Pregnancy is a special period during which baby should be protected. Many medicines are therefore discouraged. But what about antidepressants? Should treatment be stopped in case of pregnancy, at risk of relapse? How best to preserve the future child but also the mother? Read for a cloudless pregnancy!

It was long believed that pregnancy was a protective factor against depression. But the happiness of becoming a mother does not always manage to fight against the black ideas. In this case, can antidepressants be used?

What risks in early pregnancy?

Many women get pregnant while on antidepressants. But you have to be reassured if this is your case: a priori, the recent antidepressants carry little risk for the baby. A compilation of the studies on several molecules (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine mainly) showed that the risk of malformation was not higher than in the general population. There is also no a priori influence on birth weight or risk of prematurity.

Complications at birth?

While the risks to the development of the baby are therefore minimal, the debate is raging on the complications at birth. The use of antidepressants during the 3 rd trimester of pregnancy appeared to be prone to prematurity, respiratory problems, hypoglycemia and convulsions. Sleep disorders or hyperactivity are also reported. For some scientists, these symptoms would be a withdrawal syndrome related to the end of exposure to drugs through the placenta. These problems would then disappear within weeks of birth. In all cases, the class of selective serotonin reuptake inhibitors appear to be less deleterious than so-called "tricyclic" antidepressants.

And in all cases there does not seem to be any long-term effects of antidepressants during pregnancy in children. Studies do not find behavioral disorders, decreasing Q.I. or language development by growing.

Breastfeeding without risk

As far as breastfeeding is concerned, antidepressants are not recommended because in the first weeks of life, the baby's digestive system is fragile and its liver will have difficulties to eliminate the drugs. If the use of these products is essential, paroxetine and sertraline appear to be the most appropriate, as their passage through breast milk is lower.

Psychotherapy first

The risks of antidepressants are therefore relatively low during pregnancy. But in order not to unnecessarily expose the fetus, the health authorities advocate privileging psychotherapies alone in first intention. And if the different approaches do not work, then only taking antidepressants may be considered. Because it is clear that a happy mother is essential for the development of the baby!

News on antidepressants and pregnancy, B. Claudel, P. Fossati and J.F. Allilaire, Entretiens de Bichat, September 2006

Every week, your personalized pregnancy tracking: see an example