Physician Groups Recommend Pregnant Women Consider Psychotherapy Before Antidepressants

Main Category: Pregnancy / Obstetrics
Also Included In: Psychology / Psychiatry;  Depression;  Pediatrics / Children's Health
Article Date: 25 Aug 2009 - 4:00 PDT

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A recent report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists recommends that pregnant women with depression first consider psychotherapy before taking antidepressants, the Wall Street Journal reports. The report said that risks of untreated depression to the fetus also should be taken in account because depressed pregnant women might have more stress and take poorer care of themselves, which can affect fetal development. The report was published Friday in the journal General Hospital Psychiatry.

The recommendations say that pregnant women who have experienced moderate to severe depressive symptoms, including thoughts of suicide, or repeated bouts of depression should continue taking medication. Kimberly Yonkers, the lead author of the report and a professor in the departments of psychiatry and obstetrics and gynecology at Yale University, said, "The black box of this -- what we don't know -- are people with milder depression." She added, "The story is not established in the literature whether that group of people should be kept on antidepressants in pregnancy."

The recommendation is based on concerns that popular antidepressants, such as Zoloft and Prozac, can increase risk of pulmonary hypertension in fetuses. Newborns who were exposed to this class of drugs, known as selective serotonin reuptake inhibitors, after 20 weeks' gestation are six times more likely to develop this condition, with an absolute risk of one to two cases per 1,000 infants, according to the report (Wang, Wall Street Journal, 8/21).

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