Are Medications “Optional” During Pregnancy?

This is an incredibly interesting post from MGH. The author, Helen Kim, MD, reflects on the dilemma of medicating psychiatric symptoms during pregnancy. I hope you take the time to read it. She does an amazing job simplifying an extremely complex situation. She refers to the notion that we have somehow made taking psychotropic medication “optional” for a pregnant woman, when, in fact, it should not be during certain circumstances.

Clinicians and moms should both take the time to read this. I would love to hear what you think about it.

It’s complicated, to be sure. And it seems that everyone is on the same page, for the most part. Everyone agrees that we should postpone the use of medication during pregnancy whenever possible or whenever symptoms are not severe enough to warrant it. But that’s where it gets murky. And that’s when judgement are made: “It would be better, if…”., “you will feel better, if….”, “it is safe, under these specific circumstances,” “You will be fine, if…”

The problem is, conditions vary. Individuals vary. Environmental stressors vary. Predispositions and risk factors vary. Expert perspectives vary.

It can feel as if making the decision to medicate during pregnancy is a risk too great to take.

But many of us know that the risk of not treating a significant depressive episode can also lead to less than favorable outcomes. Marriages are strained, symptoms can exacerbate, pregnancies are compromised. These, and other negative events can lead to devastating consequences.

Healthcare providers and women who are pregnant, or considering pregnancy, who are at risk for depression, should carefully review the literature so they can, in collaboration with partners and other involved healthcare practitioners, agree to a treatment plan that reduces symptoms and increases the probability of a successful experience all around.

 

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