229983 Antidepressants in Pregnancy: Messages to Women and Their Care Providers

Monday, November 8, 2010

Azar Mehrabadi, MSc , School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Background:

In 2004, the National Institute for Clinical Excellence in the United Kingdom recommended that selective serotonin reuptake inhibitors (SSRIs) not be used as the first line treatment for mild depression. Currently growing evidence questions the effectiveness of SSRI medication for the majority of depression cases encountered in clinical practice, from mild to moderate and even severe.

Objective:

The purpose of this review is to highlight key issues in the debate over SSRI use during pregnancy, with special emphasis on how evidence on effectiveness of SSRI use for the treatment of depression and risks associated with use during pregnancy are presented in peer-reviewed literature.

Methods:

Medline and Embase will be searched for MESH headings pregnancy and SSRI from 2005 to 2010. Key issues in the controversy over SSRI use during pregnancy will be described. Characteristics of articles that are cited disproportionally will be described with regard to 1) assumed benefits of SSRI use during pregnancy and 2) recommended best practices regarding discontinuation of SSRIs during pregnancy.

Conclusion:

Debate continues regarding best practices with regards to SSRI use in general, and in particular in pregnancy, where there are risks of neonatal complications. Women and their care providers may receive a distorted risk-benefit assessment of SSRI use during pregnancy through the often assumed benefit of SSRI use for pregnant women. Messages about prescribing are complicated by the fact that many women become pregnant already using SSRIs and best practice for discontinuation remain controversial.

Learning Areas:
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe key issues in the controversy over SSRI use during pregnancy.

Keywords: Maternal Care, Pakistan

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Azar Mehrabadi is responsible for conducting this literature review and has written this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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