Antidepressant Drugs and Fetal Brain Development, 1/1998

Should women taking medication for depression discontinue the medication during pregnancy in order to protect the developing fetus?

Between 8-20% of women are reported to have depression at some time during their lives. It occurs most often during childbearing years and often requires drug therapy. The drugs commonly used for the treatment of depression cross the placenta and enter the circulation of the fetus. The fetal brain develops throughout pregnancy but is believed to be most vulnerable to drug-induced malformation during the first trimester.

Thus the dilemma: maternal well being may require the continuation of anti-depressant drug therapy during pregnancy. What effect will continuation of anti-depressant drugs have on fetal brain development?

A research study done in Canada explored this question.¹ The investigators found that two commonly used anti-depressant drugs taken by the mother had no detrimental effects on their children's intelligence, language or behavioral development as measured during preschool years.

Comment: All substances used by a pregnant woman must be assumed to enter the circulation of the developing fetus: food; liquid; alcohol; tobacco; drugs; etc. In general, all authorities agree that non-food substances other than physician recommended vitamin supplements should be avoided. However, pregnant women do have illnesses that require medications for the maintenance of their physical and mental health. In all instances, the use of these medications taken during pregnancy need to be carefully monitored by the woman's physician. In the use of selected anti-depressants, the present study indicates they have no recognized ill-effect on the developing fetal brain and can be continued. It must be emphasized that the present study only investigated the effects of two common types of anti-depressants. The results cannot be broadened to include effects of other medications.  

¹ Nulman, I.et al. Neurodevelopment of Children in Utero to Antidepressant Drugs. NEJM 336:4; 458-262  

© UCP Research & Educational Foundation, January 1998

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