Is the Use of Antidepressants Secure During Pregnancy a Concern?
Let's Talk Pregnancy and Depression: An Unfiltered Guide
You might be surprised to know that around 1 in 10 women experience depression during pregnancy. It's a bummer, but it's common. And if you're feeling low, it's vital to address it. After all, when you're feeling good, you're more likely to take better care of yourself, and that's crucial for the little one growing inside you.
So, let's discuss antidepressants, their potential impacts, and how they may help you during your pregnancy. Remember, though, that every situation is unique, so chat with your healthcare provider to make the best decision for you.
Why Treat Depression During Pregnancy?
Pregnancy hits us differently, and for some, depression symptoms get better. Others, unfortunately, deal with worsened symptoms, or depression may even crop up out of nowhere - known as prenatal depression. Untreated, depression during pregnancy can be dangerous for you and might impact the baby's development. It can up your risk for postpartum depression and lead to troubles like poor fetal growth, early labor, low birth weight, and health complications after birth. Plus, it could keep you from taking proper care of yourself, affecting your prenatal appointments, exercise, diet, and overall lifestyle.
Should I Stop Taking Medication When I Get Pregnant?
Whenever you pop a pill during pregnancy, it can enter the littleperson's bloodstream and possibly cause side effects. So, if you're pregnant or think you might be, speak with your provider before starting or stopping any medication, including antidepressants.
It's tricky to know for sure how a medication will affect fetal development. Experts don't run high-level randomized clinical trials on pregnant women – it's too risky. But they collect data over time and observe whether it's caused any harm. Most antidepressants seem to be safe, but the details vary.
The Safest Antidepressants for Pregnant Women
The antidepressants that have the most data available during pregnancy are selective serotonin reuptake inhibitors (SSRIs), especially sertraline (Zoloft). That's because SSRIs have been around for a while and are the most commonly prescribed medications for depression, which adds up to a lot of data. Antidepressants, especially most SSRIs, appear to be safe, with the benefit of treating depression often outweighing the potential risks.
Antidepressants to Avoid During Pregnancy
There are a couple of antidepressant medications that could potentially cause side effects, like paroxetine and tricyclic antidepressants. Studies suggest that paroxetine may increase the risk of heart defects in babies. Research also finds that many medications in the older class of tricyclic antidepressants may increase the risk of birth defects affecting a baby's head and neck. So, it's a good idea for pregnant people to switch these medications to a different antidepressant if possible.
Can Antidepressants Cause Gestational Diabetes?
Research suggests that some antidepressants during pregnancy may increase the risk of gestational diabetes (GD), but SSRIs are not associated with an increased risk. It's likely that unmanaged depression might present a higher risk of developing diabetes during pregnancy.
Alternatives to Antidepressants During Pregnancy
If hormonal changes during pregnancy improve your depression symptoms, you might be able to stop your medicine. But always discuss with your provider before stopping medications at any time.
If you'd rather not take antidepressants during pregnancy or if your provider doesn't recommend them for you, there are non-medication options they may suggest, like lifestyle changes, psychotherapy, or electroconvulsive therapy (ECT). Electroconvulsive therapy has been demonstrated to be safe and effective during pregnancy for severe mental health disorders.
"Lifestyle changes and other treatments can help some people avoid antidepressant medication," medication specialist Diana Isaacs, PharmD, explains. "But everyone's different, so you may benefit most from medication – and that's okay."
Speak to Your Provider About Antidepressants and Pregnancy
Dr. Isaacs advises talking with a healthcare provider to weigh the risks of untreated depression against the potential for risks associated with medication. "It's an individual process best navigated through shared decision-making with the pregnant person and their healthcare team," she says.
If you're trying to conceive, you can discuss a trial period off your antidepressant medication before you get pregnant to see how it affects you. Some providers and pregnant women may also decide to taper off antidepression medication at the end of the second trimester.
Ultimately, remember to prioritize your mental health. When you're in a headspace to properly care for yourself during pregnancy, it's the safer choice for everyone.
Reach Out for Help
Depression can be heavy, but treatment is available. And you don't have to battle through it alone. Talk with your provider about what you're experiencing. If you have any thoughts about harming yourself or the fetus, take immediate action. In the U.S., text or call the Suicide and Crisis Lifeline at 988 for 24/7 free and confidential support. You deserve to be the best version of yourself – for your well-being and for that of the developing fetus.
- Mental health is crucial during pregnancy, as depression can impact both the mother's health and the baby's development.
- Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), are often safe antidepressants for pregnant women, according to available data.
- Non-medication options like lifestyle changes, psychotherapy, or electroconvulsive therapy (ECT) may also be suggested by healthcare providers as alternatives to antidepressants during pregnancy.
- It is important for pregnant women to discuss antidepressant use and its potential risks with their healthcare provider to make informed decisions about their treatment options.
