Treatment of nonpsychotic major depression during pregnancy: Patient safety and challenges

Richard A. Epstein, Katherine M. Moore, William V. Bobo

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

In pregnant women with major depression, the overarching goal of treatment is to achieve or maintain maternal euthymia, thus limiting both maternal and fetal exposure to the harmful effects of untreated or incompletely treated depression. However, the absence of uniformly effective therapies with guaranteed obstetric and fetal safety makes the treatment of major depression during pregnancy among the most formidable of clinical challenges. Clinicians and patients are still faced with conflicting data and expert opinion regarding the reproductive safety of antidepressants in pregnancy, as well as large gaps in our understanding of the effectiveness of most antidepressants and nonpharmacological alternatives for treating antenatal depression. In this paper, we provide a clinically focused review of the available information on potential maternal and fetal risks of untreated maternal depression during pregnancy, the effectiveness of interventions for maternal depression during pregnancy, and potential obstetric, fetal, and neonatal risks associated with antenatal antidepressant use.

Original languageEnglish (US)
Pages (from-to)109-129
Number of pages21
JournalDrug, Healthcare and Patient Safety
Volume6
DOIs
StatePublished - Sep 18 2014

Keywords

  • Antidepressants
  • Depression
  • Major depressive disorder
  • Pregnancy
  • Safety

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

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