depression, it can bring an overabundance of fear and anxiety. It may mean choosing between continuing on antidepressants – as nearly 15% of pregnant women do – or weaning off the medication that helps them.
Depression is one of the most common mental health disorders in the U.S. It affects twice as many women than men and it occurs almost as commonly in pregnant women as it does in non-pregnant women. According to the American College of Obstetrics and Gynecologists, it is also one of the most common medical complications during pregnancy and postpartum period, affecting 1 in 7 women.
If you are thinking of getting pregnant and are currently taking an antidepressant for depression or another mental health disorder, Lindsay Allen, MD, a Banner Health Center OBGYN, shared what you should know to ensure a happy, healthy pregnancy.
Should I stop “cold turkey” on my medication?
While staying on antidepressants during pregnancy is a personal decision, it’s important to discuss with your doctor before going off of them. Doctors often treat pregnant women’s depression similarly to how it would be treated outside of pregnancy, with counseling or psychotherapy, medication, or a combination.
“It’s a balancing act,” Dr. Allen said. “We look at not only the medication our patients are taking, but we also weigh the benefits and risks, so we give the best chance for a healthy patient and healthy baby.”
Why is prenatal treatment of depression important?
Women take medications for different illnesses, such as seizure disorders, arthritis and hypertension, so depression is no different. If moderate to severe depression is left untreated, it is likely to affect a woman’s self-care, prenatal care and bonding with her baby.
“The most important factor to consider is that untreated severe depression during pregnancy can have adverse effects,” explained Dr. Allen. “Severe depression is associated with lagging growth rates in utero and following delivery, newborns have shown to have increased levels of stress hormones, crying, and admission to the neonatal intensive care unit.”
Are antidepressants safe to take during pregnancy?
“The decision to use this class of medication is individualized – based on weighing the risks and benefits – but overall it is considered safe and effective to use throughout pregnancy,” Dr. Allen said. “We often worry more about the impact of depression on mom and baby than the effects of the medication.”
The advantages of antidepressants like serotonin reuptake inhibitors (SSRIs) are that depression is controlled and manageable. Mom can enjoy her pregnancy, and there are reduced chances of the complications mentioned above.
“Risks are very few, but include a temporary neonatal risk of respiratory distress, irritability or weak cry,” Dr. Allen said. “Generally, these symptoms are mild for a newborn and resolve quickly.”
Are certain antidepressants better to take during pregnancy than others?
“SSRIs are used most commonly to treat depression during pregnancy,” Dr. Allen said. “Currently, the only SSRI that should be avoided is paroxetine, which has been associated with a small increased risk of a fetal heart defect. Tricyclic, bupropion, and serotonin and norepinephrine reuptake inhibitors (SNRIs) should each be individualized for a specific patient, her obstetric provider and psychiatrist.”
If you are currently taking an antidepressant and are newly pregnant or planning on getting pregnant, speak with your healthcare provider first. They can help you determine what types of medications are safest to take and the risks and benefits of each, so you can make a well-informed decision.
If you have unresolved questions or concerns about your medication and need to speak with a healthcare provider, visit: bannerhealth.com, or call the Banner Nurse Now line at 844-259-9494 24 hours a day, seven days a week to speak with a nurse on-call.