A Common Clinical Conundrum: Antidepressant Treatment of Depression in Pregnant Women
Overview
Affiliations
Depression during pregnancy is associated with adverse maternal, pregnancy, and infant outcomes. Treatment during pregnancy requires a balanced discussion of the risks of both drug exposure and untreated depression. An updated review of the epidemiology, outcomes, and management of maternal depression is presented. Adverse outcomes are associated with both maternal depression and antidepressants. Research gaps include data on the longitudinal developmental trajectory of offspring exposed to antidepressants compared to depression, with assessment of in utero symptom exposure and environmental exposures. Additionally, neonatal syndrome associated with antidepressant use during pregnancy has no consensus definition or mechanistic explanation. With sophisticated large-scale epidemiologic studies, there has been progress in distinguishing the impact of depression processes from medication used for treatment. Optimal treatment of perinatal depression includes close symptom monitoring and medication adjustments to maintain symptom remission. This evolving field requires frequent consultation with reproductive data sources included in this article.
Wang C, Wu B, Lin R, Cheng Y, Huang J, Chen Y Front Neurol. 2024; 15:1516242.
PMID: 39734634 PMC: 11671402. DOI: 10.3389/fneur.2024.1516242.
Wallace C, Audet M Womens Health (Lond). 2024; 20:17455057241277072.
PMID: 39287570 PMC: 11409294. DOI: 10.1177/17455057241277072.
Cipolla S, Catapano P, Messina M, Pezzella P, Giordano G Arch Womens Ment Health. 2023; 27(2):157-178.
PMID: 37957411 PMC: 10933171. DOI: 10.1007/s00737-023-01394-1.
Psychiatric illness and pregnancy: A literature review.
Abdelhafez M, Ahmed K, Ahmed N, Ismail M, Mohd Daud M, Ping N Heliyon. 2023; 9(11):e20958.
PMID: 37954333 PMC: 10632674. DOI: 10.1016/j.heliyon.2023.e20958.
Li Y, Wu Y, Jiang T, Xing H, Xu J, Li C Ther Adv Drug Saf. 2023; 14:20420986231200746.
PMID: 37780667 PMC: 10540608. DOI: 10.1177/20420986231200746.