Treatment for opioid use disorder before, during, and after pregnancy

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Antidepressants & Pregnancy: Tips from an Expert Managing Mood and Stress Fertility, Pregnancy and Childbirth Rare Pregnancy Complications Living with Depression

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Most pregnant women want to bởi everything right for their baby, including eating right, exercising regularly and getting good prenatal care. But if you’re one of the many women who have a mood disorder, you might also be trying lớn manage your psychiatric symptoms as you prepare lớn welcome your new baby.

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It’s common for doctors to lớn tell women with mood disorders to lớn stop taking drugs like antidepressants during pregnancy, leaving many moms-to-be conflicted about giving up the medications that help keep them healthy.

Lauren Osborne, M.D., assistant director of theJohns Hopkins Women’s Mood Disorders Center, talks about why stopping your medication may not be the right approach. She explains how women can — & should — balance their mental health needs with a healthy pregnancy.

Antidepressants & Pregnancy

Women who take antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), during pregnancy may worry about whether the medications can cause birth defects.

There is good news on this front. Osborne says that there is generally no need lớn taper off medications during pregnancy. “We can say with strong confidence that antidepressants don’t cause birth defects,” says Osborne. She adds that most studies finding a physical effect on babies from antidepressants taken during pregnancy fail to trương mục for the effects of the mother’s psychiatric illness.

In fact, untreated mental illness itself poses risks to lớn a developing fetus. A woman who is depressed is less likely khổng lồ get goodprenatal careand more likely khổng lồ engage in unhealthy or dangerous behaviors, lượt thích smoking và substance abuse. Osborne also says mental illness has direct effects on newborn babies.

“Untreated depression may increase preterm birth or cause low birth weight,” she says. “Babies of depressed moms have higher levels of a hooc môn called cortisol. This raises a baby’s risk of developingdepression, anxiety & behavioral disorders later in life.”

Weighing the Risks

While doctors don’t believe antidepressants cause birth defects, it’s still possible for them to affect the baby. It’s important for a mother and her doctor khổng lồ know the risks.

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About 30 percent of babies whose mothers take SSRIs will experience neonatal adaptation syndrome, which can cause increased jitteriness, irritability & respiratory distress (difficulty breathing), among other symptoms. Doctors aren’t sure whether this effect is due to lớn the baby’s withdrawal from the SSRI after birth or exposure khổng lồ the drug itself before birth.

“It may be distressing & cause pediatricians khổng lồ run tests, but it will go away,” says Osborne, pointing out that these symptoms also sometimes occur in babies whose mothers don’t take SSRIs.

Common medications women frequently ask about include:

Paroxetine: Early studies on a small number of patients connected the SSRI paroxetine with cardiac defects in babies. However, these studies didn’t tài khoản for smoking, obesity & other risk factors that are more common in women who have depression. Osborne says larger, more recent studies show no such liên kết with cardiac defects. She doesn’t recommend switching medications if paroxetine is the only one that works for you. Benzodiazepines: Women should avoid using tranquilizers, such as diazepam, alprazolam và clonazepam, in high doses during pregnancy because they can lead to sedation và respiratory distress in the newborn. You can still use them in small doses for short periods of time. However, Osborne will typically try to get mothers on intermediate-acting options like lorazepam. These medications don’t linger in the baby’s bloodstream like longer-acting forms and aren’t associated with high rates of abuse like shorter-acting forms.

Seeing a Reproductive Psychiatrist

If you have a mood disorder, you may benefit from speaking with a reproductive psychiatrist when you are pregnant or thinking about becoming pregnant. Ideally, this should happen when you are planning for pregnancy, although this isn’t always possible. Meeting with a doctor after you become pregnant is not too late.

Osborne says her approach with patients is lớn limit the number of potentially harmful exposures khổng lồ the baby. This means considering the number of medications a mother is on, as well as her psychiatric illness.

“If a woman takes a low dose of many medications and we have time lớn plan, we’ll try khổng lồ get that down lớn a higher dose of fewer medications,” she says. “If a woman is on a low dose và it’s not controlling her illness, then her baby is exposed khổng lồ both the medication và the illness. In that case, I would increase the medication dosage so her baby isn’t exposed to the illness.”

If your illness is mild, your doctor might recommend getting off medication & replacing it with treatments such as psychotherapy, prenatal yoga oracupunctureto improve your mood.

Ultimately, Osborne says women should weigh the risks of medication against the risk of untreated illness.

“If a particular side effect is extremely rare, it’s still a very rare event even if you double the risk,” she says. Medication risks are typically not greater than those of untreated mental illness. “Switching a woman’s medication is something I vì chưng very carefully và reluctantly.”