Resources  email page print page Basic Information Introduction and Types of Depression Major Depression and other Unipolar DepressionsClassic Symptoms of Major DepressionUnderstanding Mood Episodes in DepressionThe Course of Major DepressionDSM Specifiers for Major DepressionPrevalenceFormal DSM Diagnoses for Other Depressive Mood DisordersSymptoms - Dysthymic DisorderFormal DSM Diagnoses Continued Related Disorders / Conditions Other Conditions Related to DepressionMajor Depression Related Conditions ContinuedMajor Depression Related Conditions ConclusionThe Far Reaches of Depression Historical and Current Understandings Historical Understandings of DepressionHistorical Understandings of Depression ContinuedCurrent Understandings of Major Depression - Biopsychosocial ModelCurrent Understandings of Major Depression - Diathesis-Stress Model Biology, Psychology and Sociology Biology of Depression - NeurotransmittersBiology of Depression - Neuroplasticity and EndocrinologyBiology of Depression - Genetics and ImagingBiology of Depression - PsychoneuroimmunologyPsychology of Depression- Psychodynamic TheoriesPsychology of Depression- Behavioral TheoriesCognitive Theories of Major Depression - Aaron BeckCognitive Theories of Major Depression - Ellis and BanduraCognitive Theories of Major Depression - SeligmanSociology of Depression - Effects of CultureSocial and Relational Factors in Major DepressionLifestyle Factors and Environmental Causes of Major Depression Treatment - Medication and Psychotherapy Treatment: When to Seek Professional Help and Where to Find Help for Major DepressionMeasuring DepressionClinician-Rated and Self-Report Questionnaires/Tests for Major DepressionModes of TreatmentMedications for Major DepressionAntidepressants for Major Depression - SSRIsAntidepressants for Major Depression - SSNIsAntidepressants for Major Depression - With Children, TCAs, and MAOIsMood Stabilizers for Major DepressionNon-pharmaceutical Medical Therapies for Major DepressionPsychotherapy - Evidence-Based Treatments for Major DepressionCognitive Behavioral Therapy for Major DepressionCognitive Behavioral Therapy for Major Depression ContinuedInterpersonal Therapy for Major DepressionOther Forms of Psychotherapy for Major Depression - Behavior TherapyOther Forms of Psychotherapy for Major Depression - Psychodynamic TherapyOther Forms of Psychotherapy for Major Depression - Group, Family and Couples Therapy Alternative Medicine and Self-Help Resources Complementary and Alternative Treatments for Major DepressionMajor Depression and St. John's WortMajor Depression and ExerciseMajor Depression and Omega 3 Fatty AcidsMajor Depression Serotonin Precursors: SAMeMajor Depression Serotonin Precursors: 5-HTPLess Well-Studied CAM Remedies For Depression - B-Vitamins and Traditional Chinese MedicineLess Well-Studied CAM Remedies For Depression - Ayurveda and HomeopathySelf-Help Methods for Major Depression Community and On-line Self-Help Resources for Major Depression Depression Reading List Special Issues Further Observations Regarding Major Depression Treatment and Special Issues - SuicideSpecial Issues - Severe Depression, Dual Depression and Dual Diagnosis References Depression Article References More Information Aging and DepressionAntidepressants No Better Than Placebo Says A New Study, But It's Really More Complicated Than That... Blunt InstrumentsBrain Neuroplasticity and Treatment Resistant DepressionComing Out of the Depression ClosetCosmo Magic to Cyclothymic: Highs, Lows and States of FlowDepression and CancerDepression and DiabetesDepression and Heart DiseaseDepression and HIV/AIDSDepression and ParkinsonsDepression and StrokeDepression and WomenDepression, ADHD, Psychotherapy and MedicationDysthymic Disorder SymptomsElliott Smith and the gift of Vulnerability MusicFeeling Good, It's Not Just In the BrainGoing Postal: The Road to Depression and SalvationGuest Editorial: Celeb Feud Brought Up Critical IssuesHelping Children Understand and Cope with Parental DepressionListening to Readers on Prozac, Depression & the Medical System: Part IListening to Readers on Prozac, Depression & the Medical System: Part IIMajor Depression SymptomsMen and DepressionNational Depression Screening Day, Thursday October 8, 2009Older Adults: Depression and Suicide FactsOrganizationsPost Partum Depression and The Importance of SleepReader Feedback on the Depression SeriesRunning On FiftySt. John's Wort FAQStudents and College, A Stressful Time of Life: Parents and Students BewareSymptoms of Depressive DisordersThe Biochemical - Psychosexual Revolution: Getting Up and Close while Being Down and OutThe Existential Crisis, Depression, Anxiety and MortalityThe Liberating and Entangling Webs of Technology, Depression and ProzacThe Long Term Effects of BullyingTop Twelve Tips for Beating (Mostly) Moderate Chronic Clinical DepressionTreatmentTreatment 1 of 2Treatment 2 of 2Unmasking Mental IllnessWebsitesWhat about the "milder" depression: Dysthymic disorder?Why People Might Use Anxiety to Avoid Depression: Part 2Why People Might Use Anxiety to Avoid Depression: What We Can Learn From a Wartime ExperienceWise Counsel Interview Transcript: An Interview with James Gordon MD on Mind Body Medicine and His Book 'Unstuck'Wise Counsel Interview Transcript: An Interview with with Ronald Dworkin, MD, Ph.D. on Artificial Happiness Tests Goldberg Depression Questionnaire Latest News Phone Care Can Help Combat Post-Heart Surgery DepressionClinical Trials Update: Nov. 16, 2009Depression Linked to Immune Response in PregnancyClinical Trials Update: Nov. 12, 2009Health Tip: Symptoms of Postpartum DepressionBrain Stimulation May Ease Treatment-Resistant DepressionClinical Trials Update: Nov. 9, 2009Adjunctive Psychotherapy for Depression StudiedDepression May Blur Memory of Aches and PainsCognitive Behavioral Therapy Helps Overcome Winter BluesPsychotherapy Beats Light Treatment for SADPhone Counseling for Depression Rings With PromiseDepression Often Goes Untreated in Working MomsConstant Light Linked to Symptoms of DepressionOmega-3 Augmentation of Antidepressant EvaluatedSuicidal Thoughts May Vary by AntidepressantImpact of Maternal Depression and Abuse on Children StudiedRecession Adds to Ranks of Americans With DepressionDepression, Anxiety May Raise Odds of ObesityTelephone Care and Therapy Help to Treat DepressionMother's Use of Antidepressant May Carry Risks for NewbornTroubled Minds Can Mean Wider WaistlinesTeens With ADHD, Depression Risk Internet AddictionAntidepressants May Be Linked to Birth ProblemsMediterranean Diet May Help Prevent DepressionAntidepressants Linked to Heart Defects in NewbornsPredicting Postpartum Depression May Be PossibleDrinking, Weight, Depression Linked in Young Women: StudyHealth Care Assistants May Be Useful in Depression CareDepression May Hasten Cancer DeathStudies Explore Genetic Factors Underlying DepressionSevere, Lasting Depression Tied to Heart Patient DeathsDepressed Teens Continue to Suffer into AdulthoodReport Addresses Depression Management in PregnancyDepression's Effect on Pleasure Is RealForeclosures Plunge People Into DepressionSuicide Risk With Antidepressants Falls With AgeCombo Treatment May Ease Depression After StrokeAntidepressant Use in U.S. Has Almost DoubledCan Children Headed for Teen Depression Be Spotted Early?Primary Care Identification of Depression ExaminedGloomy Days Dim Cognitive Powers of the DepressedDepression Poses Pregnancy RisksDepression, Anxiety Bad for the HeartStudy Refutes Depression Gene FindingDrug May Stem Slide Into Alzheimer's for SomeEffects of Depression on Families Need to Be AddressedIf Mom or Dad Is Depressed, Kids Need Help TooEarly Bedtime May Help Stave Off Teen DepressionNew Program May Help Teens at High Risk for Depression Questions and Answers Help Me Please. What is Going On With Me?I'm Afraid I'm Going CrazyI Don't Know What To DoAm I Wallowing in Depression?AngerSexual Abuse and Its Effects on Relationships AfterwardsWhat Is Wrong with Me, Doc? HelpDBSAm I Suffering a Kind of Psychological Problem? Blog Entries Depression, ADHD, Psychotherapy and MedicationKeeping You Sane: Do You Need a Day Out? Exploring the Upside of ADHDHow to Gain Control of Your Mind, Instead of Your Mind Controlling YouWhat You Need to Know about H1N1 and DepressionMindfulness and ADHD: A Tip from Dr. Lidia ZylowskaFreedom from Your Anxious MindThe Existential Crisis, Depression, Anxiety and MortalityADHD - Breaking the Cycle of ShameFeeling Good, It's Not Just In the BrainAre You Wired to Worry? Children, ADHD and Stimulant MedicationNational Depression Screening Day, Thursday October 8, 2009Mental Health: Our Troubled TeenagersDepression and Its MeaningsTeenage Depression and Consequences5 Steps to Emotional Freedom: Placebo or Panacea?Couples Therapy for Robert and Julia (Romeo and Juliet)New Research: Mindfulness-Based Program as Effective as Antidepressant MedicationAnxiety as a Defense Against Depression: Part 7Students and College, A Stressful Time of Life: Parents and Students BewareAnxiety as a Defense Against Depression: Part 6Brain Neuroplasticity and Treatment Resistant DepressionWhy People Might Use Anxiety to Avoid Depression: Part 5Feeling Stuck? 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THURSDAY, Sept. 24 (HealthDay News) -- Women who take certain antidepressants during the first three months of pregnancy may have a slightly increased risk of giving birth to babies with heart defects.

Septal heart defects -- malformations in the wall separating the right side of the heart from the left -- were more common among women taking antidepressants in the first trimester, Danish researchers found. Some of these heart defects resolve on their own, while others require surgery.

The risks were seen in sertraline (trade names Zoloft and Lustral) and in citalopram (Celexa), both of which belong to the class of medications known as selective serotonin reuptake inhibitors (SSRIs).

Women who took more than one SSRI early in their pregnancy had a fourfold higher risk of having babies with this problem, said the authors of a study appearing online Sept. 24 in BMJ.

Still, the authors said the absolute risk is relatively low: 246 women would have to take such medication in order to see one septal heart defect. And 62 mothers would have to take more than one SSRI to see a problem in one child.

"A potential association with malformations must be considered in the choice of treatment of depression during pregnancy," said Dr. Lars Henning Pedersen, lead author and a research assistant in the department of epidemiology at Aarhus University in Denmark. However, "if our data is correct, the absolute risk is low, which must be balanced against the potential substantial risk of under- or untreated depression during pregnancy."

Other experts agree. "Early exposure can slightly increase the risk of heart defects, but the overall risk is still very, very small," added Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City.

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And discontinuing antidepressants also carries risks.

"The concern with pregnant women with depression, if you take them off their medication, they can have a relapse into severe depression and this could lead to self-destructive behaviors," Wu said.

Previous studies have found that pregnant women who stopped taking their antidepressant medications were five times more likely to relapse than women who continued with the medication.

In the United States, 13 percent of women have taken an antidepressant while pregnant, according to an accompanying editorial.

Recent research has indicated a higher risk of various defects, including heart defects, among pregnant women taking antidepressants, and the U.S. Food and Drug Administration and the American College of Obstetricians and Gynecologists (ACOG) have issued warnings about possible birth defects associated with the use of the SSRI Paxil (paroxetine) by moms-to-be.

But existing studies have yielded conflicting results about dangers associated with specific drugs.

These researchers looked at almost 500,000 children born in Denmark between 1996 and 2003, a time when the number of pregnant women taking antidepressants quadrupled.

Although no overall association was found in this study between mothers taking SSRIs during the first trimester and birth defects in general, there was a doubling in the risk for septal heart defects for women using Zoloft and Celexa, but not Prozac (fluoxetine) or Paxil.

Pedersen recommended more and larger studies to explore the matter.

In August, the American Psychiatric Association in collaboration with ACOG recommended that women with major depression who are pregnant or planning to get pregnant can start or continue with antidepressant drugs, while women who choose to stop taking the drugs should consider psychotherapy.

"Ideally, you'd want to work closely with a psychiatrist and ob/gyn when planning a pregnancy," Wu said. "When you are suddenly pregnant, there's a lot of anxiety involved and other hormones, so it's probably not a good time at that point to try to go off medications, and it certainly should be supervised."

Patients who are relatively stable, on the other hand, could consider going off their medications for the first trimester, knowing that it will take four-to-six weeks for the drug effect to wear off and also knowing that the medications would be resumed at the first sign of a relapse, Wu said.

More information

The National Women's Health Information Center has more on using antidepressants during pregnancy.

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