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DEPRESSION MEDICATIONS AND PREGNANCY: A MATTER OF STRIKING A BALANCE

By Tess Thompson

Given that carrying a baby is an extremely critical task, a pregnant woman is always wary of what she eats. This is specifically so because what she ingests has a direct impact on the child’s overall health. Irrespective of whether it is something to eat or drink, cigarette or drug, the expecting mother always wants to be sure if it is safe for the baby she is carrying.

Since most conventional medications have some side effect or another, the general rule is that expecting mothers should avoid taking any type of medication during pregnancy. But the state of pregnancy creates many challenges – some physical and other psychological.

The first trimester of pregnancy brings along nausea and vomiting and a major hormonal changes. The second trimester is easier. The third trimester is a harbinger of backaches and a strong desire to get it over and done with.

Pregnancy also increases a woman’s vulnerability to psychiatric disorders by nearly four times than normal. Treating depression becomes a necessity as depression and other mental conditions mean serious consequences for the child. Pregnant women who are depressed:

* Have a higher rate of miscarriage.
* Are more likely to have babies with some genetic illness.
* Have a higher probability of having complications during childbirth which can lead to death.

Depression is better cured in its initial stages because if left untreated it can cause serious relationship problems with the spouse.

Given that depression cannot be left untreated and needs to be attended to, there is another complication that arises. The question that pops up is ‘should the pregnant mother take drugs for treating depression or not?’ Let’s review the options.

There have been different types of antidepressants in use since their inception in 1950:

* Tricyclic antidepressants act by blocking the reuptake of norepinephrine and serotonin. Therefore, they make more of those substances available so that they can act on receptors in the brain.
* MAO inhibitors curb production of an MAO enzyme that catalyzes the oxidation of many body compounds (e.g., epinephrine and norepinephrine and serotonin).
* Mood stabilizers like Lithium Carbonate, Carbamazepine and Sodium Valproate.
* Later, in the 1980’s newer drugs, known as SSRIs or Fluoxetine were developed for use in treating depression.

All medications are tested for teratogens before being launched in the market. Teratogens are agents that interfere with normal embryonic development.

However, drugs are tested on animals and cannot be tested on humans for ethical reasons. This leaves an element of doubt about the use of any medication during pregnancy. The only way of arriving at the safety of depression drugs like antidepressants during pregnancy is the studies carried on women who voluntarily used these drugs during pregnancy. Even the most extensive studies depend upon on individual interpretations leading to confusing inferences.

And that is the reason why there is no concurrence between experts about the safety of antidepressants during pregnancy.

The safe solutions that exist for pregnant women are in the area of natural remedies.

Treating depression naturally with psychotherapy, counseling and Bibliotherapy can ensure that there are no side effects that the fetus will suffer from.
Natural remedies for depression are usually safe. But these should also be administered under the supervision of a trained professional during pregnancy.

It all boils down to taking a studied decision and striking a balance. The mother’s well being is as important as the safety of the fetus.

References:
http://www.mentalhealth.com/mag1/p5m%2Ddp06.html
http://www.geocities.com/HotSprings/2265/medication.html
http://depression.about.com/cs/pregnancy/a/prozacpregnancy.htm
http://www.drgreene.com/21_1816.html