(Jan 16, 2012)- A recent research paper published in the British Medical Journal reported that taking serotonin reuptake antidepressants (SSRIs) like Fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) during the second half of a woman’s pregnancy could mare than double the risk that babies will develop persistant pulmonary hypertension of the newborn (PPHN).

This finding supports a warning issued by the FDA during 2006 that alerted women that those taking SSRIs wer six times more likely to deliver babies with PPHN.

PPHN is high blood pressure in the arteries of the lungs. It causes the right ventricle of the heart- which must pump blood through the lungs to pick up oxygen- to work harder, too hard. This can ultimately cause weakening of the heart and heart failure.

Pulmonary hypertension affects about 1 in 1,000 newborns, but more than double that number of newborns of mothers taking antidepressants in the second half of their pregnancies seem to be affected. And an increased risk-though lower- appears to be present in those babies born to mothers who take antidepressants in the first half of their pregnancies.

Antidepressants of one kind or another have been implicated in- but not proven to be absolutely responsible for- increasing the risk of low birth weight, premaurity, and low blood sugar.

So, women should stop antidepressants when they learn they are pregnant, right? Not exactly. There are reasons to stop and theire are reasons to continue.

So, my advice is this:

1) If you are a woman considering pregnancy, try to stop or not to start antidepressants- as long as your symptoms are relatively mild. If you require treatment for depression, try psychotherapy or  Transcranial Magnetic Stimulation (TMS), which treats depression with magnetic pulses delivered to the head and which has no known contraindications in pregnancy. But, if you have serious symptoms of depression, use SSRIs, with the advice and under the care of your physician.

2) If you find out you are pregnant while you are already taking anti-depressants, talk to your doctor about very slowly stopping them, but only if you can do so safely, without severe symptoms of depression returning.

3) Never stop antidepressants all of a sudden. This can cause serious symptoms that affect you and your unborn child.

4) Do not stop antidepressants during pregnancy if you have been suicidal while depressed in the past and antidepressants have been necessary to ward off thoughts of harming yourself.

As a final note, while many obstetricians and many primary care doctors are comfortable treating depression, I believe it is best to be seen by a psychiatrist if you are taking antidepressants and want to have a baby.

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