Pregnancy and Depression please read our DISCLAIMER before using the website see also *how to evaluate health information on the web*
Pregnancy
Treatment of Depression during Pregnancy
(pages marked with were added after February 22, 2006)
Professional Journal Articles (click here for items in the popular press)
2006
Selective Serotonin-Reuptake Inhibitors and Risk of Persistent Pulmonary Hypertension of the Newborn. New England Journal of Medicine, February 9, 2006. Neonatal Abstinence Syndrome After In Utero Exposure to Selective Serotonin Reuptake Inhibitors in Term Infants. Archives of Pediatrics and Adolescent Medicine, February 2006. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA, February 2006.
2005
Risks Associated With Selective Serotonin Reuptake Inhibitors in Pregnancy. Obstetrics and Gynecology, December 2005. Citalopram use in pregnancy: Prospective comparative evaluation of pregnancy and fetal outcome. American Journal of Obstetrics and Gynecology, December 2005. Nutrition and Depression: Implications for Improving Mental Health Among Childbearing-Aged Women. Biological Psychiatry, November 2005. Psychosocial and psychological interventions for prevention of postnatal depression: systematic review. British Medical Journal, July 2005. Using antidepressants during pregnancy. Canadian Medical Association Journal, November 2005. Using antidepressants during pregnancy. Canadian Medical Association Journal, November 2005. Commentary on "Medication Exposure During Pregnancy: Antidepressants" by Siobhan M. Dolan, MD, MPH. Medscape OB/Gyn & Women's Health, June 1005. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Safety, 2005. Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates? Canadian Medical Association Journal, May 2005. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA, May 2005. Antidepressant Use During Pregnancy and the Rates of Spontaneous Abortions: A Meta-Analysis. The Annals of Pharmacotherapy, March 2005. Pain Reactivity in 2-Month-Old Infants After Prenatal and Postnatal Selective Serotonin Reuptake Inhibitor Medication Exposure. Pediatrics, February 2005. The use of selective serotonin reuptake inhibitors during pregnancy and breast-feeding: a review and clinical aspects. Journal of Clinical Psychopharmacology, February 2005. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. The Lancet, February 2005. SSRI during pregnancy and risk of fetal neurotoxicity. Follow precautions and look for other therapeutic alternatives. Lakartidningen, January 2005. Pregnancy, Delivery, and Neonatal Complications in a Population Cohort of Women With Schizophrenia and Major Affective Disorders. American Journal of Psychiatry, January 2005.
2004
The National Toxicology Program (NTP) Center for the Evaluation of Risks to Human Reproduction (CERHR), April 2004. Fluoxetine Expert Panel Report (PDF format, Free Adobe Reader Required)
Note: This report has been widely publicized in the popular media using sensational headlines. It is ALWAYS important to evaluate the source of your information; in this case it is critical. The press hasn't necessarily provided a comprehensive and unbiased summary of this report. It is important, as always, that you review the available information with your healthcare providers and make an informed decision based on the potential risks and benefits to you and your child, taking into account your unique needs and concerns.
Newer antidepressants in pregnancy: prospective outcome of a case series. Reproductive Toxicology, December 2004. Findings From Selective Serotonin Reuptake Inhibitor-Exposed Neonates Should Be Interpreted With Caution: In Reply. Pediatrics, December 2004. Findings From Selective Serotonin Reuptake Inhibitor–Exposed Neonates Should Be Interpreted With Caution. Pediatrics, December 2004. Paroxetine use throughout pregnancy: does it pose any risk to the neonate? Journal of Toxicology & Clinical Toxicology, 2004. Neonatal Outcome following Maternal Antenatal Depression and Anxiety: A Population-based Study. American Journal of Epidemiology, 2004. A pilot study of newer antidepressant concentrations in cord and maternal serum and possible effects in the neonate. International Journal of Neuropsychopharmacology, September 2004. The use of selective serotonin reuptake inhibitors in pregnancy. Journal of Obstetrics and Gynaecology Canada, September 2004. Health Canada advises of potential adverse effects of SSRIs and other anti-depressants on newborns. Health Canada Online, August 2004. Hypnotic Drugs in Early Pregnancy. Medscape Family Medicine, August 2004. Mood changes during pregnancy and the postpartum period: development of a biopsychosocial model. Acta Psychiatrica Scandinavia, July 2004. The impact of depression and fluoxetine treatment on obstetrical outcome. Archives of Women's Mental Health, July 2004. Platelet Serotonin in Newborns and Infants: Ontogeny, Heritability, and Effect of In Utero Exposure to Selective Serotonin Reuptake Inhibitors. Pediatric Research, July 2004. Transient Neonatal Jitteriness due to Maternal Use of Sertraline (Zoloft®) Journal of Perinatology, June 2004. Neonatal complications after intrauterine exposure to SSRI antidepressants. Prescrire International, June 2004. Venlafaxine Associated With Neonatal Complications. Medscape (free registration required), June 2004. The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders, May 2004. Omega 3 oils and pregnancy. Midwifery Today Int. Midwife Spring 2004. Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry, Spring 2004. Screening for and Detection of Depression, Panic Disorder, and PTSD in Public-Sector Obstetric Clinics. Psychiatric Services, April 2004. Prevalence of Depression During Pregnancy: Systematic Review Obstetrics & Gynecology, April 2004. Two overlooked mood disorders in women: subsyndromal depression and prenatal depression. Nursing Clinics of North America, March 2004. Comment on "The Effectiveness of Various Postpartum Depression Treatments and the Impact of Antidepressant Drugs on Nursing Infants". Medscape General Medicine, March 2004. Prevalence of mood symptoms and depressions during pregnancy: implications for clinical practice and research. CNS Spectrum, March 2004. Diagnosis and treatment of depression during pregnancy. CNS Spectrum, March 2004. Structural Effects and Neurofunctional Sequelae of Developmental Exposure to Psychotherapeutic Drugs: Experimental and Clinical Aspects. Pharmacology Review, March 2004. Omega-3 fatty acids for the prevention of postpartum depression: negative data from a preliminary, open-label pilot study. Depression & Anxiety, February 2004. Maternal Selective Serotonin Reuptake Inhibitor Use During Pregnancy and Newborn Neurobehavior. Pediatrics, February 2004. Risk factors associated with childbearing-related episodes in women with bipolar disorder. Psychopathology, January 2004. Risks of untreated depression during pregnancy. Canadian Family Physician, January 2004.
2003
Research on maternal and fetal safety after exposure to antidepressants in utero. American Journal of Obstetrics & Gynecology, December 2003. Postpartum mood disorders: a review of clinical and epidemiological factors. Journal of Psychosomatic Obstetrics & Gynaecology, December 2003. Suicide in pregnancy. Obstetrics & Gynecology, December 2003. Paroxetine withdrawal syndrome as differential diagnosis of acute neonatal encephalopathy? Zeitschrift für Geburtshilfe und Neonatologie, November-December 2003. Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: further evidence that lowered n-PUFAs are related to major depression. Life Sciences, November 2003. Neonatal intraventricular haemorrhage associated with maternal use of paroxetine. British Journal of Clinical Pharmacology, November 2003. Maternal fluoxetine treatment in the postpartum period: effects on platelet serotonin and plasma drug levels in breastfeeding mother-infant pairs. Pediatrics, November 2003. Screening depressive patients in pregnancy with the pregnancy mood profile. Journal of Reproductive Medicine, October 2003. Assessment and treatment of depression during pregnancy: an update. Psychiatric Clinics of North America, September 2003. The prevention and psychotherapeutic treatment of postpartum depression Archives of Women's Mental Health, August 2003. Psychiatric disorders during pregnancy and lactation. Tidsskr Nor Laegeforen, August 2003. Point prevalence of psychiatric disorders during the second trimester of pregnancy: a population-based study. American Journal of Obstetrics & Gynecology, July 2003. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Archives of General Psychiatry, July 2003. Psychopharmacologic treatment of depression during pregnancy. Current Women's Health Reports, June 2003. Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. American Journal of Obstetrics & Gynecology, May 2003. Placental Passage of Antidepressant Medications. American Journal of Psychiatry, May 2003. Screening for postpartum depression in an inner-city population. American journal of Obstetrics and Gynecology, May 2003. Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women's Health, May 2003. Clinical Management of Perinatal Depression: Focus on Paroxetine. Psychopharmacology Bulletin, Spring 2003. Neonatal convulsions and subarachnoid hemorrhage after in utero exposure to paroxetine. Revista de neurologia, April 2003. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? Journal of Affective Disorders, April 2003. Pharmacokinetics of fluoxetine and norfluoxetine in pregnancy and lactation. Clinical Pharmacology & Therapeutics, April 2003. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. Journal of Pediatrics, April 2003. Addressing depression in obstetrics/gynecology practice. General Hospital Psychiatry, March-April 2003. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Canadian Journal of Psychiatry, March 2003. Birth outcomes after prenatal exposure to antidepressant medication. American Journal of Obstetrics and Gynecology, March 2003. Controlled Clinical Trial of Interpersonal Psychotherapy Versus Parenting Education Program for Depressed Pregnant Women. American Journal of Psychiatry, March 2003. Hormones and mood: from menarche to menopause and beyond. Journal of Affective Disorders, March 2003. Psychosocial assessment and management of depression and anxiety in pregnancy. Key aspects of antenatal care for general practice. Australian Family Physician, March 2003. Taking St John's wort during pregnancy. Canadian Family Physician, January 2003. Maternal stress and preterm birth. American Journal of Epidemiology, January 2003.
2002
Reproductive Decisions by Women With Bipolar Disorder After Prepregnancy Psychiatric Consultation. American Journal of Psychiatry, December 2002. Study Finds No Link Between Antidepressants, Birth Defects Psychiatric News, December 2002 Antidepressants During Pregnancy: Benefits for Children. Journal Watch Psychiatry, December 2002 Outcomes of prenatal antidepressant exposure. American Journal of Psychiatry, December 2002. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. American Journal of Psychiatry, November 2002. Perinatal outcome following third trimester exposure to paroxetine. Archives of Pediatric and Adolescent Medicine, November 2002. Child Development Following Exposure to Tricyclic Antidepressants or Fluoxetine Throughout Fetal Life: A Prospective, Controlled Study. American Journal of Psychiatry, November 2002. Benefits and Risks of Psychiatric Medications During Pregnancy. American Family Physician, August 2002. Parental Depression: Animal Models of an Adverse Life Event. American Journal of Psychiatry, August 2002. Case report and review of the perinatal implications of maternal lithium use. American Journal of Obstetrics and Gynecology, July 2002. Managing bipolar disorder during pregnancy: weighing the risks and benefits. Canadian Journal of Psychiatry, June 2002. Prenatal anger effects on the fetus and neonate. Journal of Obstetrics and Gynaecology, May 2002. Reducing depression in pregnancy: designing multimodal interventions. Social Work, April 2002. The impact of reproductive events on the course of bipolar disorder in women. Journal of Clinical Psychiatry, April 2002. An open trial of morning light therapy for treatment of antepartum depression. American Journal of Psychiatry, April 2002. Effect of maternal fluoxetine administration on uterine blood flow, fetal blood gas status, and growth. Pediatric Research, April 2002. SSRIs in Pregnancy –Are they safe? Pediatric Research, April 2002. Prolonged prenatal psychotropic medication exposure alters neonatal acute pain response. Pediatric Research, April 2002. Maternal depression: a child's first adverse life event. Seminars in Clinical Neuropsychiatry, April 2002. The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-spectrum psychotropics. Journal of Clinical Psychiatry, 2002. Depression during pregnancy: diagnosis and treatment options. Journal of Clinical Psychiatry, 2002.
American Academy of Pediatrics Policy Statement, April 2000 Use of Psychoactive Medication During Pregnancy and Possible Effects on the Fetus and Newborn
Journal Articles Prior to 2002
Journal Articles requiring Adobe Reader An Update on Mood and Anxiety Disorders During Pregnancy and the Postpartum Period (PDF File) (The Primary Care Companion to the Journal of Clinical Psychiatry, 2000). Major Depression During Conception and Pregnancy: A Guide for Patients and Families (Post Graduate Medicine, March 2001)
Journal Articles requiring Adobe Reader
News Stories (usually based on Journal articles above)
Suffering for two: The bind of maternal depression. Radio program for NPR and American Radioworks featuring Drs. Lee Cohen, Sandy Zeskind, & Helen Kim, August 2004. Antidepressant Use May Harm Fetus: Newborns Had More Tremors, and Described as Underaroused. (WebMDHealth report on February 2004 Pediatrics article) Can light therapy ease depression among pregnant and bipolar women?: Two studies examining possible benefits of light treatment. (from Pittsburgh Post-Gazette) Paxil in Late Pregnancy May Cause Problems Experts Publish Review On Pregnancy And Antidepressants New Type Of Antidepressant Safe For Pregnant Women Study says antidepressants don't cause birth defects Possible link between Prozac and premature births Depression treatment poses dilemmas for pregnant and nursing women Medical Experts Dispute Findings in NEJM Study Group Urges Pregnant Women on Prozac to Consult With Their Physician
"Ask an Expert"
Ask the Expert - Zoloft and Pregnancy Ask the Expert - Depression Medication and Pregnancy Ask the Experts - Question regarding Elavil (amitriptyline) and Pregnancy Re: Prozac & Pregnancy & Down Syndrome Ask the Expert - Questioning Serzone Ask the Expert - SAD Medication and Pregnancy Ask the Expert - Meds in the Second Trimester Is it safe to take Prozac during pregnancy? (Expert: The BabyCentre Editorial Team) Zoloft (from a certified nurse midwife at parentsplace.com) Medications & Pregnancy (from an OB at ivillage health)
Additional Webpages
Psychiatric Disorders During Pregnancy Reproductive Mental Health - Emotional Disorders in Pregnancy The MARCÉ SOCIETY (An international society for the understanding, prevention and treatment of mental illness related to childbearing.) Pregnancy and the Drug Dilemma (U.S. Food and Drug Administration, FDA Consumer magazine, 2001) Prozac and pregnancy (from Women's Health Information, UK) Antenatal Depression Dartmouth-Hitchcock Medical Center Factsheet on Depression in Pregnancy Light Therapy for Depression During Pregnancy (Antepartum Depression) Recognizing and Treating Antepartum Depression (from Pregnancy Today) Glaxo Wellcome Pregnancy Registries (register if you have taken Wellbutrin during pregnancy) Light Therapy for Depression During Pregnancy (Antepartum Depression) Prozac, Luvox, Paxil, Zoloft in Pregnancy & Breast Feeding Medication, Pregnancy and Lactation Prozac (Fluoxetine) in Pregnancy (from the Organization of Teratology Information Services) Clozapine and pregnancy: one woman's decision
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Do your own search in PUBMED or MEDLINE
I have a doctorate in psychology and experience in health research, but am not a licensed health care provider. The links above are intended to assist women, their families, and their doctors in making decisions about having children and treating their depression. Most of the links deal with traditional antidepressant treatment of depression, but some discuss alternative medicine treatments and psychotherapy. I hope that they are fair and unbiased, I have tried to include ALL information I have found so that you can make the best decision for YOU and YOUR FAMILY.
I have a doctorate in psychology and experience in health research, but am not a licensed health care provider.
The links above are intended to assist women, their families, and their doctors in making decisions about having children and treating their depression. Most of the links deal with traditional antidepressant treatment of depression, but some discuss alternative medicine treatments and psychotherapy. I hope that they are fair and unbiased, I have tried to include ALL information I have found so that you can make the best decision for YOU and YOUR FAMILY.
DISCLAIMER:
The information contained in these pages is not medical advice. All information contained in this website is for informational and educational purposes ONLY. This information is not, in any way, a substitute for consultation with and/or evaluation by YOUR MEDICAL CARE PROVIDER(S) (e.g., psychiatrist, psychologist, psychotherapist, and/or OB). The website owner is not responsible for the validity or accuracy of the information contained in the links on these pages. Use of this site constitutes understanding and acceptance of this disclaimer.
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Pregnancy and Depression Website © 1999-2006 Christine L. Cameron, Ph.D.
Last revised: February 23,2006.