Antidepressants are commonly used to treat depression and anxiety. However, many women believe that they need to stop their antidepressant medication once they fall pregnant.
This is because it is commonly thought that antidepressants are detrimental to the foetus. However, in reality there is no conclusive evidence that antidepressants are harmful. In fact, in some cases the antidepressant medication is essential for the mother’s mental state.
Lets look at some statistics as given by Dr Kimberley Yonkers, MD and Professor at the Yale School of medicine.
- 10 – 20% of pregnant women suffer from depression and anxiety.
- More than 50% of these, go off their medication after conception.
- While many can manage their anxiety and lowered mood, not all women stay well. In fact, if a woman has severe recurrent depression, stopping antidepressant medication increases her risk of relapse by a factor of 5.
- Anxiety can have a greater impact on pregnancy outcomes than antidepressants. In other words, anxiety itself can lead to pregnancy complications.
- Depression can lead to problems like preterm birth.
To be clear, while there may be some risk in taking antidepressant medication (and the jury is still out), not treating anxiety and depression can also lead to pregnancy complications.
Factors to keep in mind:
- The magnitude of the risk needs to be assessed before a decision is made. If the risk from the medication is small (only 2%), then it may be more beneficial to keep the expectant mother on her medications rather than risk a relapse.
- Women who respond to psychotherapy, may be candidates to go off medication. But for those who do not respond, antidepressant medication may be the only option.
- Consider the whole picture. Weigh the benefits to the mother against the risk to the foetus (real, proven risk).
- Ask your doctor for hard facts and statistics to help you make your decision. Understand what those figures mean. For example, if antidepressants have a 2% chance of shortening a pregnancy, that translates to 3-4 fewer days of pregnancy.
- A mother who is anxious will be transmitting anxiety hormones such as cortisol to her baby. This may lead to the newborn being agitated.
- After birth, a depressed or anxious mother may have difficulty bonding with her child which could potentially lead to long term emotional problems.