Is Stopping Your Depression Medication During Pregnancy A Good Idea?Katlyn Joy |16, October 2014
Any woman with a chronic medical condition who becomes pregnant requires special care and consideration. With any medication, the question of the risks of the medications versus the benefits is paramount. While a diabetic would not be told to withhold insulin treatment while pregnant, many depressed women or those with anxiety are advised to quit their medications. The reason seems to be that even those in the medical community sometimes view mental health as a will power or character issue rather than the biologically based issue it is.
Who is at Risk?
According to the Office of Women's Health in the US Department of Health and Human Services, about 13 percent of pregnant women and new mothers suffer from depression. Those with a history of depression, family members with depression, and those with little or no support from friends or family are most at risk. Others who may have more of a likelihood of depression include those who previously had problems in their pregnancies, those who are anxious about pregnancy, women with marital problems, struggling with addictions and those with other life stresses whether financial or other types.
Risks of Drug Treatments for Depression and Anxiety
In an article on The Washington Post, Dr. Kimberley Yonkers of Yale School of Medicine, warns of grave consequences for many women who stop their prescription treatment for depression, "If a woman has severe recurrent depression, stopping antidepressant treatment in pregnancy increases her risk of relapse by a factor of five. There is also evidence that depression itself is linked with problems such as preterm birth. My work shows that a number of anxiety disorders, which also are typically treated with antidepressants and often accompany depression, can have a greater impact on pregnancy than antidepressants."
Even the Women's Health.gov website warns, "If you take medicine for depression, stopping your medicine when you become pregnant can cause your depression to come back. Do not stop any prescribed medicines without first talking to your doctor. Not using medicine that you need may be harmful to you or your baby."
There is a great deal of conflicting information found in medical studies with use of antidepressants in pregnancy. In 2004, for instance, the Food and Drug Administration warned about using certain antidepressants in the late third trimester. The FDA recommended that doctors taper women's dosages down in the final months gradually, and then resume dosing to normal after delivery.
Dr. Yonkers refers to certain studies, "One also needs to consider the magnitude of the risk. Problems such as preterm birth or physical malformations that may occur after in-utero exposure to antidepressants are relatively rare."
She cites that heart valve defects are present in 1 percent of babies at birth; with antidepressant use, the numbers only rise to 2 percent. While some studies suggested babies are born sooner if mothers take antidepressants, the difference is probably only a few days. Furthermore, those differences may well be attributed to something other than antidepressant use, such as obesity, cigarette smoking or other lifestyle choices.
Risks of Untreated Depression
The risks of depression left untreated can be great. A woman is less likely to care properly for herself while pregnant if her depression is not treated, so she may not eat well, get enough rest and may miss doctor's appointments. Depression also raises the risk of complications in pregnancy and increases the odds of a premature birth or a low birth weight baby.
Of course, the greatest concern is that of a woman committing suicide or self-harm due to untreated depression or mental health issues.
If you have depression or anxiety and are now pregnant, or trying to get pregnant, have a detailed conversation about your condition with your physician. Be honest about your symptoms, concerns and your support network. If you take a medication known to cause serious health problems in unborn babies, you may be able to taper off during the dangerous period of gestation and then resume your regular meds. Some women will begin dosing near the end of the pregnancy, to return to full dosing at birth, since the risk of post-partum depression is greater in women with histories of depression.
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