July 1, 2013

expert reaction to BBC Panorama programme on antidepressants and pregnancy

A BBC Panorama programme, ‘The Truth about Pregnancy and Pills’, suggested if a mother takes a Selective Serotonin Reuptake Inhibitor (SSRI) in early pregnancy the risk of having a baby born with a heart defect increases from two in 100 to four in 100. 

Dr Ian Jones, Vice Chair of the RCPsych’s Section of Perinatal Psychiatry, said:

“Although it is still difficult to know for definite whether antidepressant medication increases the risk of malformations in babies, what we can be certain of is that any increase in risk is small. Depression in pregnancy and following childbirth (the postpartum period) is common, and is an illness with potentially serious consequences. It can be severe, with serious implications for the woman, her baby and her wider relationships. Suicide is a leading cause of maternal death in the UK.”

Dr Liz McDonald, Chair of the RCPsych’s Section of Perinatal Psychiatry, said:

“Women should not be taking medication in pregnancy if they don’t need to. For a woman taking an antidepressant and who is considering starting a family, or finds that she is pregnant, this is an excellent time to consider whether the medication is still required. Women should not stop their medication suddenly and, if they are concerned about continuing the antidepressant in pregnancy, they should discuss the options with their doctor.

“The decision to take medication in pregnancy is always difficult. It must be made by women themselves, following discussion with their doctors where they weigh up the risks and benefits of all options, taking into account their individual needs and circumstances. It is important to recognise that severe psychiatric illness may have negative consequences for the woman, her baby and her family, and these must be weighed against what is known about the risks of taking medication.

“Antidepressants definitely have their place. Not only is suicide a major risk, but if a woman has an episode of depression it can have profound implications for the mother, baby and the whole family. There may be risks with taking antidepressants, as with other medications, but the risks are small and women who are concerned should discuss the balance of benefit and risk with their doctor.”