Beware of Using Psychotropics During Pregnancy

Andrea Donsky and Randy Boyer

Taking medication during pregnancy can be a difficult road to navigate. What's good for you isn't always good for your baby, and what's good for your baby isn't always good for you. Case in point: A new study suggests expectant mothers who continue to take antidepressants, antipsychotics, sedatives or hypnotics during pregnancy may be increasing their child's risk of a number of birth defects.

Researchers of the University of Copenhagen's Faculty of Pharmaceutical Studies examined data from the national Danish adverse drug reaction database, focusing on adverse drug reactions among children from birth to age 17. In total, 429 adverse drug reactions related to psychotropics were reported in children from 1998 and 2007, and of these, 70 were among children less than a year old.

In seven cases, reports directly correlated psychotropic drug exposure during pregnancy with depressed respiratory function, apnea, pallor and other reactions in infants. In all but one of the cases involving children up to two years of age, the reactions were serious and included convulsion, feeding disorder, apnoea, and heart defects. Two cases, involving the antidepressants citalopram and fluoxetin, were fatal.

"A range of serious side effects, such as birth deformities, low birth weight, premature birth, and development of neonatal withdrawal syndrome were reported in children under two years of age, most likely because of the mother's intake of psychotropic medication during pregnancy," says associate professor Lisa Aagaard, one of the lead researchers of the study.

The Mayo Clinic cautions pregnant women from using specific antidepressants during pregnancy, including paroxetine (Paxil) and the MAOIs Nardil and Parnate. They also list potential side effects of other antidepressants, and recommend carefully weighing the risks of both continuing and discontinuing medication use.

If nothing else, researchers say, this new study indicates further research and better resources for expectant mothers are needed. "We are constantly reminded about the dangers of alcohol use and smoking during pregnancy, but there is no information offered to women with regards to use of psychotropic medication. There is simply not enough knowledge available in this area," says Aagaard.

While some mental health issues must be treated with medications, there are ways to help support your mental health, particularly if you have mild depression.

Studies have found that people suffering from depression have low levels of serotonin degradation byproduct in their blood, indicating serotonin production is decreased in depressed people. The amino acid tryptophan is a precursor to serotonin, so increasing tryptophan levels may help manage depression. Combining tryptophan-rich foods such as meat, fish and soybeans with carbohydrates will help tryptophan enter the brain, where serotonin is produced. Try a turkey sandwich, cheese and whole-grain crackers, or soybeans and wild rice. Another factor to consider is your vitamin B6 levels, since the vitamin helps convert tryptophan into serotonin.

Folic acid also plays a role in mood and cognitive function. Pregnant women are advised to take folate in order to prevent a variety of birth defects, including spina bifida, developmental delay, and behavioral or psychiatric symptoms. As a side benefit, the folate you take to keep your baby healthy may help reduce your symptoms of depression.

Magnesium may also play a role in mood and depression. Studies have shown depression patients often have low magnesium levels, and one study showed significant increases in magnesium levels after recovery. Swiss chard and spinach are both high in magnesium, but salmon, halibut, raw pumpkin seeds, and soybeans are also good sources of the mineral.

Vitamin D deficiency has also been linked to depression. Getting vitamin D is as simple as spending a little time in the sun each day. Take a walk around your office building on your break. Sit outside at lunch. About 10 minutes each day will give you plenty of vitamin D, which will help boost your mood.

While natural support for depression and other mental health issues is worth considering, it may not be effective for everyone. If you are pregnant or many become pregnant and have been prescribed a psychotropic drug, talk to your doctor about the best way to support your mental health and your baby's needs.

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