To date, the literature on the safety of antidepressants during pregnancy has yielded conflicting results that can be difficult to apply toward practical clinical recommendations.

As elegantly click here stated by Rubinow in his 2006 American Journal of Psychiatry editorial on antidepressant treatment of pregnant women, “our therapeutic confusion derives in part from the requirement to calculate risk profiles for two individuals (mother and infant), involving multiple predictors and outcomes.”72 Unfortunately, Inhibitors,research,lifescience,medical calculation of risk based on high-quality studies is challenging because research focused on women during pregnancy or postpartum (and during lactation) present substantial ethical and practical challenges for the investigator, thus compromising the rapid accumulation of reliable data.73 However, despite the absence of a large evidence base to guide treatment recommendations, the clinician Inhibitors,research,lifescience,medical must carefully discuss treatment options with the woman suffering from perinatal depression so that an understanding of the riskbenefit ratio of treatment versus no treatment is achieved. Accordingly, the decision to use antidepressant medication during Inhibitors,research,lifescience,medical pregnancy or lactation must be weighed against the risks of untreated

maternal depression and this risk:benefit ratio must be carefully discussed and tailored to the individual needs with each patient. A recent and helpful development in the creation of evidence-based practice guidelines for perinatal depression was the 2009 publication by Yonkers et al: a joint report on the management of depression during pregnancy endorsed by the American Psychiatric Association (APA) and the American College of Obstetricians and Gynecologists Inhibitors,research,lifescience,medical (ACOG) and published simultaneously in both General Hospital Psychiatry and Obstetrics and Gyencology. 74,75 This report

represents the first time that the APA and ACOG have collaborated to create practice guidelines for clinicians, and as such, signifies a significant Inhibitors,research,lifescience,medical contribution to the field. The report states that both MDD and antidepressant exposure are associated with fetal growth changes and shorter gestations, and that the current literature was unable to control for the possible effects of a depressive disorder in women and their infants exposed of to an antidepressant during pregnancy (thus complicating interpretation of the risks associated with antidepressant use during pregnancy).75 Weighing risks and benefits of antidepressants during pregnancy There are significant risks associated with exposure to untreated depression during pregnancy that are associated with serious adverse consequences for the developing neonate, such as premature birth, low birth weight, and future behavioral disturbances.76,77 Studies have shown that terminating antidepressant treatment in pregnancy in women with a previous history of depression leads to relapse of symptoms in as many as 60% to 70% of women.