Pregnancy may not protect against depression

Hormonal changes during pregnancy do not protect women from depression, and those taking antidepressants may need to continue despite concerns about fetal damage, researchers said on Tuesday.

"We found that patients who stopped their antidepressant during pregnancy were five times more likely to have a return of depressive symptoms than those patients who had decided to continue (them) during pregnancy," said Lee Cohen, a doctor at Massachusetts General Hospital in Boston who led the research.

The relapse rate was about the same as it would be for nonpregnant women who cut back or stopped using their antidepressants, the report said.

The study looked at 201 pregnant women between 1999 and 2003 who had suffered from severe depression before conception and who kept taking their medicine or tried to eliminate or reduce it out of fear it might hurt the fetus.

Cohen said it appears that "pregnancy does not protect women against depression during pregnancy" through hormonal and other biological changes that occur.

The study, published in this week's Journal of the American Medical Association, said researchers have not found that antidepressants lead to major birth defects.

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But it said several recent reports have found a possible tie between some drugs and a heart malformation and some distress among newborns exposed in the womb.

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"The goal of the obstetrician and the psychiatrist is to use the safest drugs that are effective for the patient," said Jennifer Wu, an obstetrician at Lenox Hill Hospital in New York,

Instead of eliminating antidepressants during pregnancy, she said, "a better approach would be to reduce medications down to a single agent and to use the lowest effective dose possible."