June 9, 2023

There are so many antidepressants available but what you really want to know is what’s the safest antidepressant in pregnancy?

So the question is what is the safest antidepressants to use in pregnancy we have different types of antidepressants which include the ssris such as cetalopram fluoxetine circulin pyroxetine and then you have the newer antidepressants such as metazepine then you have velifaxin and the older generation antidepressants as well as tricyclics which include amitriptyline

Which are known to help with pain anxiety migraines as well as depression but which of these are the safest to use we do not usually recommend antidepressants for pregnant women but for some who need to be on the medication the risk of taking the antidepressant outweigh the risk of not treating the depression for instance a mother can stop caring for herself and

The baby when born and this can be due to postnatal depression it is also thought that untreated depression can lead to risk of preterm birth and low birth weight also children born to mothers with untreated depression have a higher risk of behavioral problems and depression later in life and this is due to high levels of cortisol cortisol is a stress hormone that

Works on certain parts of your brain to control your mood and other systems in your body but if too high this can lead to symptoms of anxiety and depression the main concern is what side effects and risks can antidepressants have on the baby and in most cases a lot of mothers would rather stop the drug than take the risk at the expense of their own mental health i

Mean antidepressants can cross the placenta into the amniotic fluid and affect the baby so some of these side effects and risks include birth defects such as abnormality of the baby’s skull so you have a condition called craniosyntosis which is a birth defect in which the baby’s core joined too early together you also have abnormality of the wall of the abdomen

In some cases you might see a bit of the intestines outside of the baby’s body there is also the risk of heart defects and parasiting for instance has been linked to heart defects in smaller studies though this has not been proven in larger studies there is thought to be an increased risk of miscarriage in the first trimester and pre-term birth however there is no

Strong evidence that antidepressants can cause miscarriage also there is a risk of autism you can check out my video on the causes of autism where i discuss the association between antidepressants and risk of autism however the risk is thought to be so small that it’s not significant reason to stop taking antidepressants and in actual fact it’s found that there’s

Actually an association between untreated severe depression and autism taking antidepressant pregnancy can cause withdrawal symptoms of the baby and one in three babies might experience symptoms such as agitation poor feeding being jittery and low blood sugar but these symptoms usually result within two weeks however with a drug like amitriptyline your baby might

Get more severe symptoms such as fast heart rate seizures and irritability the greatest risk of antidepressants is actually a condition that’s so rare however it is something to be considered and it’s called persistent pulmonary hypertension of the newborn this is when the blood vessels of the lungs do not open fully and as a result oxygen cannot get to brain and

Other organs i mean most doctors will tell you that a lot of antidepressants are safe in pregnancy however you might find that some antidepressants are safer than others i mean the risks that i mentioned are all very low so if you look at the general population there is a one to three percent of having birth defects anyway without being on medication so some

Antidepressants might increase the risk by let’s say one percent while you might find that other antidepressants might increase the risk by two to three times that of the general population so i’m going to give you two scenarios or dilemmas muscle effects the first scenario is women who might have been on antidepressants before falling pregnant and now that are

Pregnant they want to know whether to stop to continue or to switch to another antidepressant it is generally advised that due to the risk of relapse if you are already on an antidepressant it is better to stay on it rather than switching just because of the possible risk to your baby as i mentioned the side effects or risks are quite rare but if your depression

Is mild or you do want to stop then you can consider non-drug options such as counseling or talking therapy support groups outdoor activities like exercise and other lifestyle changes if you are on the hideous of the drug and you do want to stop or you’ve been using it for a few years and you feel better now then with the help of a doctor you have to try winning

Yourself off the medication because stopping abruptly can lead to withdrawal symptoms such as rebound depression and this can last from weeks to months if however you’re not happy with the safety profile of the medication or it’s not working for you and you do want to switch to what’s considered to be safer then bear in mind that you still have to be weaned off

Or cross tapering of the medication which again can take weeks and days the risk of relapse during this period now the second scenario is when women who are already pregnant then have depression and they do need to be on medication now the question is which anti-person can i take that are safe and effective at the same time so if you’re pregnant maybe eight weeks

Pregnant perhaps you’re moderate or severely depressed and maybe you have negative thoughts of suicidal self-harm you’ve tried all the different options like self-help talking therapy lifestyle changes or maybe you do not feel these options are suitable for you perhaps you’ve tried them in the past and they haven’t worked or your doctor might have done an assessment

And feels you need to go on medication what this class is safe medication is based on studies and data taken on pregnant women as you cannot do trials and experiments on pregnant women and you have to remember what might affect one woman in pregnancy might not affect the other woman and vice versa so you might have the newer antidepressants like metazepine that

Might be safe to take in pregnancy but due to lack of sufficient data on larger numbers is difficult to come to the conclusion that metazapine is safe to take in pregnancy so citalopram acetalogram and sertraline as drugs recommended in pregnancy or circulating is considered as the first drug of choice as it has the best safety data and it’s not associated with

Any heart or birth defects also know that what you consider the safest antidepressant is not necessarily what might be the best antidepressant for you as you have to take into account your medical and drug history you know previous experience of the medication possible interaction with other medications as well as the type of depression you might be going through

And any other coexisting mental health problems so in terms of the safest antidepressant the first choice is certainly other choices you can take include citalopram and acetalopram ideally you want to avoid medications like paroxytene velifaxine and fluoxetine as these are known to cause as these are thought to cause you know birth or heart defects so if you

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Transcribed from video
The Safest Antidepressant In Pregnancy By The Caring Medic