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Expert Still Skeptical
Boston psychiatrist Lee Cohen, MD, concedes that the clinical evidence suggests a link between SSRI antidepressant exposure just before birth and infant jitteriness. But he remains skeptical about other symptoms supposedly caused by prebirth exposure.
He tells WebMD that the studies that have evaluated newborns exposed to antidepressants are highly flawed.
Cohen directs the Center for Women's Mental Health at Massachusetts General Hospital, one of the few treatment facilities in the country that specializes in treating depression during pregnancy.
He worries that pregnant women who are depressed will get the message that they will harm their babies if they get the treatment they need. Cohen has studied depression in pregnancy for two decades and is a consultant for Prozac manufacturer Lilly.
"What we have learned over the last 20 years is that at the end of the day the most important predictor of how a kid does long term is whether the mother is psychologically well during pregnancy," he says.
Kirshenbaum now knows that much of what she heard from doctors during her first two pregnancies was wrong. A psychiatrist told her that depression usually goes away during pregnancy, and other doctors warned her that taking antidepressants early in pregnancy caused birth defects.
Under Cohen's care, she took antidepressants during a third pregnancy and gave birth to a healthy baby.
"Women with depression need to educate themselves about this subject because there is still a lot of bad information out there," she says.
SOURCES: Moses-Kolko, E.L. The Journal of the American Medical Association, May 18, 2005; vol 293: pp 2372-2383. Eydie L. Moses-Kolko, MD, department of psychiatry, University of Pittsburgh School of Medicine, Pittsburgh. Lee Cohen, director, Center for Women's Mental Health, Massachusetts General Hospital, Harvard Medical School. Lisa Kirshenbaum, Cranston, R.I.