Friday, July 4, 2008

Antidepressants: Weighing the Decision

It's almost the definition of a good mother: someone who puts her child's welfare ahead of her own. So women may agonize if they are pregnant and must decide whether to accept a treatment that could help them but harm their fetus. As many as 20 percent of pregnant women experience significant depression. Stopping antidepressant medication during pregnancy may increase the risk of relapse for the mom, but some drugs may hold dangers for the fetus. What's a mother to do?

The answer is to focus on the right issues. Just as no medical treatment is without risk or potential discomfort, doing nothing also carries risks and discomforts. Try not to overreact to scary news accounts; instead, look at your own situation carefully. Since the sources of depression are very varied, learn as much as you can about the nature of your depression. For example, depression varies in intensity and may disturb sleep or appetite, or interfere with functioning. Mood may be constantly mildly low, or there may be shorter, more severe episodes with relatively normal periods in between. Any amount of distress is worth reporting to your doctor.

Data from decades of research on treatment are reassuring. Until recently, most data have shown that exposing a fetus to antidepressants has not increased the risk of birth defects. The FDA did circulate a warning recently about the drug paroxetine but is still studying it and has not yet issued a final recommendation.


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