Several studies have shown that women are more prone to suffer from severe depression than men, and this tendency seems to increase when a woman is pregnant. Pregnancy and postpartum are considered to be relatively high risk periods, especially for women who have already suffered from some psychiatric illness in the past. Studies have shown that there is a significant increase in the occurrence of psychological problems in the first three months of pregnancy.
Women who have been on antidepressant medications before conception have greater chances of an aggravation during pregnancy. It is a common practice for women who are on antidepressants to stop taking them before or after they conceive. A medical expert is often in a dilemma in such cases because taking antidepressants during pregnancy may not be safe, but terminating treatment could precipitate a relapse that can affect the unborn child adversely. It is therefore very important for the clinician to closely monitor every such case on a regular basis.
Doctors have to be very cautious when prescribing antidepressants for pregnant women due to the potential risk posed to the fetus by these medicines. Although research findings and clinical trials show that both selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants do not have any teratogenic effects, yet more information needs to be gathered in such cases. Depression can affect the pregnant woman as well as her offspring; hence, treatment becomes the utmost priority.
The biggest risks of administering psychotropic medications are toxicity and the manifestation of withdrawal symptoms following delivery. There is also a possibility of the infant’s nervous system not developing properly or getting affected in the long run. In a nutshell, the factors to be borne in mind before starting or stopping antidepressant therapy are teratogenesis, toxicity or withdrawal symptoms in the newborn, neurobehavioral effects, the dangers of untreated depression during pregnancy, and the risk of discontinuation of medication.