Until recently, antidepressants—especially selective serotonin
reuptake inhibitors (SSRIs)—were considered fairly safe for pregnant
women. But late last year, citing evidence from several sources, the
FDA warned that infants of women who took the SSRI paroxetine (Paxil)
during the first trimester had an increased risk of birth defects and
might develop transient withdrawal symptoms. Fortunately, studies of
other SSRIs and tricyclic antidepressants indicate they are relatively
safe, reports the March issue of the Harvard Mental Health Letter.
The FDA warning has many women reconsidering their options, says the Harvard Mental Health Letter.
Some may be inclined to avoid all antidepressants during the first
third of pregnancy. But the evidence has to be viewed in a larger
context: The findings are reason for caution, but not for alarm.
"Luckily, there are many good treatment options, with or without drugs," says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter.
"Women with milder depression may want to gradually reduce the dose of
medication and rely on psychotherapy and family support from the time
they try to get pregnant until the middle of the pregnancy. But that
may not be a good choice for women with moderate to severe depression.
For them, antidepressant treatment may sometimes be necessary."
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