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Don't Panic If You Took Anti-Depressants During Pregnancy

14/08/2014 16:51 | Updated 22 May 2015

Don't panic if you took anti-depressants during pregnancy

I'll never forget the frantic phone call from my GP when he found out I was pregnant.

I had to stop taking anti-depressants immediately or I'd harm my baby.

For someone who had suffered depression on and off for 10 years, his words were terrifying: for my unborn son, I could've unwittingly harmed him in the early weeks, subjecting him to a lifetime of illness, something I could never forgive myself for.

And for me because pregnancy simply heightened my anxiety – how was I going to get through the next seven-and-a-half months without Seroxat, which had given me a lease of life, normality, stability, not least wanting to actually get out of bed and function?

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I was between a rock and a hard place: carry on and threaten my baby's health or go cold turkey and expose him to the effects of a crash. I needed the facts so I went to see a specialist who spelled it out.

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Yes, there was evidence SSRIs (selective serotonin reuptake inhibitors) can increase the risk of a child being born with a heart defect. But each case had to be considered on its individual merit and his advice to me, already desperate with worry and full of fear, was to cut down my dose from 20mg to 10mg. He believed it was a compromise which would suit both mum and baby and besides, it was still a tiny risk.

The run-up to my 21-week scan was torturous, exacerbated by the dip in my mood, presuming the worst and feeling the fingers of depression on my shoulders.

The silence as the sonologist checked my baby's heart seemed endless; but we were lucky, there was nothing wrong with him. The birth was consultant-led and in the minutes leading up to his arrival, a gang of four specialists appeared in the delivery suite, ready to leap into action if there were undiagnosed cardiac problems. They melted away as soon as he was given the all-clear.

We were fortunate. But that's not the case for eight mums on Panorama this week who had babies born with serious heart defects after taking SSRIs while pregnant.

Professor Stephen Pilling told the BBC that the risk posed by some popular antidepressants in early pregnancy is not worth taking for women with mild to moderate depression, because they double the risk of a child being born with cardiac problems. Prescription guidelines only currently warn against taking paroxetine in early pregnancy.

One in six women of child-bearing age have used the drugs.

Prof Pilling, an adviser to the National Institute for Health and Care, argues: "We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we're perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar - if not greater – risks."

Prof Pilling says the guidance will now be re-written to take in to account evidence that the SSRI antidepressants, as a group, are linked to heart defects.

He says the risk of any baby being born with a heart defect is around two in 100; but the evidence suggests if the mother took an SSRI in early pregnancy that risk increases to around four in 100.

He says that women not suffering from the most severe depression who become pregnant whilst taking the drug are taking an unnecessary risk.

"You've got double the risk. And for women who are mild to moderately depressed, I don't think that those risks, in most cases, are really worth taking" he said.

"It's not just when a woman who's pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that's the large majority of women aged between 15 and 45."

Lundbeck, the manufacturer of Citalopram, says a recent review of scientific literature concluded that the drug 'does not appear to be associated with an increased risk of major foetal malformations'.

"The decision not to prescribe anti-depressants to a woman who is depressed... may generate greater risks to the woman and her foetus than the risks of exposure to the medication."

It's one of the hardest dilemmas facing a woman who is expecting a baby, combining the very worst of both worlds.

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But I dread to think how life would've been if I'd been without antidepressants. After all, there is research which reports a correlation between depression in pregnancy and behavioural problems in children.

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Just what is a mum to do? I am in the enviable position of being able to say I have no regrets. And risks during pregnancy seem two-a-penny these days; earlier this month the Royal College of Obstetricians and Gynaecologists warned mums-to-be to avoid non-stick pans, new cars and air fresheners due to the risk of exposing their babies to toxic chemicals.

Most of us pooh-poohed that, making light of it, even – blimey, it's a wonder any of us were born in the 'olden days' when mums-to-be smoked and drank.

But it's clear if experts are raising these sorts of issues then extensive research needs to be done.

In the meantime, all I can say to any woman affected by the dilemma of antidepressants during pregnancy is to seek specialist advice – and don't panic.

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