Through the course of pregnancy, a woman has to take considerable care and precautions so that neither the health of her nor the developing fetus is compromised in any way. Besides going through an emotional roller coaster, a pregnant woman needs to take the necessary nutrients, choose a health care provider and avoid consuming hazardous substances.
If a pregnant woman is experiencing the symptoms of a mental disorder during her pregnancy, the challenges of delivering a healthy child compound. If she is seeking treatment for any psychological disorders, she needs to consider the repercussions of drugs on the health of both her and the baby.
Given that various antidepressants are considered unsafe or may have serious side effects, their consumption during pregnancy remains controversial and debatable. The consequences of antidepressants for the treatment of mental disorders during pregnancy has been widely debated among medical practitioners and experts. As a result, many health care providers remain doubtful and uncertain about the best way to approach pregnant patients suffering from mental disorders.
On the one hand an untreated psychiatric disorder negatively affects the fetus and mother by causing complications due to higher body mass index (BMI), low adherence to prenatal care, poor nutrition and decreased rates of breastfeeding; on the other hand the risk of relapse is believed to rise during pregnancy when antidepressants are abruptly discontinued, particularly during the first trimester.
There have been studies focusing on analyzing the effects of medications like benzodiazepines and selective serotonin reuptake inhibitors (SSRI) antidepressants and complications of psychiatric disorders like anxiety, depression, etc. on pregnant women have underlined the importance of continuing the medications under the supervision of an expert. Moreover, untreated mental disorders like major depressive disorder (MDD) are associated with an increased risk of preterm birth, low birth weight, impaired mother-child bonding, impaired cognitive-behavioral skills in children, etc.
Consequences of medications manageable in nature
While the symptoms of anxiety disorders are commonly witnessed during pregnancy, the decision to treat pregnant women using antidepressants is not easy. It involves taking into account the safety of the unborn child due to the in utero exposure to medications and the risk of health complications to the mothers due to the misuse and discontinuation of antidepressants.
Interestingly, a recent study published in the journal JAMA Psychiatry discovered that the benefits of using benzodiazepine-based antidepressants for anxiety disorders during pregnancy outweigh the risk of experiencing adverse birth outcomes. This cohort study comprising 2,654 pregnant women followed up the effect of mental disorders on maternal and neonatal outcomes and the impact of certain benzodiazepines and SSRI antidepressants, such as Zoloft, Paxil, etc. The study found that most of the medication exposures occurred early in pregnancy.
Moreover, the use of these medications entailed minuscule risks. Besides the need for respiratory support after birth and the shortening of pregnancy, some other implications of antidepressants are as follows:
- C-section deliveries, low birth weight and use of ventilator support for the newborn were more common among women on benzodiazepines.
- Hypertensive diseases, preterm birth and use of minor respiratory interventions were associated with serotonin reuptake inhibitor.
- While benzodiazepine treatment reduced the duration of pregnancy by 3.6 days, the use of serotonin reuptake inhibitors decreased pregnancy by 1.8 days.
The study authors allude that pregnant women, particularly the ones grappling with anxiety disorders and panic disorders, do not need to stop taking antidepressants during pregnancy, as they do not affect the development of the fetus as adversely as untreated psychiatric disorders.
While there are still some apprehensions among health care providers and expecting mothers about the use of antidepressants during pregnancy, the study suggests that the antidepressant treatment is linked with some adverse outcomes that are easily manageable and non-threatening in nature. However, pregnant women experiencing mental disorders must consult their health care providers to achieve the optimum treatment outcomes with the lowest possible doses of such medications.
Consult experts before popping pills
The symptoms of mental disorders, particularly anxiety disorders, are quite common during pregnancy. They have debilitating effects on women when left unaddressed and underdiagnosed. Since mental disorders are highly treatable, even an expecting mother should not hesitate from seeking medical intervention.