New guidelines offer hope for depression in pregnancy

Now, two of the nation’s leading physicians’ groups have issued the first guidelines on how to safely and effectively treat the depression in pregnancy.

As many as 23 percent of pregnant women experience a depressive disorder during pregnancy, but many worry antidepressant medications use during pregnancy could be harmful for the newborn.

In a bid to resolve that dilemma, the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) on Friday issued the first guidelines for the better treatment of depression in pregnancy.

New hope for pregnancy and depression
The joint report from the two groups offers new hope to treat pregnant women with depression more safely and effectively.

"Depression in pregnant women often goes unrecognised and untreated in part because of concerns about the safety of treating women during pregnancy," said lead author Kimberly Ann Yonkers, MD, Yale University, New Haven, Connecticut. "It is our hope that this will be a resource to clinicians who care for pregnant women who have or are at risk of developing major depressive disorder."

After reviewing extensive studies, researchers found that using antidepressants during pregnancy can sometimes be the safest option for treating mother's depression, which has been linked to problems in the newborn.

But, at the same time, these drugs could also be risky for the fetuses, putting them at risk of birth defects and reduced birth weight.

Psychotherapy: an alternative to antidepressants
The report, however, indicated that psychotherapy may be a suitable alternative to antidepressants for some women with mild-to-moderate depression symptoms. The new guidelines suggest that women with suicidal or acute psychotic symptoms should be referred to a psychiatrist for aggressive treatment.

“This is a very exciting time in obstetrics and psychiatry, a golden opportunity for us to really make a difference in the lives of women and their children,” said University of California, Los Angeles psychiatrist Dr. Vivien Burt, a leading researcher in mood disorders and women. “The professional organization of ob/gyns has now clearly stated depression is a problem, and that as the medical gateway for many women, it is incumbent on them to be aware of it and screen women of childbearing age.”

The guidelines also suggest that women planning to conceive may possibly taper or discontinue their antidepressants if they have had mild or no symptoms for 6 months or longer.

The report is published simultaneously in the September issue of Obstetrics & Gynecology and in the September/October issue of General Hospital Psychiatry.