Effects Of Antidepressants Or Psychotropic Drugs On Pregnancy
Psychotropic drugs and other antidepressants have seen consistently high consumption over the years. These types of drugs were presumed to be very safe yet incongruous with its consistent high demand so too have health issues skyrocketed. These issues cover a wide spectrum of variables ranging from conception to senility.
Among the many pressing issues, the combination of antidepressants and pregnancy ranked as one of the top concerns. Countless studies have been made in different laboratories. However, why do we still see so many unanswered questions regarding the same issue?
To start off shedding some light on that matter, let us begin by understanding what antidepressants or psychotropic drugs are designed to do.
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders like social anxiety disorder. http://en.wikipedia.org/wiki/Antidepressant However, antidepressants are most commonly used for treating depression. However, these medications can also be used for other conditions as well. For example, newer antidepressants (such as SSRIs, SNRIs, and NDRIs) have been approved for treating conditions such as panic disorder, bulimia, and social anxiety disorder. General off-label antidepressant uses include the treatment of Tourette syndrome, autism, migraines, and premature ejaculation. http://depression.emedtv.com/antidepressants/antidepressant-uses.html
As you can see from the above definitions, antidepressants seem to be doing well and have even evolved to treating or medicating other health conditions. Incidentally, SSRI stands for Selective serotonin reuptake inhibitors, SNRIs stands for Serotonin–norepinephrine reuptake inhibitor, and NDRIs stands for Norepinephrine and Dopamine Reuptake Inhibitors.
Now that we have covered the technical aspects, what possible side effects, proven or otherwise, can we expect when antidepressants are used by pregnant women?
The most common of these antidepressants is SSRI, which was discovered by Pfizer. The most common side effects of this type of antidepressant are nausea, diarrhea, insomnia and sexual side effects. http://en.wikipedia.org/wiki/Sertraline Pregnant women on this type of antidepressant have significant concentrations of the drug in their fetal blood. Furthermore, the drug has also been associated to a higher rate of various birth defects as well as a higher rate of suicidal behavior.
SSRI antidepressants are commonly used for Bulimia, depression (also known as major depression or clinical depression), generalized anxiety disorder (GAD), panic disorder, premenstrual dysphoric disorder (PTSD), obsessive compulsive disorder (OCD), and social anxiety disorder. http://depression.emedtv.com/antidepressants/antidepressant-uses.html
It was once assumed that pregnancy hormones protect women from depression. However, researchers now claim that this isn’t true. Instead, pregnancy can actually trigger a whole range of emotions that make it more difficult to cope with depression. http://www.mayoclinic.com/health/antidepressants/DN00007 Naturally enough, more and more doctors have been prescribing antidepressants to qualified pregnant women. However, the decision to use antidepressants during pregnancy is not made outright. The medical professional would have to weigh the risks and benefits and discuss this with the person concerned. Generally speaking, the risks can include birth defects, miscarriage and mild prematurity. The latter could have anything from neonatal withdrawal symptoms, which is otherwise known also as adaptation syndrome, breathing problems and persistent pulmonary hypertension of the newborn, thus, the decision to use these types of drugs during pregnancy has to be decided upon individually or on a case to case basis. In this connection, many pregnant women have shown concerns regarding breast feeding while on antidepressants. Although the infant may be exposed to antidepressants through the mother’s milk, less than 5% of SSRI is being consumed. This amount is considered to be too low to be of any clinical significance. Many women who have chosen to breastfeed while taking antidepressant medication have not reported any adverse effects. A small number of studies available to date suggest that antidepressant use while breastfeeding is not harmful in terms of the baby’s developmental milestones and preschool performance. http://www.blackdoginstitute.org.au/docs/Safetyofantidepressantsinpregnancyandbreastfeeding.pdf
Considering the information above, most doctors and women would reason that the benefits outweigh the risks, right? What happens if we throw in something like “Antidepressant use associated with increased mortality among critically ill patients”? That’s a title from an article in http://www.eurekalert.org. Although the title doesn’t say anything about pregnancy, that doesn’t exclude the fact that there still are many troubled and critically ill pregnant women out there. The article details a study performed on thousands of ICU patients. They wanted to find out if antidepressants were a contributing factor to deaths occurring in Intensive Care Units. Here’s what they found:
“We found that mortality was higher overall for patients taking antidepressants prior to admission to the ICU and remained significantly higher a year later,” said Katherine. M. Berg, MD, one of the physicians involved in the study. “We also found that certain subgroups of patients, particularly patients admitted for cardiac problems, appeared to be at even greater risk.” http://www.eurekalert.org/pub_releases/2012-05/ats-aua051412.php
They actually found out that patients who were taking SSRIs or SNRIs before being admitted to the ICU were 73% more likely to die in a hospital.
As if that wasn’t enough, a more specific study was conducted regarding the advantages and disadvantages of antidepressant use during pregnancy. Published in the Archives of General Psychiatry, the study found that pregnant women on antidepressants were more likely to have babies with reduced head size and had twice the risk of preterm births compared to depressed expectant mothers who didn’t take any medications. However, expectant and depressed mothers who weren’t on any medications were more likely to have babies with smaller body size and reduced fetal head growth. http://healthland.time.com/2012/03/06/the-pros-and-cons-of-antidepressant-use-during-pregnancy/ The same study also compared the effects of antidepressant usage during pregnancy to smoking and marijuana usage. Top of the list is marijuana which has the largest effect at 0.21 mm per week. Closely behind it are SSRIs such as Zoloft and Prozac at 0.18 mm per week. Smoking reduces fetal head growth by 0.13 mm per week.
Seratonin, a naturally produced chemical of the body, is responsible for regulating our moods. However, it is also used by our body in forming blood clots on wound sites, digestion, reproduction and development. Paul Andrews, an evolutionary biologist at McMaster University and lead author of the article “Anti-Depressants Likely Do More Harm Than Good, Study Suggests” that was recently published in the online journal Frontiers in Psychology, couldn’t have said it clearer:
“Serotonin is an ancient chemical. It’s intimately regulating many different processes, and when you interfere with these things you can expect, from an evolutionary perspective, that it’s going to cause some harm.” http://www.sciencedaily.com/releases/2012/04/120424120450.htm
On a last note, this article merely attempts to shed light on the still-unresolved issue of antidepressant usage during pregnancy. It is always important to talk to a trusted medical professional about these things especially if you’re considering using any form of antidepressant medication.