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Controversies About the Use of Antidepressants in Pregnancy

Robinson, Gail Erlick MD, DPsych, FRCPC

The Journal of Nervous and Mental Disease: March 2015 - Volume 203 - Issue 3 - p 159–163
doi: 10.1097/NMD.0000000000000256
Clinical Controversies
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There is controversy about the use of antidepressant medication during pregnancy. Decisions about their use are affected by understanding the risks of these medications causing pregnancy loss, congenital malformations, neonatal adaptation syndrome, persistent pulmonary hypertension of the newborn, autism spectrum disorder, or long-term neurocognitive deficits. Although some research has raised concerns about antidepressants causing harm to the fetus and neonate, other studies have disputed these findings or noted that any risks found do not exceed the risk of congenital problems found in 1% to 3% of neonates in the general population. Untreated depression during pregnancy can also cause harm from poor diet, substance abuse, suicidal behavior, or prematurity. Decisions about the use of antidepressants during pregnancy must be based on a risk-benefit analysis based on the best evidence of the risks of treating or not treating maternal depression.

University of Toronto, Toronto, Ontario, Canada.

Send reprint requests to Gail Erlick Robinson, MD, DPsych, FRCPC, Toronto General Hospital, 8-231 EN, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4. E-mail: gail.robinson@uhn.ca.

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