FDA Consults on Antidepressant Medication During Pregnancy
In a recent meeting, experts gathered to discuss the use of Selective Serotonin Reuptake Inhibitors (SSRIs) during pregnancy, a topic that has sparked much debate due to the potential risks and benefits of treating maternal depression.
SSRIs, a type of antidepressant, are commonly used to manage depression. However, their use during pregnancy is a contentious issue. Some panelists suggested alternative treatments like therapy or older antidepressants as possible choices for managing depression during pregnancy. Others noted that many SSRIs have been well-studied and found to be safe during pregnancy.
One of the concerns raised was the potential risks associated with SSRI use during pregnancy. These risks include heart problems, lung complications, and behavior issues like attention disorders or anxiety. Nearly a third of babies exposed to late SSRI use may experience a condition causing shakiness or fussiness after birth.
However, untreated depression during pregnancy can lead to complications like early birth, lower birth weight, and poor connection with the baby after birth. This complex situation, where both the medication and the underlying maternal illness can lead to adverse outcomes, has fueled the ongoing debate.
The meeting ended without any formal rule changes, but it stirred debate about how depression in pregnancy should be handled. Some speakers argued that women may not need medications at all, while others emphasised the significant risks of untreated depression, such as relapse, suicide, and overdose.
The FDA, which convened an expert panel in 2025 to assess these risks and benefits, faced criticism for spreading misinformation and bias, especially regarding the efficacy of SSRIs and overstating potential harms. Some panel members questioned the effectiveness of SSRIs in severe depression, which was strongly contested by other psychiatrists citing solid clinical evidence supporting their use during pregnancy.
Professional bodies like the American College of Obstetricians and Gynecologists endorse SSRI safety during pregnancy, emphasising that the risks of untreated depression often outweigh potential medication side effects. The debate underscores the complexity of separating medication effects from those of underlying maternal illness and highlights the FDA’s role in fostering rigorous research and balanced communication to guide clinical decisions.
Solutions proposed during the meeting included adding QR codes on bottles leading to short videos explaining the risks in plain language, and a discussion about who should be responsible for providing information about SSRI risks: the FDA or doctors.
The topic remains complicated, with strong views on both sides and many unanswered questions about how best to support mothers and their babies. It is clear that a balanced approach, which considers both the potential risks and benefits, is needed to ensure the health and wellbeing of both mother and child.
[1] Research Study 1 [2] Research Study 2 [3] Research Study 3 [4] American College of Obstetricians and Gynecologists Guideline [5] Criticism of FDA's Handling of SSRI Debate
- The discussion about depression management during pregnancy brought forth suggestions for alternative treatments, with some experts advocating for various health-and-wellness practices such as mental-health therapies-and-treatments and nutrition, which may assist in managing maternal depression without the potential risks associated with Selective Serotonin Reuptake Inhibitors (SSRIs).
- The American College of Obstetricians and Gynecologists supports the use of SSRIs during pregnancy, citing their guidelines that often deemed the risks of untreated depression to outweigh potential medication side effects, a stand that highlights the importance of understanding both the risks and benefits of various therapies-and-treatments in ensuring the health-and-wellness of both mother and child.
