Cautious use of SSRIs during pregnancy may be preferable to medication discontinuation, new beyondblue guidelines suggest.
However, the risks and benefits should ultimately be discussed on a case-by-case basis, according to new NHMRC-endorsed guidelines launched by Minister for Mental Health and Ageing, Mark Butler, this week.
The recommendations note that there have been only limited studies into the efficacy of antidepressants in pregnancy, and some evidence indicates that maintaining rather than discontinuing medication reduces the chance of relapse.
However, preterm births and low birth weights have been linked to use of antidepressants such as SSRIs as well as benzodiazapines and antipsychotics.
“While there are risks associated with the use of psychotropic medications in this period, it should not be assumed that it is always better to avoid medication,” the guideline authors say.
The use of antidepressants during the perinatal period also needs to be weighed against minimal possible exposure to the infant during breastfeeding, the guidelines say.
Other recommendations from the "Clinical Practice Guidelines for Depression and Related Disorders – Anxiety, Bipolar and Puerperal Psychosis – in the Perinatal Period" include routine assessment of emotional health and wellbeing during both pregnancy and the following year as part of GP management. They also recommend that women with perinatal depression have access to CBT and other non-drug therapies.
