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Pregnancy is supposed to be one of the happiest times in a woman’s life; however, an estimated 10-15% of pregnant women struggle with depression. Many don’t even realize they’re experiencing depression, while others don’t report their symptoms due to shame. Depression treatment during pregnancy is essential; untreated depression in pregnancy can be life threatening, and has been linked with increased risks of miscarriages, prematurity and low birth weight. Additionally, the strongest predictor of postpartum depression is depression in late pregnancy.

Fortunately, expectant mothers don’t need to suffer from this condition; depression is treatable during pregnancy with psychotherapy and antidepressant medication.

As a healthcare professional specializing in mental health and pregnancy, it’s my job to educate expectant mothers about safe treatment options for depression. Today, there are more than 35 published studies and thousands of reports from pregnant women on antidepressant medications – the common consensus among specialists is that the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is low and the benefits of these medications by far overweigh any potential risks.

Still, some studies have shown that pregnant women may perceive the risk of any medication taken during pregnancy as significantly higher than the reported risk. Even with safer medicines, we in Motherisk have shown that women believe their own child’s risk for birth defects is a startling 25%. This leads many expectant mothers – not just those suffering from mental disorders – to avoid therapy or consider terminating their pregnancy. (Editor’s note: The Centers for Disease Control and Prevention (CDC) estimates that about 1 in every 33 babies (3%) born in the U.S. has a birth defect.*)

I recommend that women do not stop taking antidepressants as soon as they find out they’re pregnant; doing so can lead to a relapse of symptoms, which may do greater harm to the child and mother than taking medication. Pregnant women should discuss with their healthcare provider the best course of treatment during her pregnancy.

All this fear and confusion that surrounds the safety of medication use during pregnancy has led me, after counseling women for more than 30 years, to write my latest novel, Prozac Baby (check out the CGP review), a diary told by an unborn baby. My novel is designed to help inform, mitigate unfounded fears, and empower optimal management surrounding medication use during pregnancy for expectant women, as well as their partners, relatives and friends.

In summary:

1. Talk to your physician about your feelings and potential mental problems as early as you can;
2. Seek mental health advice from an expert physician, preferably a psychiatrist with experience in treating expecting mothers;
3. Do not stop taking or go “cold turkey” on your medications as soon as you find you’re pregnant;
4. The risk of birth defects and other problems for babies of mothers who take antidepressant medications during pregnancy is low;
5. Do not follow advice of non-professionals. This can be life threatening;
6. Your well-being in pregnancy is by far more important for you and your baby than the unfounded rumors about risks in pregnancy.

Gideon Koren MD, FRCPC, FACMT is a Canadian pediatrician, toxicologist and clinician scientist. In parallel to his academic career at the Hospital for Sick Children and the University of Toronto, Koren is a well-established, award-winning composer and author in his native Israel. He is a Professor of Pediatrics, Pharmacology, Pharmacy and Medical Genetics at the University of Toronto, a Visiting Professor at Tel Aviv University, and the Ivey Chair in Molecular Toxicology at Western University.

He is the author of over 1,500 peer review papers and 15 medical books. In 1985, he founded The Motherisk Program, which he continues to direct. Motherisk counsels women, their families and health professionals on the safety-risks of drugs, chemicals, radiations and infections during pregnancy and lactation. The research group headed by Koren is studying the fetal effects of drugs and chemicals, as well as the effects of medications and toxins in infants and children. Through over 500 research papers on drugs in pregnancy, Koren has identified drugs and chemicals that are damaging to the fetus (e.g., organic solvents, corticosteroids, lithium, misoprostol) and those that are safe to take (e.g., calcium channel blockers, Prozac, doxylamine-pyridoxine).

Reference:

*Centers for Disease Control and Prevention. Update on Overall Prevalence of Major Birth Defects–Atlanta, Georgia, 1978-2005. MMWR Morb Mortal Wkly Rep. 2008;57(1):1-5.