Pregnancy and motherhood are periods of significant hormonal and emotional changes. Many expectant and new mothers experience mood swings, anxiety, or even depression. In such situations, the question arises about the safety and appropriateness of taking psychotropic medications, particularly antidepressants. This article...
Antidepressants during pregnancy and breastfeeding: main risks
Taking any medication during pregnancy and lactation requires special caution. Studies show a potential link between the use of certain antidepressants in early terms and a very slight increase in the risk of congenital developmental defects. There is also a possibility of developing the so‑called “neonatal adaptation syndrome” – temporary symptoms such as irritability, sleep disturbances, and feeding difficulties that may occur in the baby immediately after birth. However, it is important to understand that untreated maternal depression also carries serious risks for the health of both the mother and the child, including low birth weight, preterm delivery, and complications in the development of the emotional bond.
Selective serotonin reuptake inhibitors (СІЗЗС)
This group of antidepressants (e.g., сертралін, флуоксетин) is considered one of the most studied and safest for use during pregnancy. Physicians often prefer them when treatment is necessary. сертралін has the best safety profile because it crosses the placental barrier and enters breast milk to a lesser extent than other drugs in this group.
Alternatives and support
Not all women with mild or moderate depressive symptoms need medication therapy right away. Effective alternatives or complements can include:
- Psychotherapy: Cognitive‑behavioral therapy (КПТ) and interpersonal therapy have demonstrated high effectiveness in treating depression and anxiety in the perinatal period.
- Physical activity: Regular exercise improves mood and reduces stress levels.
- Support from family and support groups: Connecting with other mothers experiencing similar challenges can be extremely helpful.
The importance of an individualized approach
The decision to take antidepressants during pregnancy or breastfeeding should always be individualized and made jointly by a psychiatrist and an obstetrician‑gynecologist based on an assessment of the severity of the mother’s condition, potential risks, and the benefits of the specific medication. Untreated depression is also a risk. The key is not to delay seeking professional help.
