Antidepressants found safe during pregnancy, but what else can you do?
Researchers have taken yet another look at the safety of antidepressants during pregnancy. The finding, published in the Journal of the American Medical Association (JAMA), could put to rest fears have been raised that prescription drugs known as SSRIs could lead to higher infant mortality. It's also important to know there are non-drug approaches that can help with symptoms of depression during pregnancy.
The study included 30,000 women from Nordic countries who researchers tracked as having filled a selective serotonin reuptake inhibitor (SSRI) prescription during pregnancy.
They found no association between use of the drugs and deaths at birth, stillbirth or shortly after birth.
The debate about antidepressant use during pregnancy safety has been ongoing for several years.
One study, published January 2012 suggested SSRIs taken in the third trimester of pregnancy could cause infant seizures. There was also a link between stillbirths and use of the medications among women taking then earlier during pregnancy.
Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden and colleagues conducted the newest study that included in women from Denmark, Finland, Iceland, Norway, and Sweden during different times from 1996 to 2007.
The study found higher rates of stillbirth and postnatal death among women given the antidepressants. But the researchers say the reason is related to behaviors like smoking, advanced age of the mother and severity of the psychiatric disease being treated.
As in the past, experts recommend weighing the risk of the drugs against the benefits during pregnancy.
It’s estimated that between 14 and 23 percent of women experience pregnancy related depression that can also lead to negative outcomes, according to a 2009 report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists
The authors note earlier studies didn’t take into account the severity of maternal psychiatric disease, leading to reports that antidepressants are unsafe for pregnant women. The study was funded by the Swedish Pharmacy Company.
A non-drug approach
Non-drug approaches for treating mild to moderate depression include group or individual therapy, an important note for women who want to avoid medications.
Cognitive behavioral therapy or CBT has been found to help women beat gestational related depression, in findings published in 2003.
One clinical trial showed light therapy is both safe and effective. The study, published in 2003, showed morning light therapy relieved symptoms of depression by 49% after 5 weeks of treatment.
For severe depression, a combination of medication and psychotherapy is recommended.
The American Pregnancy Association recommends women seek help for symptoms that include sadness that persists, change in eating habits, anxiety, feelings of hopelessness, suicidal thoughts, change in sleep – either too little or too much – lack of pleasure from activities you usually enjoy and feelings of guilt or worthlessness.
A happier pregnancy
It’s important to note that exercise is a natural antidepressant. If you’re thinking of getting pregnant or already there, make sure you get plenty of regular activity, within guidelines recommended by your physician.
Avoid sugar and processed foods that are known to affect our mood. Caffeine, artificial food additives and eating too many carbs and not enough protein can affect mental (and physical) health.
The new study shows antidepressants known as SSRIs might be safe to take during pregnancy. Discuss the risks and benefits with your doctor if you feel the need for extra help with feelings of sadness or other symptoms that are not uncommon for pregnant women.
Obstet Gynecol. 2009 September; 114(3): 703–713.
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