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Balancing Positive and Negative Effects of Antidepressants During Pregnancy

Summary and Comment |
June 11, 2012

Balancing Positive and Negative Effects of Antidepressants During Pregnancy

  1. Barbara Geller, MD

Auditory sensory gating was impaired in infants whose mothers had prenatal anxiety but not in those whose mothers used antidepressants during pregnancy.

  1. Barbara Geller, MD

Maternal antidepressant (AD) use occurs during at least 8% of pregnancies in the U.S. and has been associated with psychopathology in offspring (e.g., autism; JW Psychiatry Aug 29 2011). In this study, researchers assessed the effects of maternal anxiety and AD use during pregnancy on infant auditory sensory gating, a measure of attentional function. Electroencephalographic responses to sequentially paired clicks were recorded, and response amplitudes to the first and second stimuli were measured (in normal gating, the second stimulus elicits a lower-amplitude response).

The participants were 242 mother–infant pairs (mean infant age, 76 days). Fourteen mothers had current or past anxiety disorders and used ADs while pregnant, 13 had no histories of anxiety but used ADs during pregnancy, 46 had anxiety but did not use ADs during pregnancy, and 169 had no anxiety and no AD use.

Infants of mothers who used ADs had sensory gating within the normal range, whereas infants of mothers with anxiety disorders but no AD use had impaired gating: Responses to second stimuli were not as diminished. Findings in treated women with anxiety disorders did not remain significant after controlling for multiple comparisons. Exploratory analyses suggested that postnatal AD use was not a significant variable.

Comment

Although the findings did not hold up to multiple comparisons, they are salient because sensory gating defects are associated with multiple major psychopathologies (e.g., JW Psychiatry Oct 29 2007). Thus, these preliminary data warrant consideration when making decisions aimed at balancing risks and benefits in treatment of anxiety disorders in pregnant women. Future sensory gating studies that control for treatment with nonpharmacologic interventions, such as cognitive-behavioral therapy, will be especially useful.

Citation(s):

Reader Comments (1)

Leslie A Batten

There are options available to us that are worth trying, such as saffron tincture and essential oil of lavender (encapsulated). Saffron works like an SSRI; lavender as a benzodiazepine. For patients with mild to moderate anxiety and mild to moderate depression, they are very effective, without side effects, and without harm to the fetus.

Competing interests: None declared

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