Perceptions of pregnant women regarding antidepressant and anxiolytic medication use during pregnancy

Abstract

Objective: The objective of this study was to explore attitudes and decision-making by pregnant women regarding antidepressant and anxiolytic use during pregnancy. Method: An observational study at an outer metropolitan hospital in Brisbane, Queensland. Pregnant women presenting for their first antenatal clinic visit were invited to complete a questionnaire. Participants were asked about current or previous antidepressant/anxiolytic use, influences on drug decision-making and the adequacy of information received. Perceptions were measured on a 7-point Likert scale. Results: A total of 503 pregnant women were surveyed. The background prevalence of anxiety and depression was 30.0% (151), with 9.3% (47) respondents using antidepressant or anxiolytic medications during the current pregnancy. Of these 47 women, 68% ceased these medications during or while trying to become pregnant, most commonly due to potential side effects to the baby (16), health professional advice (8) and symptomatology that was under control (7). While the effect was modest, decision-making was most strongly influenced by general practitioners, family and the internet. Conclusions: Most women cease antidepressant/anxiolytic medication before and during pregnancy for reasons other than stability of condition. This study reveals an unmet need for accessible reliable information to guide pregnant women and their care providers.

Prescribing antidepressants and anxiolytic medications to pregnant women: comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality Trainees and upskilled General Practitioners

“…Considerable uncertainty in prescribing AD and AX in pregnancy exists, even amongst clinicians with expertise in antenatal health care provision [2,9,11]. Women in general also express extreme reluctance to take medication in pregnancy [7,8,17]. Both clinician groups in this study felt that training had not been adequate to instil confidence in medication prescription, even though many health professionals had trained for more than 10 years.…”

Prescribing antidepressants and anxiolytic medications to pregnant women: Comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality trainees and upskilled General Practitioners

“…Considerable uncertainty in prescribing AD and AX in pregnancy exists, even amongst clinicians with expertise in antenatal health care provision [2,9,11]. Women in general also express extreme reluctance to take medication in pregnancy [7,8,17]. Both clinician groups in this study felt that training had not been adequate to instil con dence in medication prescription, even though many health professionals had trained for more than ten years.…”

“…Unclear messages contribute to pregnant women being reluctant to take psychotropic medication, including antidepressants and anxiolytics with many fearing foetal harm [5][6][7][8]. Medical personnel including O&Gs and GPs form an important part of a pregnant woman's network of information sources during pregnancy and can impact patient decision-making around medications in pregnancy [7][8][9]. The Australian clinicians' own perception of teratogenicity of antidepressants (AD) and anxiolytics (AX) may in uence counseling and care of vulnerable women and is largely unexplored.…”

Prescribing antidepressants and anxiolytic medications to pregnant women: Comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality trainees and upskilled General Practitioners

“…Considerable uncertainty in prescribing AD and AX in pregnancy exists, even amongst clinicians with expertise in antenatal health care provision [2,9,11]. Women in general also express extreme reluctance to take medication in pregnancy [7,8,17]. Both clinician groups in this study felt that training had not been adequate to instil confidence in medication prescription, even though many health professionals had trained for over 10 years.…”

“…Unclear messages contribute to pregnant women being reluctant to take psychotropic medication, including antidepressants and anxiolytics [5][6][7][8] with many fearing foetal harm.. Medical personnel including O&Gs and GPs form an important part of a pregnant woman's network of information sources during pregnancy and can impact patient decision-making around medications in pregnancy [7][8][9]. The Australian clinicians' own perception of teratogenicity of antidepressants (AD) and anxiolytics (AX) may influence counselling and care of vulnerable women and is largely unexplored.…”