As many as 15 percent of women of childbearing age are chronically depressed. Some even become suicidal. When such depression leads to alcohol or drugs, it can have especially serious long-term consequences for a woman and her baby during pregnancy or breastfeeding.
Normal brain function depends on an adequate supply of certain chemical "messengers," such as serotonin and norepinephrine, which transmit signals from one part of the brain to another. People with major depression have lower levels of these substances. The newest antidepressants, called selective serotonin reuptake inhibitors (SSRIs) have dramatically improved the mood and quality of life for thousands of depression sufferers by raising serotonin levels in the brain.
Will pregnant women and nursing mothers who need these drugs harm their children by taking them?
Here's What's New
Even though these drugs can be passed to the fetus via the bloodstream, research indicates that the newer SSRIs such as Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), and Effexor (venlafaxine), do not increase fetal risk of major birth defects or death. However, to avoid withdrawal symptoms in newborns, some doctors recommend that these medications be tapered or discontinued 10 to 14 days before the patient's due date.
Doctors at the University of Bergen in Norway analyzed breast milk from 23 women who were taking an SSRI for depression while breastfeeding their babies. Blood samples from the mothers and children revealed that the drug was not present in breast milk or the babies' blood in appreciable amounts. The researchers conclude that these antidepressants are safe to take while nursing. In fact, they are especially useful in treating postpartum depression.
The Bottom Line
If you're seriously depressed while pregnant or breastfeeding, you may benefit from taking an SSRI at the lowest effective dose. But as with any medication, it's important for your doctor to monitor its use. You should also receive appropriate counseling and emotional support. Although some SSRIs, such as Prozac, may result in higher blood levels in the nursing infants than others (Paxil and Zoloft have the lowest concentrations in breast milk), none are high enough to harm the child.
(Reprinted from Dr. Isadore Rosenfeld's Breakthrough Health 2004: 157 Up-to-the-Minute Medical Discoveries, Treatments, and Cures That Can Save Your Life, from America's Most Trusted Doctor! by Isadore Rosenfeld, M.D. (Rodale Inc., Paperback, $14.95/$21.95CAN; 1-57954-900-4). Permission granted by Rodale, Emmaus, PA 18098. Available wherever books are sold.)
About the Author - Dr. Isadore Rosenfeld's legions of fans follow his regular column in Parade magazine and his popular Sunday-morning television series Sunday Housecall on FOX News Channel. In addition to his numerous scientific publications and medical textbooks for doctors, he has written nine New York Times bestsellers. He is a distinguished member of the faculty at New York-Presbyterian Hospital/Weill Medical College of Cornell University and attending physician at New York Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center.
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