SSRIs in the Childbearing Years: A Case for Support
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Dr. Tara Whiton, PhD is a Sport Physiologist, NSCA Certified Strength and Conditioning Specialist and researcher on women’s health issues. Her latest research has centered around prescription medications for mood and anxiety disorders in women of childbearing age (pregnant or non-pregnant).
Dr. Tara Whiton, Assistant Professor in the Sport and Exercise Science Department, recently traveled to the Northeast American College of Sports Medicine Conference held in Springfield, MA, to give a tutorial lecture on “Supporting SSRI Usage in Pregnant Women”. SSRI stands for Selective-Serotonin Reuptake Inhibitors and is the most common class of prescription medications for mood and anxiety disorders, and in this case specifically, the most common medications prescribed for women of childbearing age (pregnant or non-pregnant).
Dr. Whiton gave this lecture to advocate for pharmacological mental health treatment in women of childbearing age in cases where non-pharmacologic treatments are not effective. Some examples of non-pharmacological treatments for depressive mood and anxiety disorders are stress reduction, physical activity, nutrition, sleep, mental health counseling, and other lifestyle approaches. In some cases, people need more than lifestyle or behavior change to address mental health conditions and yet, many women of childbearing age who may or may not be pregnant, do not receive treatment, or do not receive proper treatment.
Her discussion weighed the risks and benefits of taking SSRI medications while pregnant to treat depressive mood and anxiety disorders and highlighted two specific medications that are contraindicated for pregnancy due to risks on the fetus. All other SSRI medications carry some inherent risks to the developing fetus, those risks are typically short-term, are brief in the first few days of the baby’s life, and are not serious life-long complications.
The risks of untreated depression and anxiety during pregnancy were highlighted and those risks far outweigh the risks of taking medications on the offspring in most cases. Maternal depression and anxiety during pregnancy is increasingly recognized as a significant factor that contributes to adverse pregnancy and postpartum outcomes and these effects are lifelong and multi-generational. This issue should be better recognized as a public health issue since failure to treat depressive mood and anxiety disorders results in generational dysfunction within society due to high rates of morbidity and mortality. Greater recognition of this issue from a public health standpoint could provide funding and investment into mental health programming standards, improve access for treatment, and reduce societal stigma of women taking medications while pregnant.
One of the greatest barriers to receiving pharmacological treatment during pregnancy is the societal stigma associated with taking any type of medication while pregnant (even if it’s clinically warranted). Even in women who do take SSRIs to treat their mood and anxiety disorders, many receive subclinical doses during pregnancy which makes treatment of their condition ineffective. Women need proper support to receive and feel supported receiving the treatment that they need if they are diagnosed with a depressive mood or anxiety disorder. Failure to treat clinically when necessary results in a lifelong negative cycle of dysfunction- within society, lack of nurturing, failure to thrive, reduced growth and development, and even morbidity and mortality. The risks of not treating depressive mood and anxiety in pregnant women far outweigh the risks of the well-studied SSRI medications.
This tutorial lecture at the Northeast ACSM conference was well attended by both men and women. One male came up to Dr. Whiton after and said he took so many notes for his wife and future child. Another woman came up and said that her lecture touched her personally and professionally. Personally, she had just had a miscarriage and wished she had received the mood treatments she needed at the time and that this lecture gave her the permission to stop overthinking it. While there are always risks, these decisions should be discussed with your primary care physician but to also know that if you are not feeling the support you need, to seek other help and opinions!
