The American Journal of Psychiatry just published (May, 2009) an editorial written by Barbara Parry, MD, director of research at the Women’s Mood Disorder Clinic at the University of California:
Assessing Risk and Benefit: To Treat or Not to Treat Major Depression During Pregnancy with Antidepressant Medication.
It is a great article, summarizing the available research with explores this important dilemma, Dr. Parry cites work that studied the impact of maternal depression on the pregnancy versus the impact of pharmacologic treatment on the pregnancy. Most of the studies have focused on neonatal outcome.
The author concludes with this important take-home point:
“…this author thinks that the risk of untreated major depression outweighs the risk of effects of SSRI treatment on neonatal outcomes. We need to consider not just short-term, but also long-term, consequences of our decisions. In addition to focusing on the child, the clinician needs to consider the risk of untreated major depression in the mother. These risks include exacerbation or recurrence of her underlying psychiatric illness, which can have adverse effects on her morbidity and mortality and can impair not only her functioning, but that of her family and other children under her care.”