[The practical considerations of antidepressant use during pregnancy and breastfeeding]

Main indications of antidepressants (ADs) as major depressive disorder (MDD) and different kinds of anxiety disorders are quite prevalent during pregnancy and the postpartum period. Due to the possible hazards of in utero and breast milk exposition of ADs, both psychiatrists and mothers frequently have concerns about the use of ADs during the periods of pregnancy and breastfeeding. However, we should also bear in mind that affective disorders left untreated during these periods are also associated with health risks for the mother and the baby as well. Accordingly, the treatment of affective disorders during these periods is essential. For mild cases of affective disorders the recommended treatment modality is typically psychotherapy while for the severe cases pharmacotherapy (including AD treatment) is recommended. Unfortunately, due to the lack of well-designed prospective studies, only sparse information is available on the efficacy and safety of AD treatment in pregnant and breastfeeding women. In this review we try to provide some practical advice in terms of the use of ADs during the periods in question.