There is considerable debate regarding the new information about pregnant women and their use of antidepressants, released in the Journal of Human Reproduction
. The news is the result of a study conducted at Metrowest Medical Center in Massachusetts by Dr. Adam Urato, Chairman of the Department of Obstetrics and Gynecology.
For many years women have been told that the risk of depression was far greater than the side effects of certain medications deemed appropriate for use during pregnancy, but now there are doctors who are cautioning against this advice. They are warning of everything from miscarriage to preterm labor and long-term side effects as a result of taking these meds.
To counter these claims, Dr. Jennifer Payne, director of the Woman’s Mood Disorders Center at John Hopkins School of Medicine, is restating the fact that for some women these medications are crucial for their own health and for the psychological well-being of rest of their family. She states that women who are severely depressed tend to miss prenatal appointments and have poor self-care. The repercussions of these behaviors could have dire consequences. Many clinicians report that the use of antidepressant meds during pregnancy can also help to stave off post-partum depression if taken early enough.
Reports such as this one can scare women away from using medication even when they desperately need it. The primary concern of the clinicians who are criticizing this study is that the researchers did not acknowledge that in certain cases the cost benefit analysis does lean in favor of using medication.
I am not a medical doctor, and therefore I cannot weigh in on the medical risks of using these meds during pregnancy. Over the years I have seen many patients in therapy for depression during and post pregnancy and I can report that there are many non-medical treatments for these disorders. That said, there are times when behavior modification and other holistic approaches simply don’t suffice.
As I have mentioned in previous articles, so often there is a tendency to hastily write a prescription. It can be seen as a quick fix. Unfortunately there are no actual quick fixes and any woman who is suffering from depression, while pregnant, should have a thorough evaluation by a mental health professional and should be referred to a psychiatrist if the circumstances warrant.
When I see a woman in this situation I will use a number of different treatment strategies before considering a psychiatric referral, with the hope of avoiding the possible risks of medication. I believe this study would not have been viewed so harshly had the researchers presented a more balanced report instead of painting all antidepressant use during pregnancy with a broad brush. Women who truly need to take this type of medication should feel empowered to do so and should recognize that, as with most serious parenting decisions, there are pros and cons. By no means should they feel shame over the need to do whatever is in their best interest and in the best interest of their immediate family.
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