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FOR RELEASE: SATURDAY, JUNE 18, 2016
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ASK DOCTOR K by Anthony L. Komaroff, M.D.
WEIGH YOUR Choices TO Address DEPRESSION Throughout PREGNANCY
DEAR DOCTOR K: I have actually been on SSRI medicines for depression for 5 years. I’m attempting to get hold of pregnant, and I hear that SSRIs could be dangerous. Just what do I have to know?
DEAR READER: I enjoy to receive questions that I can easily answer confidently. Yours is not one of them. The evidence from various studies is conflicting. Here’s my finest attempt to weigh the risks versus the benefits.
Treating depression is crucial for the 2 your sake and your baby’s. Untreated depression Throughout pregnancy raises your risk of postpartum depression. It likewise makes it much more most likely that your baby will certainly be lethargic, irritable and underweight at birth.
But Just what sort of treatment? Medication is one option. The selective serotonin reuptake inhibitors (SSRIs) are the most common drugs prescribed for depression. SSRIs consist of fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox) and paroxetine (Paxil).
Another option is ”talk therapy.” This can easily be traditional one-on-one sessions along with a therapist. It likewise can easily mean family therapy, involving you, your spouse and possibly various other family members. Cognitive behavioral therapy (CBT) is a particular talk-therapy technique that can easily insight you learn methods to believe positively and solve problems. Even if your doctor says you have to keep on taking medication along along with talk therapy, you might be able to lesser your dose or reduce the length of time you Requirement the medication.
You can easily likewise explore various other non-drug options. For example, think of workout (under your doctor’s supervision) or mindfulness meditation to insight control your depression.
The question you’re asking is whether the SSRIs pose a risk to your baby — in particular, a risk of causing birth defects. I don’t believe such a risk has actually been proved beyond doubt. yet I believe studies suggest there might be a small yet genuine risk from some SSRIs.
A large study was conducted by the U.S. Centers for Health problem Regulate and Prevention and published in 2015. It involved nearly 30,000 babies. The study compared the medicines that babies along with and babies devoid of birth defects had been exposed to.
Most of the SSRIs, including the most often prescribed SSRI (sertraline), did not appear to be linked to birth defects. However, paroxetine and fluoxetine were. For those two SSRIs, the risk was small, yet real.
The FDA, the American College of Obstetrics and Gynecology and the American Academy of Family Physicians have actually mentioned that paroxetine most likely is unsafe in pregnancy.
Guidelines from the American Psychiatric Association and the American College of Obstetricians and Gynecologists recommend medication for expectant mothers along with major depression (except paroxetine). yet for pregnant women along with mild to moderate depression, they recommend psychotherapy.
Only your doctor can easily make individual assistance for you. yet my general help is this: If in the years prior to pregnancy your depression has actually been severe, you will certainly probably Requirement medication along along with talk therapy Throughout the pregnancy. In that case, the risk to you and your baby from not taking medication is probably higher Compared to the risk of taking it.
(This column is an update of one that ran originally in August 2013.)
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)
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