Antidepressant during Pregnancy – Is It Safe?
For women who need antidepressants to control their depression, pregnancy can be a difficult choice whether they should continuously consume it or leave it until they finish their pregnancy. In other words, if you are one of them, stopping it might pose risk for uncontrollable depression – but if you continuously take it during your pregnancy, this may pose some health risks for your baby.
In several years ago, experts believed that changes of hormones in pregnant women were helpful to protect them from depression. But today, this opinion is wrong. Even some studies found that pregnancy can put a woman at higher risk of developing a wide range of mood changes.
So, should you keep continuously taking your antidepressants during pregnancy? Are they safe enough for your baby? Then what you should do? The following are some facts about pregnancy and antidepressants.
Experts agree the answer is dependent on the balance between the benefits and risks. If there are more benefits than the risks, the use of this medicine in line with pregnancy may be allowed by doctors.
The risks of pregnancy complications (particularly birth defects) for babies of pregnant women who consume antidepressants are still debatable. Overall, some experts believe that these risks are low. Some types of antidepressants are safe, but there are also certain types that you need to avoid during pregnancy.
In essence, you need to control your depression but your doctor also needs to carefully concern the risk from the treatment. Uncontrollable depression during pregnancy can generate a lot of problems. If it occurs, you may become very poor for good care of yourself.
Even you may also have increased risk of eating less healthy foods (poor prenatal care). There is also a chance for you to drink alcohol or even smoking if you have untreated depression. And these conditions can increase your risk of low birth weight, premature weight, or other pregnancy complications.
Untreated depression also may put you at high risk of having difficulty bonding with your newborn. These explanations suggest that the risks of stopping your antidepressant may be higher than the risks when you keep taking it during pregnancy.
There are some kinds of antidepressants, but not all of them are an option for pregnant women. The following are some types that may be an option during pregnancy:
- Wellbutrin / Bupropion! This kind of medication is pretty common for smoking cessation and depression. This type may be the last option of medicine for both smoking cessation and depression. It may be prescribed if your depression doesn’t respond to other medications.
- Certain SSRIs (selective serotonin reuptake inhibitors)! Not all types of SSRIs are safe enough for pregnant women. But there are also some common choices that may be safe to be consumed during pregnancy – these include Zoloft ‘sertraline’, Prozac ‘fluoxetine’, and Celexa ‘citalopram’.
- Tricyclic antidepressants, such as Pamelor / nortriptyline and amitriptyline!
In essence, your chance of having a depression relapse is high when you stop taking your antidepressants. And this can generate other problems that can be harmful for you and your baby during and after pregnancy.
If you use certain SSRIs to control your depression, and you stop it abruptly, you may experience some of these following symptoms:
- Easy to get fatigue (excessively fatigue).
- Chills /fever.
- Nausea that may also be followed with vomiting.
- You may also experience anxiety.
So, what are your risks when taking antidepressants during pregnancy? The answer varies from person to person. But in general, there is still no clearly answer.
When you taking certain SSRIs in the last half of your pregnancy to treat your depression, you may have increased risk of having newborn with PPHN (persistent pulmonary hypertension of the newborn) and newborn with heart defects – according to some studies associates use of sertraline, fluoxetine, or citalopram!
And an early research associate use of tricyclic suggests that taking tricyclic during pregnancy may increase the risk of limb malformation.
Furthermore, there are risk for baby to have temporary discontinuation symptoms (like irritability /jitters) at birth, if you consume antidepressants in the last trimester. You may also have increased risk of certain rate birth defects – however more research are required to find the clearly answer!
As mentioned before, not all kinds of this treatment are safe for pregnant women. Paxil /SSRI paroxetine is one of them. It is commonly discouraged for pregnant women. Experts believe that there is a link between Paxil and fetal heart defects, although when it consumed only in the first trimester of pregnancy.
You should also avoid Parnate ‘tranylcypromine’ and phenelzine – these are types of antidepressants from MAOIs (monoamine oxidase inhibitors). They can aggravate your blood pressure and limit your fetal growth.
There are several choices that will be analyzed by your doctor. The gradually reduction of your antidepressant dosages may be your option. This is usually effective for women with mild depression who planning for pregnancy.
Another option is discontinue the use of antidepressants and then your doctor asks you to do certain alternative therapies (such as counseling, psychotherapy, etc) to help control your depression. In general, this option can work successfully for women with mild depression.
Changing the type of your antidepressant may also be an option for you. If you choose it, your doctor need to carefully concern any potential risks. For instance, there is a chance for a drug substitution to fail in treating your depression -which then put you at high risk of having a depression relapse. Moreover, switching medications may also expose an additional medication for your baby which then may increase the risks of other problems.
Overall, the decision to treat depression in pregnant women is not easy, especially for them with severe depression. The benefits and risks of taking certain medication need to be carefully concerned on a case-by-case basis.