The treatment of women suffering from depression who are either pregnant or breastfeeding

Kimberly A. Yonkers, M.D.

In medicine, there are often situations that require patients and their providers to make difficult management decisions. We turn to systematic evidence to guide our approach and counsel our patients, but many times the information is limited or inadequate. The treatment of women with depression who are either pregnant or breastfeeding presents a number of issues for which we have insufficient data. These include questions such as, What is the relative likelihood of becoming depressed and requiring treatment during pregnancy or the several months after delivery? What are the short- and long-term consequences for children exposed to maternal psychiatric illness or to pharmacological treatment? What are the short- and long-term consequences for a neonate exposed to an antidepressant as a result of breastfeeding? The absence of sufficient data is not the result of a lack of interest among researchers but derives largely from the ethical and practical issues that make research in this area difficult.