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American Morning
'Paging Dr. Gupta'
Aired January 14, 2004 - 08:44 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOLEDAD O'BRIEN, CNN ANCHOR: Should women who take antidepressants abandon their prescriptions during pregnancy? The risks actually might outweigh the benefits.
Dr. Sanjay Gupta joins us from the Center with more on this.
Hey, Sanjay, good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Soledad.
The gut instinct for most women when they become pregnant is basically to stop all medications out there for fear that it might harm the fetus in some way. The flip side of that is that women who are depressed, significant depression, can be treated very well with antidepressants. The question is, where do you draw the line? When do you stop? When do you start? How does it all work out? Well, this has been the subject of quite a bit of study, because depression during pregnancy can be a very significant problem, not only for the mother, but the fetus, as well.
Here's some statistics, kind of interesting. If you look at, first of all, women who stop the medications, they usually stop it abruptly, which is very difficult, particular with antidepressants. Fifty to 70 percent of those women will relapse their depression, major depressive episodes, and that relapse, most of those will occur within nine months, which is the term of pregnancy. So basically, Soledad, what this means is for most women who have depressive disorder prior to becoming pregnant, if they stop their antidepressants abruptly, which so many women do, they probably will have a relapse sometime during their pregnancy.
O'BRIEN: So then, Sanjay, then how do doctors gauge what a pregnant woman should do and which pregnant patient might relapse, and who would be OK to go off the meds?
GUPTA: Well, you know, it's interesting, because some of it is very clear, and some it is a little bit more theoretical. What I mean is that depressed episodes, you've seen some the numbers right there, high chance of relapse, high chance that relapse occurring during pregnancy. The risk to the fetus, a bit more theoretical. There have been some studies done overall on what the effect of antidepressants are on an unborn fetus, and most, surprisingly, to most doctors, and women alike, is that the effects, the significant deleterious health effects, not as significant as people would have believed.
And if you look at some of the new antidepressants, not as much as an effect on the fetus as you might think. What the concern is, though, if a woman becomes pregnant, they are more likely to have a higher rate of premature births, lower birth rate, and complications during birth. All of that, because women who become depressed, have major depressive episodes during pregnancy, are less likely to take as good care of themselves, they might smoke more, they may be unlikely to attend medical appointments not eating right, things like that.
So it really is a -- it's a difficult balance here, Soledad, but the thing I think where it becomes gray is that one is a little bit more defined and one is a little bit more theoretical in terms of the risk -- Soledad.
O'BRIEN: Have enough studies, though, been done, Sanjay, where they can say confidently, that the risk to the fetus is less than the risk to the overall risk to the mother if she stops her meds?
GUPTA: It's an excellent question, and here's the problem -- this problem arises so many times in science -- you can't knowingly do these studies, you can't knowingly take a group of pregnant women and expose their fetus to antidepressants. That would not be a good study. No one would authorize that sort of study. So a lot of this has to sort of be based on theory. What do you think medications like this would do to a developing human, and then that's where the theory comes in as opposed to the defined science -- Soledad.
O'BRIEN: Dr. Sanjay Gupta, thanks.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired January 14, 2004 - 08:44 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOLEDAD O'BRIEN, CNN ANCHOR: Should women who take antidepressants abandon their prescriptions during pregnancy? The risks actually might outweigh the benefits.
Dr. Sanjay Gupta joins us from the Center with more on this.
Hey, Sanjay, good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Soledad.
The gut instinct for most women when they become pregnant is basically to stop all medications out there for fear that it might harm the fetus in some way. The flip side of that is that women who are depressed, significant depression, can be treated very well with antidepressants. The question is, where do you draw the line? When do you stop? When do you start? How does it all work out? Well, this has been the subject of quite a bit of study, because depression during pregnancy can be a very significant problem, not only for the mother, but the fetus, as well.
Here's some statistics, kind of interesting. If you look at, first of all, women who stop the medications, they usually stop it abruptly, which is very difficult, particular with antidepressants. Fifty to 70 percent of those women will relapse their depression, major depressive episodes, and that relapse, most of those will occur within nine months, which is the term of pregnancy. So basically, Soledad, what this means is for most women who have depressive disorder prior to becoming pregnant, if they stop their antidepressants abruptly, which so many women do, they probably will have a relapse sometime during their pregnancy.
O'BRIEN: So then, Sanjay, then how do doctors gauge what a pregnant woman should do and which pregnant patient might relapse, and who would be OK to go off the meds?
GUPTA: Well, you know, it's interesting, because some of it is very clear, and some it is a little bit more theoretical. What I mean is that depressed episodes, you've seen some the numbers right there, high chance of relapse, high chance that relapse occurring during pregnancy. The risk to the fetus, a bit more theoretical. There have been some studies done overall on what the effect of antidepressants are on an unborn fetus, and most, surprisingly, to most doctors, and women alike, is that the effects, the significant deleterious health effects, not as significant as people would have believed.
And if you look at some of the new antidepressants, not as much as an effect on the fetus as you might think. What the concern is, though, if a woman becomes pregnant, they are more likely to have a higher rate of premature births, lower birth rate, and complications during birth. All of that, because women who become depressed, have major depressive episodes during pregnancy, are less likely to take as good care of themselves, they might smoke more, they may be unlikely to attend medical appointments not eating right, things like that.
So it really is a -- it's a difficult balance here, Soledad, but the thing I think where it becomes gray is that one is a little bit more defined and one is a little bit more theoretical in terms of the risk -- Soledad.
O'BRIEN: Have enough studies, though, been done, Sanjay, where they can say confidently, that the risk to the fetus is less than the risk to the overall risk to the mother if she stops her meds?
GUPTA: It's an excellent question, and here's the problem -- this problem arises so many times in science -- you can't knowingly do these studies, you can't knowingly take a group of pregnant women and expose their fetus to antidepressants. That would not be a good study. No one would authorize that sort of study. So a lot of this has to sort of be based on theory. What do you think medications like this would do to a developing human, and then that's where the theory comes in as opposed to the defined science -- Soledad.
O'BRIEN: Dr. Sanjay Gupta, thanks.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
