Antidepressants are a much-needed therapy, not a threat: Evidence

Mothers shouldn't be afraid to continue their depression treatment.

Estimates of depression rates during pregnancy vary between 5.5 percent to 33.1 percent -- a wide range that indicates more research is needed on the issue. More than 400,000 babies are born to depressed mothers every year in the U.S., according to the American Academy of Pediatrics, and we know that untreated depression during pregnancy is risky for both mother and baby: Suicide is the number one cause of maternal death in the developed world, anduntreated depression during pregnancy is linked to preeclampsia, preterm delivery, low birth weight and other complications for the baby.

But fears about the effects that antidepressants have on a developing fetus prevent many women from using this much-needed mental health treatment during their pregnancies. Researchers estimate that only about half of depressed pregnant women are taking antidepressants.

Concerns about antidepressants during pregnancy are compounded by the lack of clinical trials evaluating once and for all whether or not antidepressants are harmful. And while randomized controlled experiments would be unethical and thus hard to come by, there are ways of deciphering the risks that antidepressants or untreated depression would pose to mother and child. 

Three recent studies among large cohorts of Norwegian, Danish and Australian women are shedding light on the risks of the most common type of prescribed antidepressant: selective serotonin re-uptake inhibitors, or SSRIs. They found that SSRI use during pregnancy carries some small risks, but researchers concluded that the risks weren’t significant enough to indicate that women should stop taking the medicine. 

Most significantly, the third study found that depressed women who do not take SSRIs are at higher risk of having children with several problem behaviors, including hyperactivity, inattention and problems with peers. This could indicate that a mom's psychiatric illness may be a larger risk factor than SSRI use in children’s behavioral problems. 

Dr. Deborah Kim, a perinatal psychiatrist and researcher of the Perelman School of Medicine at the University of Pennsylvania, was not involved in the studies but agreed that they affirm what we already know about antidepressant use during pregnancy: It poses slight risks, but may also help mother and baby avoid the negative outcomes linked to untreated mental illness. 

Anna Almendrala