Wednesday, February 24, 2016

Benefits of Taking Antidepressants During Pregnancy Outweigh Risks, Expert Says

As conflicting studies about the risk of birth defects in offspring of women who use antidepressants during pregnancy continue to be published, some experts say it is important to compare the risk of exposure to the medication with the risk of exposure to untreated maternal psychiatric illness.

“Many of these studies [exploring the association between antidepressants and birth defects in offspring] have resulted in sensational headlines when there have been positive findings,” Jennifer L. Payne, M.D. (pictured above), director of the Women’s Mood Disorders Center at Johns Hopkins School of Medicine, wrote in a recent column for Psychiatric News. “However, there are a number of limitations in these studies that, when taken into account with other studies, resulted in negative findings that do not seem to make it into the headlines.”

A major limitation of studies attempting to examine the risks of in utero exposure of antidepressants, Payne noted, is that they fail to control for factors associated with the psychiatric illness. For example, diabetes, obesity, smoking, and substance use are more common in patients with a history of depression than in the general population of pregnant women.

“Studies that have not controlled for the underlying psychiatric illness and its attendant risks may find associations between antidepressants and outcomes that are not caused by exposure to the medication itself, but by the presence of other risk factors that are highly prevalent in the population of patients who take antidepressants during pregnancy,” Payne wrote, before describing several studies that suggest that the association between antidepressant and cardiac defects is likely secondary to other underlying risk factors in women with depression.

“Depression is not a benign illness for either mother or child that can be ignored and untreated during pregnancy,” Payne concluded. “When considered as a whole, the literature supports the use of antidepressants in pregnancy in appropriate cases. In most cases, the benefits of treating maternal depression outweigh the minimal and rare risks of in utero exposure to antidepressants.”

Payne’s full column is posted at “Yes or No: Prescribing Antidepressants to Pregnant Patients.”

(Photo Courtesy of Johns Hopkins School of Medicine)


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