Antidepressants During Pregnancy: Never an easy choice, but…

“Women with prior experience of taking antidepressants and greater illness insight were more likely to use antidepressants during pregnancy.”

Interesting, don’t you think?

In reviewing the article, Factors Impacting Decisions to Decline or Adhere to Antidepressant Medication in Perinatal Women with Mood and Anxiety Disorders, Deborah Crowley, MD acknowledges the difficult decision to weigh the risks and benefits of taking meds during pregnancy versus not treating the illness. The small study looked at the reasons for accepting or declining the antidepressants in women with moderate-to-severe major depression and anxiety.

Thirty women decided to take the antidepressant  and 20 decided not to. During the remainder of their pregnancies, those who took the medication became significantly less depressed and anxious while those who declined became more depressed and anxious. The primary reasons for avoiding medication were fear of fetal exposure and the belief that symptom severity did not warrant medication treatment. Those who decided to take the medication had a “more positive view of antidepressants and greater insight into their illness.”

Her conclusion is that this study further supports the observation that symptoms worsen in women who discontinue antidepressant medication during pregnancy. She goes on to say that this study

“demonstrates the importance of clinicians fully informing patients of risks associated with both taking and not taking antidepressant medication, and helping to enhance illness insight, especially in patients with no previous experience taking antidepressants.”

It is never an easy decision. As clinicians, we can help by providing the evidenced-based information that is available as well as offer the opportunity for moms to explore all options in order to determine the best course of action.

Stay informed and work well.


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