Reluctance to prescribe antidepressants during pregnancy could cause harm

Photo: Shutterstock
Photo: Shutterstock 

Doctors' reluctance to prescribe antidepressants to pregnant women could cause harm, a researcher says.

Brisbane-based obstetrician/gynaecologist and researcher Alka Kothari surveyed 550 GPs and gynaecologists from Australia and New Zealand last year and found most overestimated the risks of taking antidepressants and anti-anxiety medication during pregnancy.

Only a third were interested in mental health disorders in pregnancy and the majority (96 per cent) had not done any research on the topic in the last five years.

GPs were more confident and had more knowledge about mental health than gynaecologists.

Wellington mother and blogger Jess Bovey was on medication to treat her postnatal depression when she became pregnant with her second child.

"I was very anxious about having another baby."

She decided to reduce the dose with her GP and midwife's support but when she picked up her prescription, a pharmacist gave her a lecture.

"He said my baby could die. I sat in my car petrified and rang my midwife in tears."

Ms Bovey said she saw a lot of judgement on social media against pregnant mums taking medication .

Advertisement

"Some people think it is selfish but they have no idea what it's like to have depression."

She worried pregnant women did not feel comfortable talking about depression or anxiety with their GP or midwife.

"My advice is find a GP that you trust and go with what they are telling you."

Dr Kothari said many pregnant women quit taking antidepressants abruptly and without medical advice when they became pregnant, which could be "very dangerous".

The risks associated with depression and anxiety could be greater for mothers and their babies than the small risk of birth defects that may be associated with some antidepressants, she said.

The decision to continue or quit taking the medication should be made carefully, weighing the small risks to the baby against risks of suicide, psychosis, substance abuse and potential harm to the baby. 

The research on birth defect risks was contradictory and inconclusive, she said.

About one in five women suffer from perinatal anxiety and depression (PNAD).

Women needing antidepressants or anti-anxiety medication should ask their doctor which drugs would be safer to use if they planned to have children in the future, Dr Kothari said.

More research and education for doctors and midwives was needed to reduce the maternal mortality rate here and in Australia, she said.

She presented the survey at the Royal Australian and New Zealand College of Psychiatrists congress in Auckland this week.

PNAD FACTS

  • The year after having a baby, a woman is more at risk of becoming mentally unwell than at any other time in her life.
  • Depression, anxiety and psychosis can affect pregnant women and mums and dads for several years after the birth.
  • About 15 per cent of women and 10 per cent of men experience postnatal depression.
  • Risk factors include lack of social support, history of abuse or domestic violence and history of mental illness.

 
PNAD WARNING SIGNS
 
If someone experiences some of the following symptoms for at least two weeks, they could have PNAD:

  • Tearfulness
  • Lack of enjoyment, motivation and sex drive
  • Disruption in sleep and appetite
  • Wanting to die
  • Compulsive thoughts and actions
  • Panic attacks
  • Constant worry

If you are suffering from anxiety or depression, or know someone who might be, contact BeyondBlue.org.au (call 1300 224 636), LifeLine (call 13 11 14 or chat online after hours), or PANDA National Helpline (1300 726 306).

- Stuff NZ