Taking Antidepressants During Pregnancy

Take Antidepressants During Pregnancy – What the Science Says

For years, the decision about whether to continue taking SSRIs and other psychiatric medications during pregnancy has been a complicated one. The previous information on the subject advised people to take caution due to concerns about the drugs affecting fetal development. 

This has had far-reaching effects on people considering pregnancy and weighing their healthcare options with concerns about the health of their pregnancy.

However, recent findings from Rutgers University indicate that taking antidepressants while pregnant is safer than the medical community previously thought. Here’s a breakdown of the news and what it means for anyone considering becoming pregnant.

What the Recent Findings Say

A recent study from Rutgers University shows that pregnant people taking antidepressants may no longer need to worry about their medication affecting fetal neurodevelopment. 

The new study followed over 145,000 women and their children across the United States. Researchers followed some of them for as long as 14 years. 

The study found no association between antidepressant use during pregnancy and conditions like autism, ADHD, behavioral disorders, developmental speech, language, learning, and coordination disorders, or intellectual disabilities.

What did Past Studies Have to Say About Antidepressants During Pregnancy?

Studies over the past several decades have linked antidepressant use during pregnancy with developmental concerns in children. This correlation was particularly noted for autism and ADHD. 

But those studies were mostly observational, which limits their usefulness in terms of generalizability. They often didn’t control for other contributing factors like other health conditions, environmental toxins, inflammation, maternal weight during pregnancy, and maternal stress levels. 

Understanding the True Risks and Costs of Untreated Depression – For Parent and Child

Past studies also didn’t consider the potential impact that an uncontrolled mental illness like depression or anxiety might have on a developing fetus. Untreated mental disorders have been linked to conditions such as:

• Stillbirth
• Preterm birth
• Stunted or delayed growth
• Birthweight issues
• Impaired bonding
• Adverse neurodevelopmental outcomes
• Increased risk of mental health issues for the child after birth

Depression is a notoriously difficult condition to manage for most people. That doesn’t just stop when someone becomes pregnant. 

Depressed people, pregnant or not, often struggle to adequately take care of themselves. Even if they have every intention of being an attentive parent and taking excellent care of their child before and after birth, untreated mental health conditions get in the way of those efforts by their very nature. Depressed pregnant people can miss prenatal check-ups, miss meals, self-harm, or overuse alcohol, cigarettes, or other drugs to cope with their symptoms. When they can’t take their medication, that can affect fetal development.

What do These New Findings Change About How We Approach Medication During Pregnancy?

This new information can reassure potential or expectant parents as they make decisions about treating their psychiatric conditions.

Previous studies on this topic produced mixed results, which led a lot of people to approach taking antidepressants during pregnancy with caution. But the study author says that because of the thorough study design and large sample size, providers and patients can use this information to make decisions about how they’ll treat their mental health symptoms during pregnancy. 

Weighing the Risks and Benefits

Pregnant people, potential parents, and health professionals should have the risks explained to them. But they should also understand that the risk during pregnancy isn’t as high as was previously thought. This also applies to people with mental conditions other than depression, but for which antidepressants are often prescribed (which is very common).

Because of their concerns about the risks of taking antidepressants during pregnancy, pregnant people sometimes decide to suddenly stop their medications as soon as they find out they’re pregnant. This can have far-reaching consequences. While they want to protect the developing fetus, stopping a needed psychiatric medication can have long-lasting repercussions for the pregnant person and the child. 

What This Means for People Seeking Mental Health Services

This news gives pregnant people more options for care and more freedom to decide what’s best for them in partnership with their medical provider.

Taking antidepressants is extremely common. Statistically, about 20% of perinatal individuals experience mental health conditions. This especially makes sense when you consider that women and people assigned female at birth have a higher risk of experiencing psychiatric disorders.

There are a lot of societal and medical expectations for how pregnant people will adapt their lifestyles to accommodate a future or current pregnancy. This finding makes progress in lessening that burden in an area of life that’s key for well-being: mental health.

More Care Options for Women and Other Perinatal Individuals

As Dr. Tiffany Moore Simas, a member of the Committee on Clinical Practice Guidelines on Obstetrics for the American College of Obstetricians and Gynecologists, put it when speaking about this study, “We must stop shaming [perinatal individuals] for doing what is needed to care for themselves. Healthy babies need healthy [parents].”

The Ability to Stay on Medication During Pregnancy

Going off antidepressants can be a difficult process. Some people go through withdrawals on top of their symptoms returning (the reason why they started taking the medication in the first place). Navigating that on top of the physical and emotional rollercoaster that can come along with trying to get pregnant or adjusting to pregnancy and parenthood can be a lot to handle. 

Improved Quality of Life and Less Upheaval for Parent and Child

Going back on antidepressants after giving birth (or staying off antidepressants after giving birth) also has potential consequences. 

Anyone who’s taken antidepressants before knows there’s always some risk of side effects while starting on a medication. Even if that person’s already taken the medication before and knows what to expect, and even if the side effects eventually go away or become manageable, that’s still a transitional period that adds stress to the parent’s life.

This can severely impact quality of life for them and their family. When you factor in issues like the potential for developing postpartum depression, dealing with the upheaval and potential side effects associated with restarting medication can be a significant ordeal. Thanks to this new information from the Rutgers study, this ordeal can be avoided for more people.

What Antidepressants are Considered Safer During Pregnancy?

The CDC still considers some antidepressants to be risky during pregnancy. Specifically, fluoxetine and paroxetine can both be dangerous when taken during the early stages of pregnancy. However, others like sertraline haven’t been found in connection to fetal developmental problems.

In light of that, it’s important to remember that despite increased risks for certain fetal problems from some SSRIs, the actual risk of these health problems occurring among babies born to people taking these medications is still quite low.

This information can help guide healthcare providers and their patients to the safest, best options overall. Ideally, that means weighing the pros and cons and potentially trying different, safer medications first when needed, instead of just avoiding all medication and writing it off as risky right off the bat. This approach lets providers and individuals maximize the benefits to the parent and child, minimizing risks to both.

The CDC’s website provides more information and resources on this topic for those who want more information. 

How the New Guidelines Interact with Existing Mental Health Stigmas

Of course, there’s still a wide stigma to accessing mental health care and taking medication. People who are pregnant or may become pregnant someday are often scrutinized for the choices they make, including what medications they may choose to take, and how those choices relate to their potential as a parent. So much so that they often reason, “I shouldn’t start antidepressants to treat my symptoms because I might want to get pregnant someday. Why get help if I’ll have to stop taking those medications if I ever get pregnant?”

How to Use This Information

Pregnant people (or people considering getting pregnant) should still discuss their medication with their doctors. But with the information we have now, that discussion should include weighing the benefits of treatment and the risks of certain medications. We now know enough that patients can think about their medication changes during pregnancy in context with their well-being, health, and quality of life in general.