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Use of antidepressants by pregnant women: Evaluation of perception of risk, efficacy of evidence based counseling and determinants of decision making

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Background: The World Health Organization predicts that by 2012, depression will be the number one disease in the world. Thus, many women who become pregnant will require treatment with antidepressants. We are aware that women and their health care providers remain hesitant to prescribe and take these drugs during pregnancy, despite evidence of the relative safety.

Objectives: 1) To determine perception of risk of antidepressant drugs by pregnant women with depression, 2) to determine the efficacy of evidence-based counseling, and 3) to identify determinants that influence women in their decision making regarding the continuation/discontinuation of antidepressants during pregnancy.

Methods: Women who called The Motherisk Program requesting information about the safety of an antidepressant during pregnancy were compared with two other groups: 1) Women who called about antibiotic use (i.e., non-teratogenic drugs used short-term) and 2) women who called about gastric medications (i.e., non-teratogenic drugs used long-term). Their perception of risk was measured before and after evidenced-based information was given and determinants of decision making was also evaluated.

Results: We recruited 100 women taking antidepressants during pregnancy and 100 in each comparison group. Despite receiving evidence-based reassuring information, 15% of antidepressant users, compared to 4% using gastric drugs and 1% using antibiotics, chose to discontinue their medication. The main determinants of decision making were based on: information received prior to calling Motherisk, family and friends advice, the internet, sequence of advice given and if a women was undecided at the time of call.

Conclusions: Women continue to fear taking antidepressants during pregnancy, more so than non psychiatric drugs, however, evidence based counseling can lower this fear, although not totally. Deciding whether to continue to take a medication or not during pregnancy, is a complex decision for women and their healthcare providers to make.

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  • M Bosquet B Egeland (2001) ArticleTitleAssociations among maternal depressive symptomatology, state of mind and parent and child behaviors: implications for attachment-based interventions. Attach Hum Dev 3 173–199 Occurrence Handle11708736

    PubMed  Google Scholar 

  • CD Chambers KA Johnson LM Dick RJ Felix KL Jones (1996) ArticleTitleBirth outcomes in pregnant women taking fluoxetine. N Engl J Med 335 1010–1015 Occurrence Handle10.1056/NEJM199610033351402 Occurrence Handle8793924

    Article  PubMed  Google Scholar 

  • TK Chung TK Lau AS Yip HF Chiu DT Lee (2001) ArticleTitleAntepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 63 830–834 Occurrence Handle11573032

    PubMed  Google Scholar 

  • A Einarson B Fatoye M Sarkar L Lavigne J Brochu C Chambers P Mastroiacovo A Addis D Matsui L Schuler T Einarson G Koren (2001a) ArticleTitlePregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. Am J Psychiatry 158 1728–1730 Occurrence Handle10.1176/appi.ajp.158.10.1728

    Article  Google Scholar 

  • A Einarson P Selby G Koren (2001b) ArticleTitleAbrupt discontinuation of psychotropic drugs due to fears of teratogenic risk and the impact of counseling. J Psychiatry Neurosci 26 44–48

    Google Scholar 

  • A Einarson L Bonari S Voyer-Lavigne A Addis D Matsui Y Johnson G Koren (2003) ArticleTitleA multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Can J Psychiatry 48 106–110 Occurrence Handle12655908

    PubMed  Google Scholar 

  • N Kulin A Pastuszak S Sage B Schick-Boschetto G Spivey M Feldkamp et al. (1998) ArticleTitlePregnancy outcome following maternal use of the new serotonin reuptake inhibitors: a prospective multicentre study. JAMA 279 609–610 Occurrence Handle10.1001/jama.279.8.609 Occurrence Handle9486756

    Article  PubMed  Google Scholar 

  • T Kurki V Hiilesmaa R Raitasalo H Mattila O Ylikorkala (2000) ArticleTitleDepression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol 95 487–490 Occurrence Handle10.1016/S0029-7844(99)00602-X Occurrence Handle10725477

    Article  PubMed  Google Scholar 

  • SM Marcus HA Flynn FC Blow KL Barry (2003) ArticleTitleDepressive symptoms among pregnant women screened in obstetric settings. J Women’s Health 12 IssueID4 373–380 Occurrence Handle10.1089/154099903765448880

    Article  Google Scholar 

  • TJ Mathews F Menacker MF MacDorman (2003) ArticleTitleInfant mortality statistics from the 2001 period linked birth/infant death data set. Nat Vital Stat Rep 52 IssueID2, SE 15 1–28

    Google Scholar 

  • PR McElhatton H Garbis E Elefant T Vial B Bellemin P Mastroiacovo et al. (1996) ArticleTitleThe outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants: A collaborative study of the European Network of Teratology Information Services (ENTIS). Reprod Toxicol 10 285–294 Occurrence Handle10.1016/0890-6238(96)00057-3 Occurrence Handle8829251

    Article  PubMed  Google Scholar 

  • I Nulman J Rovet DE Stewart J Wolpin HA Gardener J Theis et al. (1997) ArticleTitleNeurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 336 258–262 Occurrence Handle10.1056/NEJM199701233360404 Occurrence Handle8995088

    Article  PubMed  Google Scholar 

  • ST Orr CA Miller (1995) ArticleTitleMaternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings. Epidemiol Rev 17 165–171 Occurrence Handle8521934

    PubMed  Google Scholar 

  • A Pastuszak B Schick-Boschetto C Zuber M Feldkamp M Pinelli A Donnenfeld M McCormak M Leen-Mitchell C Woodland A Gardner M Hom G Koren (1993) ArticleTitlePregnancy outcome following first trimester exposure to fluoxetine. JAMA 269 2246–2248 Occurrence Handle10.1001/jama.269.17.2246 Occurrence Handle8474204

    Article  PubMed  Google Scholar 

  • B Zuckerman H Amaro H Bauchner H Cabral (1989) ArticleTitleDepressive symptoms during pregnancy: relationship to poor health behaviors. Am J Obstet Gynecol 160 IssueID5 Pt 1 1107–1111 Occurrence Handle2729387

    PubMed  Google Scholar 

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Bonari, L., Koren, G., Einarson, T. et al. Use of antidepressants by pregnant women: Evaluation of perception of risk, efficacy of evidence based counseling and determinants of decision making. Arch Womens Ment Health 8, 214–220 (2005).

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