U.S. survey of women and physicians indicates wide differences in perceptions surrounding safety of antidepressants during and after pregnancy
There are wide differences between the perceptions of
U.S. women and physicians regarding the safety of antidepressants during and after
pregnancy, according to the Society for Women's Health Research, which commissioned
the surveys.
Only 10 percent of women think it is safe for women to
take medication for depression while they are pregnant, compared to 68 percent
of doctors, according to a new survey of women and physicians released today by
the Society for Women's Health Research. Even after pregnancy, in the postpartum
period, only half of women think it is safe for women to take medication for depression,
compared to 97 percent of doctors.
"This survey shows a tremendous disconnect between doctors'
beliefs about managing depression and the perceptions held by women," said Sherry
Marts, Ph.D., vice president of scientific affairs for the Society, a Washington,
D.C., based advocacy organization. "The health care community needs to do a better
job communicating with women about depression. We need to carefully explain the
full range of treatment options for mood disorders and the pros and cons of taking
medications during pregnancy and after pregnancy so that women can make better
informed choices."
African American women and women 18-34 years of age in the survey were even
more likely than others to say that it is not safe to take antidepressants during
pregnancy or the postpartum period.
"Many pregnant and postpartum women falsely think that depressive symptoms,
and even clinical depression, are part of the normal experiences of being pregnant
and delivering a baby," said Kimberly Yonkers, MD, an associate professor of psychiatry
and obstetrics and gynecology at the Yale University School of Medicine in New
Haven, Conn.
"Moreover, they often assume that these symptoms will spontaneously go away
when that is not always the case. There are a range of treatments available to
women and we need to get the message out and encourage depressed women to access
care for their emotional symptoms."
The survey also revealed that women underestimate their risk for depression
at specific life stages involving hormonal transition. The gap is largest for
perimenopause and menopause. Only 47.5 percent of women thought perimenopause
is a time of heightened risk for depression compared with 83.2 percent of doctors.
Even fewer women, 39.5 percent said menopause presents unique depression risks,
while 77.8 percent of doctors noted this time of risk. Women's recognition of
depression risk at puberty and in postpartum was better.
"Women's bodies undergo changes in hormone levels during key life cycle transitions
from puberty to menopause," said Marts. "Most women navigate these transitions
with minimal mood disturbances, but some women experience mood disorders such
as depression or bipolar disorder. We need more research to understand the underlying
mechanisms in the brain where mood disorders are triggered by hormone changes.
Women need to be aware of this issue and talk to their health care providers about
their individual risk factors, warning signs and treatment options if needed."
When asked about the major symptoms of depression, women focused on emotional
symptoms and most neglected to mention the physical symptoms that can accompany
depression, such as trouble sleeping, fatigue, changes in appetite or pain. Only
38.2 percent of women noted at least one physical symptom that can be a sign of
depression, compared to 86.4 percent of doctors.
Regarding risk factors for postpartum depression, less than one percent of
women mentioned family history, previous depression problems or genetics as a
risk factor, compared with 53.8 percent of doctors.
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