Antidepressant Use in Early Pregnancy

Since 1993 there have been numerous published reports on teratogenic risks of antidepressants. Most of the studies indicate that the risk of major malformations associated to the use of antidepressants in early pregnancy is not greater than the risk of major malformations in the general population without known risk factors. Few studies have shown a slight increase in the presence of malformations associated with the use of antidepressants, especially septal heart defects, as compared with general population. These data are not consistent enough, and are in contrast with most of other studies. In any case, if there were an increased risk of septal heart malformations, this would be very limited. Furthermore, an overestimated perception of risks would impede the needed treatment of mothers with psychiatric disorders requiring antidepressants. The risk of untreated moderate -severe psychiatric disorders is far more dangerous for the foetus and the mother than the possible increased risk of septal heart malformations. As with any medication, a careful and personalized evaluation of the treatment is required, but with the available data at hand, in most occasions the decision should incline towards adequate treatment of the psychiatric problems.