Antenatal/ Prenatal Depression – Medication

While there are many treatments for antenatal depression that are recognised as safe, there are no medications that are proven to be 100% risk-free. Often, medication is used as a last resort, and combined with Cognitive Behavioural Therapy and other treatment options that minimise complications. Untreated antenatal depression in expectant mothers has been linked to the following increased risks in their children: irritability, shorter attention spans, fewer facial expressions, and less activity. On the other hand, antidepressant use during pregnancy may cause a higher instance of pregnancy complications. There are a few factors that outweigh the risk of using antidepressants during pregnancy, however. Here, we’ll examine these cases and help determine whether medication may be essential.

Why Medication is Used as a Last Resort

While the risks of medication during pregnancy are low, there have not been definitive answers regarding their safety. The associated risk to the unborn child is often a moral issue for many prescribers, and causes some to avoid the discussion of antenatal depression entirely. The use of selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), Bupropion, and tricyclic antidepressants has not been studied thoroughly enough to classify them as 100% safe. There is a possible link between the use of citalopram, sertraline, or fluoxetine and a condition called persistent pulmonary hypertension, a serious lung condition in newborns. Though the correlation and associated risk appears extremely low, the dangers of any medication must be weighed against the benefits.

When Medication is Necessary

For many women diagnosed with antenatal depression, treatment options including therapy, lifestyle change, and dietary support are enough to alleviate the condition. Most doctors will recommend these forms of treatment long before considering medication. However, there are cases where medication is considered and even prescribed before other options are explored.

Women with a History of Major Depression

Women who have a history of clinical (or major) depression are more likely to be prescribed antidepressants during pregnancy. There is a danger of relapse in women who are have successfully managed their depression with medication prior to pregnancy. Continuing medication while pregnant requires weighing the risks of both the expectant mother and the developing baby. Often, antenatal depression can lead to anxiety, stress, insomnia, and inconsistent eating patterns. These symptoms all have negative effects on the fetus. For women with severe depression, suicidal thoughts, or a history of attempted suicide, the safety of both the mother and the baby relies on continuing treatment, regardless of the possible side-effects.

Women Caring for Other Children

Women who are the primary caretaker for other children also face a tough decision. Not only do they need to support themselves and their unborn baby, but they must also maintain enough energy to care for their other children. When the symptoms of depression start to affect the woman’s ability to function in this role, medication may be essential, especially for women who have previously been treated with antidepressants.

Which Decision is Right for You?

If you are struggling with antenatal depression, take time to discuss your treatment options with your doctor. There are many safe, effective alternatives to explore. Medication is also a possibility, if these options are not providing the necessary relief. In the following article, we’ll examine ways to broach this topic with family and healthcare providers in order to ensure you’re getting the help you need.

Resources

Mayoclinic: Antidepressants and Pregnancy

ACOG.ORG: Depression During Pregnancy