While a quarter of the population have already taken antidepressants in their life in France, many women wonder if this treatment is compatible with pregnancy.
Antidepressants are psychotropic drugs prescribed to relieve the symptoms of depression, in particular the sadness and motor slowing that characterize this disease. They are not euphoric drugs and they have no effect on people who do not suffer from depressive disorders. All antidepressants have activity on monoaminergic neurotransmitters and their use responds to a need to restore the chemical balance of the brainbased on the monoaminergic hypothesis of depression.
For women who have been prescribed antidepressants, a question arises when a pregnancy project takes place: can you take antidepressants during pregnancy? If so, what are the risks? To answer these questions, we turned to Célia Levavasseur, a pediatrician specializing in perinatal psychology and author of A guide for young parents who don’t want to die of exhaustion (Nathan).
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Can you take an antidepressant during pregnancy?
“This subject is very delicate because the risk-benefit balance plays a big part in it.”, begins the pediatrician, “Whether in terms of toxic substances such as alcohol, in terms of pollution, etc… the best during pregnancy, is to take nothing.” The placenta, which is the temporary organ that develops in the uterus during gestation and which is used for blood exchange between the mother and the fetus, plays a role of filter. However, it does not filter everything.
“Antidepressants pose a risk to the baby. However, the greatest danger for an unborn child is that his mother will be ill”, resumes the specialist. “When a pregnant woman is depressed, cries often, feels bad, a stress hormone, cortisol, is induced in her body and passes into the fetus. This has the effect of damaging the baby’s brain, generating areas of atrophy.” Thus, according to Célia Levavasseur, it is safer to take an antidepressant during her pregnancy than to go badly for 9 months, without medication, which can be potentially harmful for the baby.
In addition, it is necessary all the same to remain positive and to know that the cerebral plasty of the babies is extraordinary and that they are in capacity to recover quickly.
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Antidepressants during pregnancy: what are the risks for the baby?
Antidepressants can cause neurodevelopmental disorders in babies (dyspraxia, attention disorder, etc.). “Ultimately, you have to weigh the pros and cons because as said before, if the cessation of antidepressants disturbs the balance of the mother, this can have serious consequences on the health of the baby, more important than those that can have antidepressants”, underlines the pediatrician.
“However, what can be interesting in a woman who has a pregnancy project, has been on antidepressants for example for 10 years for burnout and who takes this treatment “out of habit”, is to try to stop. In this case, yes it may be relevant”, explains Célia Levavasseur. The best is finally to evaluate the need for the continuity or not of the treatments when a woman informs her doctor of a pregnancy project. In the case of a surprise pregnancy, the pediatrician affirms that it is better to continue the treatment than to take the risk of decompensating the mother.
“On the other hand, concerning psychiatric women (schizophrenics, manic-depressive,…) who are serious cases, it is essential to maintain the treatment”, resumes the pediatrician. “When a woman is pregnant, she becomes 1 and a half and gains 10-20 kg. This means that for these women, it is also necessary to increase their doses of antidepressants.”
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And for breastfeeding?
There are antidepressant treatments that do not pass into breast milk and which thus pose no risk to the infant: “For women planning to breastfeed, it may be worth changing treatment if the mother cannot stop the antidepressants..”
Feeling guilty is normal!
“From the moment a woman becomes a mom, her brain changes during pregnancy. She then has more attraction to take care of other people’s babies and therefore later, of her own.”, says the pediatrician. So when a woman is pregnant, she starts prioritizing the child over her and that’s when, usually, the guilt of taking medication arises.
“It’s a complex situation because mothers are torn between the guilt of potentially poisoning their baby and that of decompensating.”, explains the specialist. “Guilt is excess of love, an excess of wanting to do well. What I like to say to my patients who feel guilty is: ‘Great, you feel guilty, you have become a mother!’.”
Parenting writer
On the lookout for news and the latest discoveries, Carla puts her pen at your service. Passionate about science and medicine, she brings another perspective in …