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Should You Use Antidepressants During Pregnancy?
Posted by: Dr. Mercola
May 07 2003 | 1,947 views

Women who take antidepressants during pregnancy have no more risk of having a baby with birth defects than women who don’t take the drugs, according to a study.

The use of antidepressants from a class known as selective serotonin reuptake inhibitors (SSRIs) during pregnancy did not increase the risk of congenital malformations, low birth weight or preterm labor, researchers said.

Previous studies have found that SSRIs might increase the risk of early labor, however the current study found no such association.

The study involved 138 non-smoking pregnant women aged between 24 and 44 years. Eighty-five women took one of four antidepressants (Paxil, Prozac, Zoloft or Luvox) for their entire pregnancy, while the remaining women started the drugs sometime during their pregnancy.

The rate of major birth defects was 1.4 percent, similar to the rate in the general population, and there was no increased risk for low birth weight or preterm babies.

Three of the women taking Prozac at relatively high doses did have low birth weight babies, however. Researchers say this may have been a result of the women’s depression rather than the drug.

There have also been reports of complications in newborns such as jitteriness and rapid breathing associated with antidepressant use during pregnancy, which researchers say need to be further investigated.

Based on the study’s results, researchers concluded that pregnant women should minimize their use of antidepressants when possible and opt for other options such as psychotherapy and group support.

American Journal of Obstetrics and Gynecology March, 2003;188:812-815


Dr. Mercola''s Comments
Dr. Mercola's Comments:
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When I first read this study I thought for sure it was funded by the drug companies, but it appears to be legitimate as it was funded by the National Institutes of Health.

However, the conclusion does fly in the face of previous research on the subject that was published about one year ago in the New England Journal of Medicine that showed that antidepressants use in pregnancy could cause a severe rebound effect in the babies. Clearly drugs are rarely the best choice for pregnant women who are depressed. There are so many better options.

However, it is great to know that if the options below aren’t working the above study provides a level of reassurance that it is unlikely there would be major problems if you were to use antidepressants in pregnancy.

If you are considering an antidepressant, it would certainly seem to better to start with tryptophan, which is a naturally occurring amino acid that is a precursor of serotonin and useful for many people with depression. It is a prescription item, but you can find it less expensively and without a prescription in a vet store.

Antidepressants are the top-selling therapeutic class, with $12.5 billion in retail sales. Depression is an enormously common problem and many people use a drug-based solution to address it.

Second generation antidepressants have traditionally been believed to be safe during pregnancy.

While I am certain many women benefit in some ways from their use, these drugs are in no way, shape or form ever responsible for improving the underlying cause of depression.

Sure seems to make a lot more sense to recommend the use of simple therapies, which are far more effective and virtually non-toxic.

Now, what would those be?

First and foremost, especially with pregnant women, the use of omega-3 oils is an absolute must. It is also clear that omega-3 fat supplementation and restriction of omega-6 fats will profoundly improve the brain function.

Dr. Stoll is the director of the psychopharmacology research lab at Boston's McLean Hospital and assistant professor of psychiatry at Harvard Medical School. He discusses this extensively in his book The Omega-3 Connection and reviews the new evidence supporting the use of omega-3 oils for depression.

I thoroughly enjoyed his book, but disagree with his recommendations to avoid using cod liver oil. It is my experience that as long as the dose is carefully monitored, cod liver oil is very beneficial. However, since it does contain vitamin D, it is wise to switch to fish oil, which does not contain vitamin D, during the warm weather months to avoid vitamin D toxicity.

If you have an excess of vitamin D you will actually cause all the problems it treats--you will actually worsen your bone density and cause heart disease if your vitamin D levels are excessive.

Fish oil and cod liver oil are excellent sources of omega-3 as, unlike other sources such as walnuts or flax seeds, they are also high in DHA and EPA, two fatty acids that are pivotal in preventing heart disease, cancer, and many other diseases, including depression.

When choosing your fish oil or cod liver oil, it is important to remember that not all brands are the same. In my research--and in my clinical experience with patients--I have found that 1) the liquid form is superior to capsules; 2) that certain brands definitely seem inferior to others; 3) that the Carlson's brand of fish oil/cod liver oil is of an exceptional quality and purity. It is likely not the only brand in the world of such high quality, but up to this point it is the only one of such quality that I can recommend, so I now carry the Carlson's fish oil and cod liver oil on Mercola.com; you can also check your local health food store to see if they carry it.

While fish is also a great source of omega-3, most fish is contaminated with mercury so I recommend avoiding it unless you have had it tested and found to be safe. Fortunately, I have done some research and have finally found a safe and delicious source for wild red salmon--one of the most nutritious foods on earth. I had the salmon, which are harvested in Alaskan waters, tested through an independent lab and it was found to be free of mercury and other toxins. I also tasted it in a variety of recipes, and now I can now confidently and enthusiastically recommend the Vital Choice brand of wild red salmon to you!

In addition to treating the depression, omega-3 will also do wonders for improving the intelligence of the child and protecting them from the epidemic of brain injuries such as autism, pervasive developmental delay and ADHD.

Exposure to full spectrum lighting is another option for treating depression. In the summer this is easy to do, just spend one hour outside in the sunlight, not behind a window. The window will filter out many of the over 1500 wavelengths that are present in full sunlight. If the problem occurs during the winter then access to full spectrum fluorescent lighting will be very important.

Even if pregnant women did only the following three steps, the great majority would notice amazing improvement in their depression:

  • Get adequate amounts of omega-3 oils, specifically fish oil
  • Drink only water, taking care to avoid fruit juices, soda and milk
  • Restrict sugar and grain intake, as eating sugars and grains cause insulin levels to be elevated

Additionally, prayer is a very powerful tool and should be used regularly in large doses. EFT can also be a profoundly helpful resource to quickly, inexpensively and permanently resolve the underlying cause of depression. I have recently updated my EFT VHS/DVD Series on how to actually perform the treatment.

Related Articles:

Antidepressant in Pregnancy Not a Great Idea

Defeating Depression: as Easy as Omega-3

Using Tryptophan to Treat Depression

Light Therapy Useful for Depression During Pregnancy





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