It’s not a secret that taking antidepressants during pregnancy can be harmful for the baby. At the same time, stopping their intake may be associated with risks to the mother’s health. Antidepressants are one of the main ways to treat most types of depression. They help coping with the symptoms and feel better. However, their intake during pregnancy has its own characteristics. So, are antidepressants and pregnancy compatible?
Depression during Pregnancy
Depression is a disease that causes symptoms such as despair, constant helplessness, anxiety, panic attacks of fear, etc. Unlike the usual feeling of sadness or lack of energy, manifestations of depression are much stronger and significantly affect the way of life, working capacity, health status of not only pregnant women, but also seemingly quite healthy people.
Unfortunately, it is very difficult to defeat depression without medications. That is why, after careful examination and revealing the cause of depression, specialists usually prescribe a course of antidepressant drugs that stop the manifestation of depression and allow you to get rid of this unpleasant condition. However, what concerns antidepressants and pregnancy, or even its planning, then you should definitely contact a specialist to adjust the dose of the drugs taken or replace them with safer ones.
The fact is that certain types of antidepressants cause less harm to the future baby than others. That’s why, no expert can say with certainty that antidepressants are safe during pregnancy.
However, for the sake of justice, it should be noted that if you ignore the manifestations of depression and do not take measures to eliminate it during pregnancy, it can cause significant harm to the health of not only the future mother, but also the intrauterine fetus. Moreover, a sharp refusal of treatment with antidepressants can provoke the return of symptoms, which is very dangerous for bearing a healthy child.
Naturally, only a doctor can tell whether you should take antidepressants during pregnancy or not. Before making the decision about antidepressants and pregnancy, the doctor carefully studies the severity of the course of your disease.
Let’s try to consider the positive and negative aspects of coexistence of antidepressants and pregnancy.
Risk Factors of Taking Antidepressants during Pregnancy
Typically, antidepressants are drugs that are called selective serotonin reuptake inhibitors or tricyclic antidepressants. The effect of these drugs on fetal development has not yet been fully studied. However, there are data that taking certain drugs in the first trimester of pregnancy can increase the risk of birth defects in the baby’s future.
Also, the use of selective serotonin reuptake inhibitors or tricyclic antidepressants can trigger the appearance of side effects that occur during the first few weeks of treatment. Side effects include gastric disturbance, lack of appetite, diarrhea, anxiety, decreased libido and headaches.
In the third trimester of pregnancy you can take antidepressants only under constant supervision of a specialist. Moreover, after giving birth, doctors may keep your baby in the hospital for a while to check the condition of the baby after the abolition of antidepressants. After all, after birth, the baby ceases to receive the dose of serotonin, which was administered in the womb. As a result, there can appear a withdrawal syndrome. There is no need to panic, as all signs usually disappear after a couple of days, but it is better, if you spend this time under sensitive supervision of the expert.
What Happens If You Do Not Treat Depression during Pregnancy?
Of course, there are certain risks about antidepressants and pregnancy. But if depression is not treated, it significant harms both the mother and the baby. The fact is that, being in a constant depressed state, a pregnant woman cannot fully take care of herself: to eat right, sleep, keep calm. In a state of depression, many pregnant women significantly increase the risk of premature birth or the birth of an underweight child. In addition, women who during the period of depression refused treatment usually develop postpartum depression, which in turn significantly complicates the care of the child. At the same time, babies, who developed during the depression period of the mother, after birth significantly slower develop, compared to other newborns.
It is very important to note that a sharp refusal of taking antidepressants is unacceptable. Therefore, if you decide to stop taking them, you should definitely consult your doctor. Don’t give up antidepressants right at once. Gradually reduce the dosage to stop taking medication.
Keep in mind, that treatment with antidepressants and rejection of them should only take place under the supervision of a doctor. Self-medication in this case can lead to disastrous results.
Also, one should know that apart from antidepressants, there are other types of treatment for depression. These are psychotherapy, acupuncture, luminotherapy, hypnosis and many others. However, in order to find the method of treatment that suits you best, you should always consult a therapist.
Antidepressants and Pregnancy
From 10% to 20% of women experience depression during pregnancy. It often leads to the development of postpartum depression. At the usual visit, a gynecologist can recognize this condition only in every eighth pregnant woman.
After diagnosis, the doctor must choose and prescribe a drug that will be effective and safe. This is especially important during pregnancy. Usually antidepressants and pregnancy coexist, since the lack of treatment can lead to disastrous consequences:
- anxiety and depression in pregnant women significantly increase the risk of premature birth and anxiety in newborns;
- women who suffer from depression do not adequately assess their condition: they often eat poorly, suffer from insomnia, may become addicted to alcohol; they often think about suicide;
- women who experience depression during pregnancy have a bigger chance of getting sick with it in the postpartum period.
Do not stop taking antidepressants on your own. If you decide to stop taking the medications, you need to discuss this with your doctor. Remember that in 70% of cases after the withdrawal of drugs, depression comes back again with even greater force.
Possible Harmful Consequences
Before taking any medicines during pregnancy, it is necessary to assess the risk of fetal pathology and the risk associated with the progression of the disease. Indeed, taking antidepressants during pregnancy in the first trimester and in the prenatal period entails certain risks:
- development of congenital heart defects (in the I trimester);
- withdrawal syndrome in a newborn (anxiety, crying, tremor, convulsions) – in the third trimester.
However, the risk that depression of the mother may be dangerous to her own life is more significant.
Throughout the entire pregnancy a woman suffering from depression should visit specialists to monitor the dosage of the selected drug. It is better to undergo several sessions of psychotherapy.
Harmless Antidepressants and Pregnancy
The following types of antidepressants may be prescribed during pregnancy:
- Selective serotonin reuptake inhibitors (SSRIs). SSRIs include citalopram, fluoxetine, sertraline.
- Serotonin noradrenaline reuptake inhibitors (SNRIs). SNRIs include duloxetine and venlafaxine.
Bupropion is an antidepressant, which is also used in the treatment of nicotine addiction. Bupropion in pregnancy can be used if taking other drugs does not bring results. It can also be used to combat nicotine dependence during pregnancy.
Tricyclic antidepressants are used in pregnancy, if other drugs have proved ineffective. They include Amitriptyline and Nortriptyline.
Some studies have found that the use of citalopram, fluoxetine and sertraline (SSRIs) in the second half of pregnancy is associated with a slight increase in the risk of a rare but severe lung problem in the child – stable pulmonary hypertension of the newborn. Nevertheless, the overall risk remains low.
What Antidepressants Are Not Recommended for Pregnant Women?
- Paroxetine (SSRIs). Paroxetine is associated with a slight increase in the risk of certain heart defects of the fetus.
- Mono Amine Oxidase Inhibitor (MAOI). MAOI, including phenelzine and tranylcypromine, can cause fetal growth retardation.
Antidepressants and Pregnancy: Is it Worth the Risk?
The reasons for taking antidepressants during pregnancy:
- You took medications for depression before, and you would not want to stop taking them during pregnancy.
- According to the research, some antidepressants do not harm the child’s health.
- You tried other methods of treating depression, and they did not help.
- You are more concerned about the impact of depression on the child, rather than the effect of the drug on his/her health.
The reasons why you should not take antidepressants during pregnancy:
- Depression is mild.
- You would not want to take antidepressants during pregnancy; other treatments for depression produce a positive effect.
- Studies do not confirm the existence of absolutely safe antidepressants for pregnant women.
- You are ready to deal with depression through a healthy diet, lifestyle, rest, consultations with a specialist.
Pregnancy and Depression Treatment
If you are depressed, and you are pregnant or plan a pregnancy, consult a doctor. With depression from mild to moderate severity, psychotherapy can help. Keep in mind that the recurrence of depression may exceed the risks associated with taking antidepressants.
Choosing the ways of treating depression in pregnant women can be difficult. Consider all the benefits and risks. In order to make the right choice, consult a doctor.