Chicago Health | Homepage
The Medicine Cabinet-Ask the Harvard Experts: Depression during pregnancy should be treated

The Medicine Cabinet-Ask the Harvard Experts: Depression during pregnancy should be treated

By Howard LeWine, M.D., Tribune Content Agency

Q: I just found out that I’m pregnant. I’m excited, but worried because I have a history of depression. I’m afraid to take medicine if I start to get depressed again. Any advice?

A: Pregnancy is a joyful time for most women, but not for a pregnant woman who struggles with depression. And it’s common. The limited data available suggest that up to 7 percent of women who become pregnant develop major depression. Another 7 percent develop minor depression.

Mental health professionals, obstetricians and their patients often need to balance:

–The chance that exposure to an anti-depressant drug may harm the developing fetus

–The danger of not adequately treating the pregnant woman

It’s terrific that you want to learn about your options “just in case.” Too many pregnant women don’t seek help. They push aside their feelings and think, “I’m pregnant. I’m supposed to be happy. I’ll get over these feelings of depression.” They also worry that the doctor will prescribe an antidepressant that might harm the developing fetus.

But depression during pregnancy should be treated. It’s important for both the mother and for the developing fetus. Among other risks, untreated depression during pregnancy increases the likelihood that a woman will develop postpartum depression and give birth to a low-weight baby. Also there’s a greater chance that the newborn will be lethargic and more irritable than expected.

For women with mild to moderate depression, talk therapy alone can be very effective. But treatment of severe depression during pregnancy almost always requires antidepressant medicine.

Selective serotonin reuptake inhibitors (SSRIs) are the drugs most often used to treat depression during pregnancy. They include fluoxetine (Prozac), sertraline (Zoloft), and others.

All psychiatric medicines cross the placenta and reach the fetus. But the risks to the developing baby are very small. More recent research suggests that SSRIs are less likely to cause birth defects than previously thought and perhaps no increased risk when used during the first half of pregnancy.

Women with severe depression during pregnancy should keep an open mind regarding the use of an SSRI. Based on current evidence, trying to taper the dose in the second half of pregnancy seems a reasonable strategy. But if your symptoms get worse — especially if you have any thoughts of suicide — you need to tell your doctor or therapist right away.

(Howard LeWine, M.D., is a practicing internist at Brigham and Women’s Hospital in Boston and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)

(For additional consumer health information, please visit


Similar Articles

Meningitis Quick Questions

Meningitis Quick Questions

Provided by Henry “Elie” Schwartz, MD, Schwartz Pediatrics Who is at risk for meningitis? Those at an

Additional tests advisable before deciding on treatment for hypothyroidism

Additional tests advisable before deciding on treatment for hypothyroidism

By Marius N. Stan, M.D., Endocrinology, Mayo Clinic DEAR MAYO CLINIC: At my last checkup, the

Critical Questions to Ask Your Pain Specialist

Critical Questions to Ask Your Pain Specialist

The following questions and answers were provided by John V. Prunskis, MD, FIPP, medical director

Critical Questions: GERD

Critical Questions: GERD

The following questions and answers were provided by Mitchell Bernsen, MD, managing partner at Illinois

Critical Questions: Prostate Cancer

Critical Questions: Prostate Cancer

The following questions and answers were provided by Rajat Malhotra, MD, Medical Oncology/Hematology at Illinois

January 2017
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
December 25, 2016 December 26, 2016 December 27, 2016 December 28, 2016 December 29, 2016 December 30, 2016 December 31, 2016
January 1, 2017 January 2, 2017 January 3, 2017 January 4, 2017 January 5, 2017 January 6, 2017 January 7, 2017
January 8, 2017 January 9, 2017 January 10, 2017 January 11, 2017 January 12, 2017 January 13, 2017 January 14, 2017
January 15, 2017 January 16, 2017 January 17, 2017 January 18, 2017 January 19, 2017 January 20, 2017 January 21, 2017
January 22, 2017 January 23, 2017 January 24, 2017 January 25, 2017 January 26, 2017 January 27, 2017 January 28, 2017
January 29, 2017 January 30, 2017 January 31, 2017 February 1, 2017 February 2, 2017 February 3, 2017 February 4, 2017