Antidepressants During Pregnancy Could Delay Developmental Milestones
A new study suggests that exposure to anti-depressants in utero could adversely affect an infant's developmental milestones. But a leading Canadian expert warns that any potential risk of taking antidepressants during pregnancy needs to be balanced by the very serious risk of leaving mental illness untreated.
As reported in the March issue of Pediatrics, a recent study done at Aarhus University in Denmark found that exposure to antidepressants in the womb could slightly delay an infant's developmental milestones in the first 19 months of life. Boys, in particular, were found to be affected more.Babies with mothers on antidepressants were twice as likely to be unable to sit without support at six months of age (an average of 15.9 days later). Babies exposed to antidepressants also walked later -- almost a month (28.9 days) later than babies who weren't exposed. As well, at 19 months, babies exposed to antidepressants in utero were twice as likely to be unable to occupy themselves for more than 15 minutes, which is a measure of attention.
However, researchers noted that most of the milestones they evaluated in the study were reached within similar amounts of time by both groups. As well, the mean times for sitting and walking without support were still within normal range for the exposed group.
"The potential delay in development thus might have limited, if any, clinical significance for the children, but may suggest that human fetal brain development is susceptible to antidepressant exposure," wrote the study's authors. They concluded that longer follow-up monitoring was needed to further explore the results.
Dr. Ariel Dalfen, who is a psychiatrist and expert on postpartum depression at Mount Sinai Hospital in Toronto, says that although it's prudent to pay attention to these kinds of studies, it's important to emphasize to patients that the results were inconclusive because "people get very scared." And while she acknowledges that every patient's situation is different, she says that women on antidepressants should never decide to go off their medication on their own.
"When people need to be on these medications, you have to balance the very small potential for side effects that haven't been well-documented with the need to treat their problem," she says. "We never want to take any prescribed treatments lightly, because there is always a small possibility that there could be negative effects on the fetus. But you need to make sure you're balancing all the risks and benefits, including the risks of having an untreated depression during pregnancy."
She recommends that women consult with their physician before making any kind of change to their medication. As well, she says it's important to be sure that the physician is up-to-date about what's safe and what isn't during pregnancy.
"So many times women will come in to see me and they'll say, 'My doctor said nothing is safe to take during pregnancy and to stop everything,'" says Dalfen. "That's a terrible thing, because people with mental illness can relapse and can become very depressed. It's very, very dangerous."
Dr. Dalfen says women should ask their physician whether they are well-informed about the risks and benefits of antidepressants during pregnancy, and if they aren't, to ask for a referral to someone who is.
Most importantly, she says, "If you read an article that says antidepressants are bad, don't draw your own conclusions, leave it to an expert to interpret it. And don't make any rash decisions on your own, because that can have very negative consequences on your state of mind and well-being."