By Nicholas Bakalar
The results of two new studies underscore the quandary that faces women taking antidepressants who are pregnant or plan to be.
In one, researchers report that pregnancy, contrary to widespread belief, provides no protection against emotional or psychiatric problems, suggesting that stopping antidepressants may be dangerous for both mother and child.
The other study confirms previous research showing that 30 percent of pregnant women who take antidepressants have babies who exhibit symptoms of drug withdrawal.
The first study, published last week in The Journal of the American Medical Association, found that women with major depression who stopped their medication relapsed more than two and a half times as often as women who continued to take antidepressants.
Dr. Lee S. Cohen, the lead author on the study and a psychiatrist at Massachusetts General Hospital, emphasized that this was an observational study of women who were already taking the drugs, and not a randomized trial.
Two of the authors have consulted for pharmaceutical companies that make antidepressants or have accepted research money from them.
The researchers found that 68 percent of 207 women who discontinued their medicine relapsed into depression while they were pregnant, but only 26 percent of those who continued their medicine through at least 16 weeks of gestation had a relapse.
According to the authors, these rates of relapse are similar to those of depressed women who are not pregnant and stop their medicine. Being pregnant, in other words, apparently provided no protection.
The second paper, published yesterday in The Archives of Pediatrics & Adolescent Medicine, reported that newborns exposed in the womb to Prozac and similar antidepressants, called selective serotonin reuptake inhibitors or S.S.R.I.'s, could develop neonatal abstinence syndrome.
This condition creates a physically uncomfortable withdrawal period of about 48 hours and can bring on crying, tremors, sleep problems and gastrointestinal disturbances, among other symptoms.
Israeli researchers tracked 60 infants exposed to S.S.R.I.'s during gestation, and found that 18 of them suffered the syndrome. None of a matched group of 60 infants whose mothers had not taken S.S.R.I.'s had the problem. The women had been taking various drugs, including Prozac, Zoloft, Paxil and Celexa.
The withdrawal usually does not require treatment and appears to have no immediate negative consequences, the researchers said. But, they wrote, "The long-term effects of in utero exposure to S.S.R.I.'s have not been demonstrated clearly."
The researchers acknowledged that their sample size was small and that they depended on mothers to report their own use of the drugs.
Yet stopping the medication also presents problems for mother and child, said Dr. Margaret G. Spinelli, an assistant professor of clinical psychiatry at Columbia, who was not involved in either study. One concern about depression in pregnancy is adverse outcomes to the baby, she said.
"Depressed mothers don't eat properly, they don't tend to their prenatal care and they're more likely to be smoking," Dr. Spinelli said. "Many physicians just stop the medicine without even thinking. We have to be aware of these things."
Dr. Gil Klinger, the lead author of the Israeli study and a neonatologist at Tel Aviv University, agreed. "Pregnant women should not stop treatment because depression during pregnancy has its own risks," he wrote in an e-mail message. "However, it should be kept in mind that prolonged S.S.R.I. exposure has at least a short-term effect on the newborn."
Dr. Cohen of Massachusetts General also stressed weighing the risks and said that the data helped to refine the risk-benefit decision of doctors and patients. "Hopefully those decisions can now be made in a more informed fashion so that we worry not just about the risks of exposure to antidepressants but also about risks to the patient from depression if they stop their medicine," he said.
"My hope is that it will be less of a reflex to stop the medicine and more a collaborative decision that weighs all the risks," he added.
* Copyright 2006The New York Times Company
IN THE WORKPLACE
Research on Depression in the Workplace.
For more information please click here
Mental Health Matters Journal for Psychiatrists & GP's
Click here for more info
If you are a journalist writing a story contact Kayla on 011 234 4837 firstname.lastname@example.org
It’s the small things that make a BIG difference. Sign up for the “My School | My Village | My Planet” Card and start making a difference to Mental Health in South Africa today.
Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.
The customizable 16-page book, read by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood by everyone across the world.
We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 100+ titles, such as TB, Malaria, Polio, Vaccines for over 45 countries.
- Click here to see speaking books in action
- Click here for sample book on clinical trials
- Click here to connect to international site
- Speaking books for Health Care YouTube
By Nicholas Bakalar
Dr Reddy's Help Line
0800 21 22 23
Cipla 24hr Mental Health Helpline
0800 456 789
Pharmadynamics Police &Trauma Line
0800 20 50 26
Adcock Ingram Depression and Anxiety Helpline
0800 70 80 90
0800 55 44 33
Department of Social Development Substance Abuse Line 24hr helpline
0800 12 13 14
Suicide Crisis Line
0800 567 567
SADAG Mental Health Line
011 234 4837
Akeso Psychiatric Response Unit 24 Hour
0861 435 787
Cipla Whatsapp Chat Line
(9am-4pm, 7 days a week)
076 882 2775
24 hour Healthcare Workers Care Network Helpline
0800 21 21 21
0800 515 515
EMERGENCY Contact Numbers for Students in South Africa - Click here
MENTAL HEALTH CALENDAR 2021
Teen Suicide Prevention Week
14 - 21 February
World Bipolar Day
SA Bipolar Awareness Day
Substance Abuse Awareness Day
Mental Health Awareness Month
1 – 31 July
Panic Awareness Day
World Suicide Prevention Day
World Mental Health Day
World Mental Awareness Month
1 - 31 October
View our list of informative Infographics.
SADAG KZN Branch
SADAG has an office in Durban with the support of Psychiatrist Dr Suvira Ramlall and Clinical Psychologist, Suntosh Pillay. Administrated by Lynn Norton
The KZN Branch is deeply committed to:
- Launching new Support Groups
- Workshops on Mental Health
- School Talks on Suicide Prevention
- Corporate Wellness For KZN companies
Want to become a volunteer counsellor? Contact Senzi 011 234 4837
Click here for more information.
If you are interested in starting a Support Group, please contact Krystle on 0800 21 22 23.
To find a Support Group in your area, please phone SADAG on 0800 21 22 23.
Click here for more information
Mental Health & Depression Book
A book called Surfacing, in which Marion Scher has sat down with a number of South Africans to share their stories of their personal struggles with mental health issues.
Want to know more? Click Here