Note: This article updates a previous piece, posted 23/10/12 

A leading psychiatrist has said coming off antidepressants suddenly or leaving mental illness untreated during pregnancy holds significant risks for mother and child.

Speaking at a press briefing last month [24 Oct] Prof Louise Howard, head of women's mental health at the Institute of Psychiatry, King's College London said "it is best that contraindicated drugs are avoided in women of reproductive age in general - because [a large amount of] pregnancies are unplanned."

However she stressed the risks were minimal and added: "The risks of taking most antidepressants are very, very small, and only a small number of treatments for severe mental health problems are known to cause significant side effects.

"Clinicians are careful to give women information to weigh up the risks of the illness against the risk and benefits of treatments. The thing to weigh up is the risks and benefits of drugs - it's not just a matter of thinking about the risks to the foetus but it is also about the risks of not treating because of the impact of the illness.

"Obviously, if we don't have to use medication we'd rather not - it's sensible not to expose a foetus to medication if you don't need to. For mild to moderate illnesses, psychological therapies are available and they would be first line. But for more severe illnesses or if there is a history of a severe illness they often will want to be thinking about medication."

New research continues to come out showing the risks of taking most antidepressants are very small while drugs associated with significant problems are not antidepressants but medication for rarer mental health disorders, some of which are known to cause side effects during pregnancy such as Sodium Valporene.

Prof Howard concluded: "Contrary to popular belief, being pregnant doesn't protect against mental illness: mental illness can develop at any time. Indeed, women with a history of bipolar disorder are at an increased risk postnatally.

"Evidence for giving women any type of medication during pregnancy is limited, and more research is needed. But, for now we go on what we know and for each woman, we need to carefully weigh up the risks of taking medication with the risks of the illness, all the time respecting her individual wishes.

"We would all like to see into the future but in practice 50% of pregnancies are unplanned, so it is sensible for a woman of child-bearing age who is on antidepressants to discuss the risks, and also benefits of treatment, with their doctor."

Posted 07/11/2012 by richard.hook@pavpub.com