When you feel the blues


Dr. Koren is the founder and director of the Motherisk Program and professor of Paediatrics, Pharmacology, Pharmacy, and Medical Genetics at the University of Toronto. He is also the Richard and Jean Ivey Chair in Molecular Toxicology in the Schulich School of Medicine, at The University of Western Ontario, where he holds the rank of professor in Medicine and Paediatrics.

Many women suffer from depression during their reproductive years, and while once the numbers were not very clear, now with better screening methods we can identify that up to 20% of women are experiencing depression.

When planning your pregnancy, diagnosing and managing depression is even more important, as this condition can affect you, your pregnancy and your baby. Women with depression have higher rates of miscarriages and prematurity, and often find it difficult to meet their own pregnancy needs, such as nutrition and prenatal vitamins. Importantly, untreated depression in pregnancy is the strongest predictor of postpartum depression, which can be serious but treatable if found early.

For all these reasons, a diagnosis and management is critical. Remember, not all symptoms will mean clinical depression, which is why diagnosis by a doctor, most appropriately by a psychiatrist, is key.

When it comes to management, there are two different approaches, which are often used simultaneously: psychotherapy and medications. The most commonly used antidepressants belong to a family called selective serotonin reuptake inhibitors, such as Prozac®, Paxil® and Zoloft®. Other options belong to a second group called serotonin-norepinephrine reuptake inhibitors, such as Effexor. These medications are used by millions of women of reproductive age.

After more than two decades of safe use, some recent studies have suggested that these medications may increase the risk of a heart defect in your baby. However, many other studies couldn’t show this, including Motherisk research that strongly suggests these drugs are safe not only for the body development of the baby, but also for the brain development of IQ, language and behaviour. Motherisk research also suggests that it is the depression—and not the medication itself—that can cause developmental problems for your baby.

See your doctor to discuss any symptoms you’ve been feeling and a possible management plan or speak to your Shoppers Drug Mart Pharmacist if you have any questions about the medications you’re currently taking for depression.

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The Information on this web page is provided for educational information purposes only. It is not designed or intended to constitute medical advice or to be used for diagnosis or to replace your physician. Consult your physician to determine the appropriateness of the Information for your specific situation and before making any decision regarding treatment and/or medication. The Information is believed to be reliable when posted. However, neither Motherisk nor The Hospital for Sick Children guarantee or warrant the quality, accuracy, completeness, timeliness, appropriateness or suitability of the Information provided. Reference to or mention of specific products or services do not constitute an endorsement by Motherisk or The Hospital for Sick Children or Shoppers Drug Mart.