• Divya Mp
  • Syed Imam Rabbani
  • Mrudula G. Department of Pharmacology, Krupanidhi College of Pharmacy, Bangalore-560035, Karnataka, India


Depression is a mood disorder which can affect 1 in every 4 women at some point of life even during pregnancy. Depression is most often not properly diagnosed during pregnancy as it is assumed by people to be just another type of imbalance in hormones. But this assumption can be very dangerous to the mother and the fetus. The health care professionals are very cautious about the treatment for depression in pregnancy as both uses of antidepressant and untreated depression in pregnancy can lead to risks for the unborn baby. This review focuses on the complications associated with both treated and untreated depression during pregnancy. In addition, if the treatment is inevitable, then factors such as teratogenesis, withdrawal symptoms, neurobehavioral effects, risk of untreated and risk of discontinuing the medication need to be considered before selecting the suitable therapy.

Keywords: Pregnancy, Depression, Drug-therapy, Fetal toxicity


Download data is not yet available.


Davis EP, Glynn LM, Schetter CD, Hobel C, Chicz-Demet A, Sandman CA. Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Adolesc Psychiatry 2007;46:737-46.

Glover V, O’Connor TG. Effects of antenatal stress and anxiety. Br J Psychiatry 2002;180:389-91.

Nulman I, Rovet J, Stewart DE, Pace-Asciak P, Wolpin J, Shuhaiber S, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry 2002;159:1889-95.

Heron J, O’Connor TG, Evans J, Golding J, Glover V. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affective Disord 2004;80:65-73.

Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM, et al.. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010;202:5-14.

O’Conner TG, Heron J, Golding J, Glover V. Maternal antenatal anxiety and behavioral/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003;44:1025-36.

Haddad PM, Pal BR, Clarke P, Wieck A, Sridhiran S. Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome. J Psychopharmacol 2005;5:554-7.

Lyons-Ruth K, Zoll D, Connell D, Grunebaum HU. The depressed mother and her one-year-old infant: environment, interaction, attachment and infant development. New Directions Child Adolescent Dev 1986;34:61-82.

Murray L. The impact of postnatal depression on infant development. J Child Psychol Psychiatry 1992;33:543-61.

Teti DM, Gelfand DM, Messinger DS, Isabella R. Maternal depression and quality of early attachment; an examination of infants, preschoolers, and their mothers. Dev Psychol 1995;31:364-76.

Weinberg MK, Tronick EZ. The impact of psychiatric maternal illness on infants development. J Clin Psychiatry 1998;59 Suppl l2:53-61.

Hart S, Field T, Nearing G. Depressed mother`s neonates improve following the MABI and Brazelton demonstration. J Pediatr Psychol 1998;23:251-6.

Murray L, Fiori-Cowley A, Hooper R, Cooper P. The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Arch Dis Child 1996;67:2512-26.

Spinelli M, Endicott J. Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. Am J Psychiatry 2003;160:555-62.

Stewart DE. Clinical practice. Depression during pregnancy. N Engl J Med 2011;365:1605-11.

O'Keane V, Marsh MS. Depression during pregnancy. Br Med J 2007;334:1003-5.

Wisner KL, Gelenberg AJ, Leonard H, Frank E. Pharmacologic treatment of depression during pregnancy. JAMA 1999;282:1264-9.

O'Mahen H, Himle JA, Fedock G, Henshaw E, Flynn H. A pilot randomized controlled trial of cognitive behavioral therapy for perinatal depression adapted for women with low incomes. Depress Anxiety 2013;30:679-87.

DiPietro JA, Costigan KA, Nelson P, Gurewitsch ED, Laudenslager ML. Fetal responses to induced maternal relaxation during pregnancy. Biol Psychol 2008;7:11-9.

Wisner KL, Zarin DA, Holmboe ES, Appelbaum PS, Gelenberg AJ, Leonard HL, et al. Risk-benefit decision making for treatment of depression during pregnancy. Am J Psychiatry 2000:157:1933-40.

Kulin N, Pastuszak A, Sage S, Schick-Boschetto B, Spivey G, Feldkamp M, et al. Pregnancy outcome following maternal use of the newer SSRIs; a prospective controlled multicenter study. JAMA 1998:279:609-10.

Hallberg P, Sjoblom V. The use of selective serotonin reuptake inhibitors during pregnancy and breastfeeding: a review and clinical aspects. J Clin Psychopharmacol 2005;25:59-73.

Costei AM, Kozer E, Ho T, Ito S, Koren G. Perinatal outcome following third-trimester exposure to paroxetine. Archives Pediatrics Adolescent Medicine 2002;156:1129-32.

Nulman I, Rovet J, Stewart DE, Wolpin J, Gardner HA, Theis JG, et al. Neurodevelopment in children exposed in utero to antidepressant drugs. N Engl J Med 1997;336:258-62.

Sandman CA, Wadhwa PD, Dunkel-Schetter C, Chicz-DeMet A, Belman J, Porto M, et al. Psychobiological influences of stress and HPA regulation on the human feotus and infant birth outcomes. Ann N Y Acad Sci 1994;739:198-210.

Gentile S. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf 2005;28:137-52.

Bonari, Bennett H, Einarson A, Koren G. Risks of untreated depression in pregnancy. Can Fam Physician 2004;50:37-9.

Altshuler LL, Cohen L, Moline M, Kahn DA, Carpenter D, Docherty JP, et al. The expert consensus guideline series: treatment of depression in women. Postgrad Med 2001;1:1-107.

Mcelhatton PR. General principles of drug use in pregnancy. Pharm J 2003;270:232-4.

Reis M, Källén B. Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med 2010;40:1723-33.

Diav-Citrin O, Schechtman S, Weinbaum D, Wajnberg R, Avgil M, Di Gianantonio E, et al. Paroxetine and fluoxetine in pregnancy: a multicenter, prospective, controlled study. Br J Clin Pharmacol 2008;66:695-705.

Levin R. Neonatal adverse events associated with in utero SSRI/SNRI exposure. Available from: ohrms/dockets/AC/04/slides/2004-4050S1_11_Levin.ppt. [Last accessed on 15 Feb 2008]

Källén B, Olausson PO. Maternal use of selective re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 2008;17:801-6.



How to Cite

Mp, D., S. I. Rabbani, and M. G. “DEPRESSION IN PREGNANCY - CONSEQUENCES AND TREATMENT MODALITIES”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 8, no. 3, Mar. 2016, pp. 24-27,



Review Article(s)