Report Outlines Treatment Recommendations Regarding Antidepressants and Pregnancy

Washington, DCWomen who take Paxil and are worried about Paxil side effects now have a little guidance regarding antidepressant use while pregnant. A joint report released on August 21, 2009, and issued by The American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA), has set out treatment recommendations for women who are experiencing depression.

For some women, these guidelines may help them to determine whether or not it is safe to risk Paxil side effects, and the side effects of other antidepressants while pregnant.

The report, titled "The Management of Depression During Pregnancy: A Report from the American Psychiatric Association and The American College of Obstetricians and Gynecologists," is published in Obstetrics & Gynecology (September, 2009) and General Hospital Psychiatry (September/October, 2009). It notes that between 14 percent and 23 percent of pregnant women experience depressive symptoms while pregnant and that approximately 13 percent of women took an antidepressant at some point during their pregnancy in 2003.

According to the report's authors, there are potential consequences for newborns when their mothers are depressed and do not use antidepressants. These include increased risk of irritability, less activity and fewer facial expressions. Furthermore, the authors state that depressed women are more likely to have poor prenatal care and pregnancy complications, including nausea and vomiting. However, as the authors note, "some studies have linked fetal malformations, cardiac defects, pulmonary hypertension, and reduced birth weight to antidepressant use during pregnancy."

Among the recommendations are that women who are taking medication and are thinking about getting pregnant with either no depressive symptoms or mild symptoms for six months or longer may consider tapering and discontinuing mediation before becoming pregnant. Women who are pregnant and are currently on medication for depression may consider tapering and discontinuing the medication, if they have no symptoms and depending on their psychiatric history.

Women who are pregnant and not currently taking medication for depression may find psychotherapy beneficial to avoid the use of antidepressants, the organizations recommend. Finally, women who have recurrent depression or who have symptoms even while taking medication may consider psychotherapy either to replace or to augment their medication.

However, the report notes that women who experience suicidal or psychotic symptoms should immediately see a psychiatrist for treatment, regardless of their circumstances.

The recommendations were written to help doctors and patients weigh the risks and benefits of various treatment options so they can determine which option works best for their individual situation.

Women who are taking medication for depression should not stop taking their medication before consulting with their doctor.