Source: DGNews  |  Posted 9 years ago

By Bonnie Darves
Special to DG News

BANFF, ALBERTA -- November 5, 2002 - A large percentage of women with major depression choose to discontinue taking antidepressants during pregnancy, without first seeking information on the extent to which that decision will adversely affect their own health or the outcomes of their pregnancies, Canadian researchers have found.

The trend is disturbing, the researchers say, because an estimated 10 percent of women of childbearing age experience major depression, which when untreated can result in adverse pregnancy outcomes as well as re-emergence of primary psychiatric syndrome and suicidal ideation.

Preliminary results of the ongoing study, being conducted by researchers at The Hospital for Sick Children in Toronto, Canada, were presented here at the annual meeting of the Canadian Psychiatric Association.

The leading factor in a pregnant woman's decision to discontinue antidepressant use appears to be misconceptions regarding safety of gestational antidepressant use, according to co-investigator Adrienne Einarson, RN, assistant director of the Toronto hospital's Motherisk Program in the Division of Clinical Pharmacology, especially regarding possible teratogenic risks. She notes that several major studies have documented the safety of selective serotonin reuptake inhibitors (SSRIs) during pregnancy, but many women are apparently unaware of the research findings. As such, the researchers are conducting a study to determine those risk perceptions in pregnant women with depression and to assess the efficacy of risk-based counseling in decreasing both risk perception and anxiety associated with psychotropic drug use.

As part of the study, women in their first trimester of pregnancy, or who are planning a pregnancy, and who call the Motherisk Program to obtain information about their current antidepressant use, are enrolled. The participants complete a questionnaire to assess their perceptions about antidepressant use and teratogenic risk, and are provided information on the drugs' safety. The women are then followed throughout pregnancy and compared with controls (women who have not been diagnosed with depression).

Preliminary findings indicate that there is a high level of anxiety among women regarding antidepressant use during pregnancy, as evidenced by the fact that 15 percent of women enrolled to date have decided to discontinue antidepressant use, despite provision of evidence-based counseling, compared to 1.6 percent of the controls, Ms Einarson said. In addition, 95 percent of participants taking antidepressants reported anxiety about continuing the medication, based on Centers for Epidemiological Studies Depression (CESD) scale scores, which were far higher (14) in the antidepressant-taking women, 87 percent, than in the controls, 11.8 percent of whom had high scores. "We're very concerned about pregnant women stopping their antidepressants, since many of them do not consider the potential effects on their own health-and on the outcome of their pregnancies," Ms Einarson said. "There appears to be a lot of misconception about antidepressants, and it is clear that more education is needed."