Do pregnant women benefit from taking antidepressants?

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However at the end of the review, none of the studies – whether large or small – showed any degree of benefit from antidepressant use. When there is no scientific evidence of benefit, says Mintzes, there is reason to be concerned when use of a treatment is widespread.

In looking at studies in non-pregnant women as secondary evidence of whether or not there might be a benefit to pregnant women, Mintzes finds there isn’t evidence that SSRIs work better than non-drug treatment, like psychotherapy for most forms of depression, and she is concerned that the benefits of SSRIs in adults – pregnant or not – have been shown to be exaggerated. There is also the consideration that depression is often incorrectly diagnosed. A systematic review of studies found that family doctors incorrectly diagnose a person with depression 15 times for every 10 correct diagnoses.

As for the impact on babies, the eight studies found that children born to women taking SSRIs had 4.2% (1 in 24) greater incidence of respiratory distress than among women with depression without SSRI exposure, and a 0.6% higher rate of cardiac malformation (1 in 159), again as compared with women not taking antidepressants. This is a signal that babies exposed to antidepressants seem to be doing worse in some ways than those not exposed. It adds to a larger body of literature on harmful effects of antidepressants in pregnancy.

“The question is, why is this treatment being very heavily recommended for use in pregnancy given the lack of scientific evidence of benefit?” asks Mintzes. “There is no rationale for the recommended use of SSRIs in pregnancy.”

Some SSRI stats:

Antidepressants are among the most frequently prescribed class of  drugs for women of childbearing age in Canada. 

• In 2003 – 2004, 11-14% of women in British Columbia between the ages of 25 and 39 received at least one prescription for an antidepressant.
• In 2008, 80% of women in Canada who spoke about depression to their doctors were given a prescription, usually for an SSRI.
• In 1998, just over of 2% of pregnant women in BC used an antidepressant.  By 2001, the rate of use had grown to 5%.

Jane Shulman is the Director of Knowledge Exchange at the Canadian Women’s Health Network.

Watch the webinar at www.cwhn.ca

CWHN is developing an in-depth information sheet about SSRIs and pregnancy available for download soon on our website.