Pregnancy theoretically is a good form of stress known as eustress. There can be several All over the world we know that 10% of pregnant women and 13% of women in the post-partum ( after delivery) period.
Symptoms of depression are persistent low or non reactive mood for more than 2 weeks, sleep disturbances, appetite loss, feelings of hopelessness, inability to enjoy things usually enjoyed ( anhedonia), feeling guilty, losing concentration at work etc.
Mood disorders particularly depressive disorders are more common in women than men and now in fact we know that 30% of post-natal depression starts before birth of the baby.
Symptoms of depression are highest around 34-38 weeks of pregnancy.
Overall, we are aware that risk of relapse is much higher in women who discontinue antidepressants during pregnancy than women who do not. Your doctor will assess if you are at higher risk of relapse during pregnancy by asking you several questions or through online counseling for depression about your past medical and psychiatric health and advice you accordingly.
By and large we can conclude that the newer antidepressants ie., SSRI class of antidepressants are safer to use during pregnancy. There are some conflicting evidence on the risks associated with use of SSRI antidepressants in pregnancy but overall it is supposed to be safe taking the benefits into consideration. For eg., there are studies that suggest that preeclampsia, spontaneous abortion, low birth weight and effects of antidepressants seen in infants on birth may occur. But these should be weighed with the fact that there are consistent benefits with continuation of antidepressants in pregnancy. Additional scans and close working with Obstetrician team must be done.
Older antidepressants such as amitriptyline is associated with central nervous system defects, developmental delays and limb defects.
The best psychiatrist in Chennai suggest that newer antidepressants are always the preferred choice in pregnancy particularly SSRIs.
Sertraline is one such SSRI which is supposed to have less effects on the baby and can be used during breastfeeding as well.
Paroxetine and fluoxetine are two SSRIs which have been found in some studies to have had effects of the heart formation of the baby when exposed to early in pregnancy ( cardiac malformations when exposed in first trimester).
When antidepressant must be initiated for the first time in pregnancy then sertraline is usually considered as the medication of choice.
Pregnant women may be taking sleeping tablets such as benzodiazepines. These are not recommended and must be discontinued as soon as possible. There are reports of cleft palate and cardiac abnormalities reported with benzodiazepines. Hence this is not something that a pregnant lady must continue.