Antidepressants and pregnancy: Women must consider the impact of drugs on baby

By Alexia Elejalde-Ruiz

Chicago Tribune

Published: Thursday, Feb. 16 2012 3:25 p.m. MST

Women with mild depression might consider gradually tapering off their medication dose before they conceive (if they have the luxury of planning) or in the third trimester (if they don't) to decrease the risk of withdrawal symptoms in the newborn, Patil said. But if it's likely the mom will relapse, it's best to stay on. He recommends patients seek guidance from their OB-GYN and mental health providers to determine the best course of action, including alternative therapies.

It's never a good idea to discontinue medication abruptly. In a 2000 study of women who stopped taking antidepressants and anti-anxiety pills upon learning they were pregnant, 70 percent reported adverse physical or psychological effects, 30 percent had suicidal thoughts and 10 percent were admitted to hospitals.

"It was pretty sad," said study co-author Adrienne Einarson, a nurse who has published extensively on the topic. "It can be more harmful for women not to be treated, but no one seems to look at it that way."

Einarson, who is semiretired as assistant director of Motherisk, a counseling service for pregnant women based at The Hospital for Sick Children in Toronto, worries the stigma and misinformation about the risks might dissuade women from taking medication they need. Injury lawyers haven't helped; last year, a family won a $2.5 million settlement from GlaxoSmithKline after a jury found it negligent for not warning the mom's physician of the risks of taking Paxil during her pregnancy. Her son was born with a heart defect.

Several studies have linked paroxetine, the generic form of Paxil, to heart malformations, but others have found no greater risk, Einarson said.

"Now they're going to think for the rest of their lives that it was her fault because she took Paxil," she said.

Resources: postpartum.net; womensmentalhealth.org

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