A Review of Antidepressants in Pregnancy
Depression is a mentally debilitating, psychiatric disease affecting a person’s day to day life. There are many risk factors and biological, psychological, and environmental causes that can contribute to the development and progression of depression. Medication is commonly used in addition to or after nonpharmacological options. In the general population, because of patient variability choosing and dosing an antidepressant involves a lot of trial and error and risk analysis to balance efficacy and safety. In pregnant women, additional challenges complicate an already difficult situation including additional risk analysis considerations for a growing fetus. Limited research is available regarding antidepressant use in pregnancy, therefore many clinical decisions are based on discussions between the patient and provider. Choosing a medication, dosing, altered pharmacokinetics, and monitoring are all key aspects to consider in this vulnerable population. Sound clinical judgment specific to the patient is critical in order to balance depression treatment and maternal, as well as fetal, outcomes.