In treating pregnant women with mood or anxiety disorders, we tend to focus primarily on the reproductive safety of psychotropic medications; however, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or [...]
Over the last few years, we have reported on several studies which have suggested an increased risk of certain types of cardiovascular malformations among children exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy. The first reports [...]
While data accumulated over the last 30 years suggest that certain antidepressants may be used with relative safety during pregnancy, our knowledge regarding the risks of prenatal exposure to psychotropic medications is incomplete. Because neuronal migration and differentiation occur throughout pregnancy and into the early years of life, development of the central nervous system (CNS) remains particularly vulnerable throughout pregnancy.
Some, but not all, studies have indicated that depression during pregnancy increases the risk of preterm birth. A recent study published in the American Journal of Obstetrics and Gynecology is one of the largest to address this question.
While there have been concerns regarding the reproductive safety of psychotropic medications, it must be recognized that withholding or withdrawing pharmacologic treatment for depression or anxiety during pregnancy may not always be the safest option. Untreated psychiatric illness in the mother cannot be considered a benign event, and a number of studies have indicated that depression during pregnancy may negatively affect pregnancy outcomes (reviewed in Bonari 2004).
