The safety of antidepressant use in pregnancy

The Hospital for Sick Children, The Motherisk Program, Division of Clinical Pharmacology & Toxicology, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Expert Opinion on Drug Safety (Impact Factor: 2.91). 04/2005; 4(2):273-84. DOI: 10.1517/14740338.4.2.273
Source: PubMed


Depression during pregnancy affects an estimated 10 - 20% of women, some of whom will require treatment with antidepressants. It is of great importance that the safety of this particular class of drugs is reviewed, to ensure the optimal treatment of the mother while protecting her unborn child. In this review, current safety data on all available antidepressants are discussed in detail, including the pharmacokinetics of the maternal-fetal unit and the epidemiological studies that have been published to date. The classes of antidepressants discussed include: tricyclics, selective serotonin re-uptake inhibitors and other antidepressants. After reviewing these studies, it is evident that these drugs appear to be relatively safe to take during pregnancy. This evidence-based information will be helpful to women and their healthcare providers, when the decision of whether or not to treat with anti-depressants during pregnancy must be made.

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    • "To date, based on a fairly substantial body of epidemiologic data, there is no evidence that antidepressants are not safe to take during pregnancy [6], in fact, emerging data in the literature documents evidence that not taking an antidepressant if it is warranted may be more harmful. The decision to discontinue taking an antidepressant during pregnancy can have deleterious effects on both the health of the mother and her baby as untreated depression during pregnancy carries its own risks. "
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    ABSTRACT: On Aug 9th 2004 Health Canada released an advisory, which followed a similar one from the FDA regarding the use of SSRI's and other antidepressants during pregnancy and potential adverse effects on newborns. In neither advisory was it stated that women should discontinue their antidepressant. In the seven days following the release of this advisory, The Motherisk Program received 49 calls from anxious women in response to the media reporting of this information. To examine the impact of the advisory and subsequent reporting in the media, on the decision-making of women, currently taking an antidepressant, who called The Motherisk Program after becoming aware of this information. We attempted to follow up all the women who had called us who were alarmed by this advisory and asked them to complete a specially designed questionnaire. We were able to complete 43/49 (88%) follow-ups of the women who contacted us. All of the callers reported that the messages in the media caused a great deal of anxiety. Seven misunderstood the advisory, ie their children were more than 1 year old, five had discontinued their antidepressant (3 abruptly (2 later restarted after speaking with Motherisk counsellors)and 2 with some form of tapering off) and(6) were considering discontinuation, but decided to continue following reassurance from Motherisk Medical information regarding fetal and infant safety, disseminated in the public domain, should be transferred in a way that does not influence a pregnant woman to make decisions that may not be in the best interest of hers or her child's health.
    BMC Pregnancy and Childbirth 02/2005; 5(1). DOI:10.1186/1471-2393-5-11 · 2.19 Impact Factor
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  • CNS Drugs 01/2005; 19(7):623-633. DOI:10.2165/00023210-200519070-00004 · 5.11 Impact Factor
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