Many pregnant women take significant steps to ensure the health of their children, foregoing behaviors like drinking and smoking that have proven damaging to developing fetuses. Psychiatric medications, on the other hand, present a far murkier debate: research suggests that meds may cause unknown changes to the fetus, so should should mothers who need these drugs continue to take them during their pregnancies? 

 

This decision is further complicated by the fact that, while researchers have very little data on the side effects of antidepressants on developing babies, they can state with certainty that untreated depression harms both mother and child. The percentage of pregnant women who continue taking antidepressants doubled between 1999 and 2003, so many women have clearly decided that maintaining their treatment regimen is in the best interest of all involved.

 

A joint report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists offers few concrete answers. Older studies from Sweden and the US found slightly higher rates of congenital heart defects among infants whose mothers were on SSRI antidepressants during their pregnancies, but the new report's authors determined the data behind these studies to be inconclusive at best. They also dismissed as unreliable reports that have linked SSRIs to low birth weights and higher rates of miscarriage, noting that no clinical studies have yet been able to control for the litany of variables - behavioral, environmental and genetic -that contribute to such outcomes.

 

In conclusion, researchers advise women who are planning to become pregnant to gradually wean themselves off their medications if they haven't experienced moderate-to-severe depressive symptoms over the preceding six months. They also warn pregnant women not to simply stop taking their meds because of withdrawal risks and suggest psychotherapy as a possible alternative for those who continue to display symptoms of severe depression during their pregnancies - severe, untreated depression has been conclusively linked to low birth weights and premature births. Women for whom this issue arises should, according to the Mayo Clinic, talk to their doctors about specific meds before deciding whether to continue taking them during pregnancy. Clinical data on the topic remains unfortunately rare, but this list of recommendations should be of some use to women who are pregnant or plan to get pregnant and also have a history of depression.