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Depression Poses Pregnancy Risks
Date:7/19/2009

on," he said. "It can be harmful to your baby."

What about antidepressant use during pregnancy?

"What I tell patients who see me in consultation [for depression] is that moms need to be well in pregnancy," Dell said.

That may or may not mean taking antidepressants, she said. There have been no head-to-head comparisons of antidepressants during pregnancy to determine which are safest, she said, making it difficult to know, if medication is needed, which to choose.

In 2008, the American College of Obstetricians and Gynecologists updated its bulletin, "Use of Psychiatric Medications During Pregnancy and Lactation." In it, the group notes that more than 500,000 pregnancies in the United States each year involve women who have psychiatric illnesses -- depression, but other illnesses as well -- that occurred before the pregnancy or emerge with it.

In the bulletin, the college experts offer a number of recommendations, including the suggestion that pregnant women avoid the antidepressant paroxetine (Paxil). In 2005, the U.S. Food and Drug Administration issued a warning about Paxil based on studies that found that it might increase the risk of birth defects.

Other reports have found that babies born to women who are taking a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor) could have breathing or feeding problems, according to the March of Dimes.

The bulletin recommends that treatment with antidepressants be individualized.

Antidepressants, though, aren't the only option to treat depression during pregnancy, Dell said. Other options include talk or cognitive therapy. Some women might find help through a support group, according to the March of Dimes. And, if a woman has the type of depression known as seasonal affective disorder, which returns in the fall and winter when less light is available, light therapy might help, according to the March of Dimes.

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