Navigating the risks and benefits of using antidepressants during pregnancy

There is no question antidepressants can help individuals lead healthier and happier lives, but for many women navigating depression, deciding to hit the pause button on their medication when trying for a baby is a complex decision that involves numerous considerations.

Can antidepressants impact fertility?

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Several studies are currently underway that examine the correlation between fertility and antidepressants. A common class of antidepressants, namely, selective serotonin reuptake inhibitors, also called SSRIs, was put to the test.

Dr. Christie Sylvester and colleagues from the University of Pittsburgh Medical Center evaluated sixteen studies in 2019 and published a paper in the Harvard Review of Psychiatry.

Six of these studies concluded that there was no significant relationship between SSRIs and fertility. Three studies found a negative influence on fertility, while one found an increase in pregnancy rates. Two studies, on the other hand, produced contradictory results. The quality of the other studies was poor.

Another Swedish study discovered that women on antidepressants had slightly lower chances of pregnancy, while women who did not take antidepressants while being diagnosed with the underlying condition had a more pronounced reduction in chances of pregnancy.

Antidepressants may affect fertility, but there isn’t enough data to say so given the wide range of results. Below, we dig a little deeper into the safety of taking antidepressants whilst pregnant or trying to conceive.

Can antidepressants cause pregnancy issues?

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As the name suggests, an antidepressant is first and foremost used to relieve symptoms of depression along with anxiety disorders. Their safety during pregnancy is hard to say, as any drug could involve an element of risk. Weighing the risks against the benefits, with the help of your healthcare provider, is always the best course of action.

Antidepressants during pregnancy could cause complications for the mum and baby, although the risks may be minimal and might depend on the type of antidepressant one takes. Researchers aren’t able to decipher which complications could be due to depression or anxiety and which may be due to antidepressants.

The three main types of antidepressants that could be prescribed for anxiety or depression are selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). They work well when treating severe depression, but it’s worth pondering over the possible risks related to pregnancy, birth defects, along with long term impact on the child.

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What are the risks of taking antidepressants during pregnancy?

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Taking antidepressants during pregnancy is a personal choice for an expectant parent and should be based on their specific situation. Without comprehensive research, there is no definite answer to whether it is the right decision or the wrong one. Having said that, there have been a few conclusive studies that have spoken about the risks of taking antidepressants while pregnant.

Some of those potential risks include:

• Increased risk of high blood pressure and pre-eclampsia
• Higher risk of miscarriage
• Premature birth and low birth weight
• Greater risk of heart defects in the baby
• Long term effects on the child’s emotional, behavioural or brain development

On the flip side, if depression is left untreated during pregnancy it can also lead to health complications for both parent and child. These complications could include:

• Negative impact of stress on the fetus
• Lasting impact on the child’s emotions and behaviour
• Going into drug and alcohol abuse to combat stress

Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low.

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The takeaway 

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With a lack of consistency in the studies conducted so far, nothing can be concluded definitively about the risks involved with taking antidepressants during pregnancy. Therefore, each individual situation should be considered with a healthcare professional.

Neglecting major depression could lead to other health problems and emotional difficulties so it’s crucial to be informed about about the treatment that will suit you the best. Your doctor and/or therapist will be able to gauge the severity of the depression along with the stage of the pregnancy and suggest the right way forward.

For mild to moderate symptoms, your doctor might even suggest you seek therapy as psychotherapy has been show to be effective in treating mild to moderate depression. Having a strong system of friends and family to support you during this time could prove to be beneficial as well as well as participating in regular exercise and eating a balanced diet.

Regardless of your choice of whether to go on medication or not, depression does not mean that you need to put your dreams of having a baby on hold. There are a number of people out there who have given birth to happy, healthy babies while struggling with depression, just be sure to seek professional advice on what is the best option for your particular situation.

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