Ladies, we are walking incubators.

[raincitygirl]

Just to take people's mind off of Hurricane Sandy, here's something infuriating, gakked from legionseagle, all about how women of childbearing age shouldn't be allowed to take anti-depressants. Because 50% of pregnancies are unplanned and anti-depressants harm a developing fetus, no woman who could possibly become pregnant should use these medications.

And are these words of wisdom coming from some politician in Texas? (no offense to Texans, but you produce your fair share of political loonies) No, they are coming from Professor Louise Howard, head of women's mental health at the Institute of Psychiatry, King's College, University of London. Note to self: if I ever move to England, I will avoid treatment at that institute like the plague. Professor Howard clearly doesn't suffer from clinical depression herself, or I doubt she'd be saying such things. Speaking as a woman of childbearing age who relies on anti-depressants to hold down a job, function in society, etc etc, I am none too thrilled.

I am well aware that anti-depressants can be dangerous for a developing fetus. In the event that I became pregnant by accident, I would probably seek out an entirely legal option that doesn't seem to have occurred to Professor Howard.

Edited to add: In comments, minim_calibre points out that this article may be a case of Daily Telegraph out-of-contextitis, going for the sensational lead and obscuring what Professor Howard was actually saying. Upon deep-breathing and then re-reading the article with deliberate calm, I think Minim may have an excellent point, and Professor Howard's advice may have been misrepresented. Or at least distorted by selective quotation. There's a whole lot much more reasonable-sounding stuff down at the very bottom of the article. Yes, I read the whole article the first time, but I was sufficiently enraged by the first few paragraphs that I didn't really consider the possibility of selective quotation. Minim also points out that the article makes no distinction between SSRIs (which are considered reasonably safe) and other drugs like lithium which are very risky.

I would certainly feel a WHOLE lot better if this were just a case of a sensationalistic journalist quote-mining, as opposed to the considered views of an expert in women's mental health.

Comments

[minim_calibre]

Just reading the article, it looks like a case of major Telegraph out-of-contextitis, with factual information about the pros and cons of medication such as you'd expect a doctor to give wrapped in Telegraph sensationalist text.

Most SSRIs under common use are considered fairly safe, so the article was more than slightly misleading, not specifying, say, that the presumed risk is entirely dependent on what drug you're talking about. Lithium, for example, is presumed risky. Everyone I've known who accidentally got pregnant while on it went for the entirely legal option of which you speak.

[raincitygirl]

You may well be right (I certainly *hope* you're right), and I've edited the entry to point that out.

Yeah, I read the article all the way through the first time around, but I was seriously, seriously pissed off by the time I got to the end of it, so I wasn't really considering that, oh hey, she sounds much more reasonable at the end, maybe she was misquoted at the beginning. Good point as well that the article makes no distinction between SSRI's like the ones I take and drugs like lithium.

Thanks! I feel somewhat better now. Although I'm still pissed off, I'm considering transferring my pissed-off-ness from Professor Howard to the Telegraph.

[katta]

That headline is so misleading I'd blow my top if I was prof. Howard. I don't know enough about antidepressants to say if her position is reasonable in general, but I do think there's a huge difference between saying that women should consider the risks and benefits of certain antidepressants, and saying NO ANTIDEPRESSANTS FOR WOMEN WHO MAY HAVE BABIES.

[minim_calibre]

All told, it's reasonable. Some psychiatric medications have known teratogenic effects, and women should be informed of that risk and given all the information they need to make an informed choice. (Which includes not only, "Am I willing to take this medication?" but "Should I wind up pregnant, what would my best choice be?" and "For fuck's sake, get me an IUD right now!" given that anecdotal evidence including my own experience says that hormonal birth control tends to further unbalance delicate brain chemistry, and other non-hormonal options are crap for seriously effective prevention.)

[minim_calibre]

http://www.telegraph.co.uk/women/womens-life/9634322/Antidepressants-are-the-only-option-for-some-women.html

Looks like a better context version of what she is saying. Which is, well, SOP for any doctor prescribing anything, especially a maintenance medication, and should be, even if they're not considering the possibility of pregnancy. Inform your patient. Make sure they know the cost/benefit analysis of any potential prescription, and what side effects to watch out for, and to inform other people around them about. (This is one of the reasons I like my brain doc. He's my age, and knows I'm a high-information patient, who has access to drug manuals intended for medical professionals. So we have very candid conversations about my treatment.)

[minim_calibre]

PS, I also have personal experience in taking drugs contraindicated during pregnancy while I was pregnant, as the treatment course for pregnancy induced hypertension suggested by the specialist on it included the use of one, plus another drug to counteract the reasons it was contraindicated, plus a whole lot of appointments and careful monitoring of the kid's growth.

As a point of anecdata, it's not the best thing for one's mental health to be worrying that the drugs you're taking to keep you alive/sane/healthy are possibly having a detrimental effect on a child you're attempting to bear. So there is that.

[legionseagle]

Except that even the "better context" version you quote still includes the words

As clinicians, we would always prefer not to give women of child-bearing age medication

. Not "some" medication, not "explain the risks and benefits of any specified medication", but that "we would always prefer" not to prescribe medication.