Significantly Fewer Pregnant Women Take Antidepressants

Pregnancy Despite years of critical focus on the side effects of antidepressants in healthcare, the consumption of antidepressants by pregnant women actually increased dramatically in the period 1997 to 2011.

A new study conducted by the National Center for Register-based Research and the Department of Clinical Medicine at Aarhus University now shows a significant decrease in antidepressant use in pregnant women - with consumption down more than 33 percent since 2011 The decline in the use of ADs after 2011 was mainly due to a decrease in the prescription of serotonin reuptake inhibitors (SSRIs) and in particular citalopram, the main type of SSRI used in Denmark, explains Postdoc Julie Wehrenberg Dreier from the National Center for Register-based research at Aarhus University.

“Research from Denmark and other countries has shown a striking increase in the use of antidepressants over the past two decades. Now for the first time, we can see a significant decrease in the use of antidepressants by pregnant women, ”says Julie Wehrenberg Dreier. She is behind the study along with Yuelian Sun, the lead author of this study and an associate professor in the Department of Clinical Medicine at Aarhus University, and Jakob Christensen, a clinical associate professor in the Department of Clinical Medicine at Aarhus University and consultant at the Neurology Department of Aarhus University Hospital.

Both emphasize that it is important to find an explanation for the sharp decline. The study found that the age of pregnant women and psychiatric disorders of pregnant women are unlikely to explain the declining trend of antidepressant use during pregnancy. In August 2011, the U.S. Food and Drug Administration issued a safety warning regarding high doses of citalopram on the heart, which could provide a possible explanation. However, more research is needed to confirm the association.

Jakob Christensen points out that additional research needs to be done by looking at the health of pregnant women - especially when it comes to psychiatric health, which can include symptoms that are difficult to distinguish.

There is no question about the value since 2011 because antidepressants are only available from pharmacies with a prescription and the value is so important that it is more than relevant to take a closer look at whether pregnant women with depressive symptoms are getting the right treatment, and in this way prevent the effects of depression in the best possible way. ”

The registry-based research is based on 1.2 million pregnancies in the period from 1997 to 2016. Of these, nearly 30,000 women (2.4 percent) collected at least one prescription for antidepressants during pregnancy. When consumption was highest in 2011, nearly one in twenty pregnant women collected prescriptions for antidepressants.

Jakob Christensen is also a clinical pharmacologist who has spent several years researching the effects of drug treatment during pregnancy. He says:

“In general, the use of antidepressants during pregnancy is considered safe, but questions have been raised about a slightly increased risk of congenital malformations and psychiatric symptoms in children where the mother took antidepressants during pregnancy. It is normal to assume that some women chose not to take the drug because they were concerned that the child could be harmed, ”says Jakob Christensen. But he points out that choosing not to take the drug isn't always the best option.

Julian Sun adds:

However, no episodes had occurred around 2011 that caused changes in concerns about the safety of unborn babies. In contrast, concerns about the safety of citalopram in pregnant women from doctors could also lead to a decrease in antidepressant use in pregnant women. ”

Depression in pregnant women is not uncommon and the depression can persist and worsen after delivery. This has been well documented in previous studies, says Jakob Christensen.

This risk for the child must then be weighed against the risk of depression in the mother. Untreated depression can have major consequences for both the mother and the newborn, for example by not blooming properly or in the worst case in the form of suicidal thoughts, ”he says.