The New Advice on Antidepressants During Pregnancy

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The decision to take an antidepressant during pregnancy is often a very tricky one. But did it just get even more complicated? According to new research from a group of Boston-area hospitals, using antidepressants during pregnancy may provide more health risks than benefits for expectant moms experiencing only mild-to-moderate depression.

What's the concern? Pregnant women diagnosed with depression are typically told it's safer for them and their unborn child to continue taking antidepressants during pregnancy rather than stop the medication. The conventional wisdom has long been that stopping antidepressants can lead to poor prenatal health and a greater chance for developing postpartum depression, among other problems.

But this advice may be off the mark.

"There is clear, consistent evidence of risk with the use of these drugs by pregnant women. Those include miscarriage, preterm birth (delivering the baby early), newborn behavioral syndrome (poor newborn adaptation)—and there is a big issue about the possible long-term effects of these drugs," Dr. Adam Urato, chairman of the Department of Obstetrics and Gynecology at Metrowest Medical Center in Framingham, Massachusetts, tells CNN about the study he co-led.

What's more, the review also turned up that SSRIs—a common class of antidepressants that includes Prozac and Zoloft—may be no more effective, or only slightly more effective, than placebo pills for treating mild-to-moderate depression in pregnant women. Other evidence turned up by researchers suggests SSRIs may make it more difficult to get pregnant for women undergoing fertility treatments.

Despite these negative findings, the answer of whether or not to take antidepressants is still not so simple. Critics of the study are concerned that women suffering from severe depression may get the wrong message.

"For many women with severe major depression, treatment with an antidepressant is not optional, just like treatment with insulin is not optional for a woman with (type 1) diabetes," Kimberly Yonkers, a professor of psychiatry and obstetrics and gynecology at Yale University, tells CBS News. "To give these women the message that treatment is optional and that it doesn't work anyway does us all a disservice."

So, what's best for you? If you suffer from depression, what's safest for your pregnancy—and what might work best to safely stabilize your mood? If your symptoms do fall in that mild-to-moderate range, alternatives to prescription antidepressants may offer effective relief. What can you try? Colorado-based therapist Julie Gladnick, MA, LMFT, offers five ways to beat the blues:

• Get connected with a support group: "Whether you talk to your existing friends and family members who are moms, or find a pregnancy support group, having other women to talk to about what you are going through can be an extremely powerful way to manage depression during pregnancy," Gladnick tells BabyZone. To find a group, ask at your hospital or birthing center or check out sites like Meetup.com for local gatherings of moms and moms-to-be.
• Exercise: Getting out for a walk and some fresh air can be a powerful way to manage feeling overwhelmed, fearful, anxious, or hopeless. And research shows that exercise is a good tool for treating mild depression. Says Gladnick, "Not only is it good for your body and your baby, but it's a great way to feel better, even if it's only a few minutes of walking!"
• See a professional: Talking to a therapist is a great way to express fears and anxieties in a safe environment. Therapy can also help keep depression at bay—before, during and after you deliver.
• Eat well: "The power of good nutrition is really underrated," says Gladnick. "Making sure that you are drinking enough water and consuming enough iron and B vitamins can be important not only for your growing baby, but also for you." Because your body takes from you to give to your baby, it's easy to be depleted of a number of vitamins and minerals that are essential to your mental and physical health.
• Practice self-care: Because being pregnant can be overwhelming physically and emotionally overwhelming in and of itself—whether it's your first child or your fourth—Gladnick advises that moms make time each day to take care of themselves. Whether that means a weekly prenatal yoga class, treating yourself to a pedicure, or reading a good, non-baby related book, do things that are good for you—and make you feel good.