New light on antidepressants during pregnancy

Nouvel éclairage sur les antidépresseurs pendant la grossesse

January 8, 2020 9h12

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New light on antidepressants during pregnancy

Jean-Benoit Legault

The canadian Press

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MONTREAL – The antidepressants being prescribed to pregnant women seem to interact with the enzyme synthesizing estrogens, aromatase, shows a study recently published by researchers from the national Institute of scientific research.

This is an important breakthrough, because the production of estrogen is essential for the development of the child and to the physiological adaptation of the mother during pregnancy.

“Depression in pregnancy is really a public health problem and a big problem for pregnant women, explained the professor, Cathy Vaillancourt. It represents more than 10 percent (of pregnant women). And the women who were depressed before falling pregnant, if they stop the drug, they will have a relapse in 75 percent of cases.”

The prescription of antidepressants in pregnant women is controversial. Studies show that the administration of some of these treatments in the mother during pregnancy would be associated with a risk of malformations of the heart and lungs in the new-born. Other antidepressants may lead to disorders of cognitive development in children, such as autism.

The harmful effect of antidepressants comes from their interaction with certain key hormones present in our body. The majority of the depression medication prescribed to pregnant women target serotonin, a hormone produced both in the brain and in the placenta.

“Antidepressants are used, but it’s still for the doctors, clinicians, and obstetricians, what is the best? Give the medicine or give anything? There are no drugs that are “safe” to 100 percent,” summarized Ms. Vaillancourt.

The researchers have tested the effect of different types of antidepressants on samples of placenta collected after birth. Some clues have been induced to examine a little more closely the effect of these molecules on the estrogen.

“It was the discovery of André-Anne Hudon-Thibault, the major discovery of his phd thesis, which showed that antidepressants will have an action on the enzyme synthesis of estrogen, so they are going to affect the production of estrogen at the level of the placenta, and not only serotonin,” said Ms. Vaillancourt.

All antidepressants will not necessarily have a harmful effect. Some of the molecules will interact lesser with the estrogen, and therefore be less harmful for the developing fetus.

The work of professor Vaillancourt and her colleagues could help to better choose the type of antidepressant and the dose to use in pregnant women, minimizing the secondary effects on the course of pregnancy and on fetal development.

“If you don’t have the placenta in health, you don’t have a healthy baby, and this is the first place where you should try to see if the drugs have impact,” said Ms. Vaillancourt.

The results of this study have been published in the journal, The Journal of Steroid Biochemistry and Molecular Biology.

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