gynecology and obstetrics
Drug Safety in Pregnancy
Antidepressants During Pregnancy
 Medications for Treatment of Depression , particularly selective serotonin reuptake inhibitors (SSRIs), are commonly used during pregnancy because the prevalence of clinical depression during pregnancy is high (7 to 12% in one review) ( Pregnant women who are taking antidepressants should be asked about depressive symptoms at each prenatal visit, and appropriate fetal testing should be done. It may include the following: A detailed evaluation of fetal anatomy during the second trimester If a pregnant woman takesparoxetine, echocardiography to evaluate the fetus's heart because in some studies,paroxetineappeared to increase the risk of congenital cardiac anomalies To reduce the risk of withdrawal symptoms in the neonate, clinicians should consider tapering the dose of all antidepressants to the lowest effective dose during the third trimester. However, the benefits of tapering must be carefully balanced against the risk of symptom recurrence and postpartum depression. Postpartum Depression is common, often unrecognized, and should be treated promptly. Periodic visits with a psychiatrist and/or social workers may be helpful. 