New study to look at impact of common antidepressants on pregnant women

Northwestern Medicine Prentice Women's Hospital and the Northwestern University Feinberg School of Medicine Department of Psychiatry is home to a landmark study that will, for the first time, take a close look at the impact of certain common antidepressants on pregnant women.

Called Optimizing Medication Management for Mothers With Depression, or OPTI-MOM, the Northwestern Medicine study is enrolling up to 200 women to systemically look at genetic and clinical profiles of those who take antidepressants during pregnancy.

Led by internationally known perinatal depression researcher Katherine L. Wisner, MD, MS, director of the Asher Center for the Study and Treatment of Depressive Disorders at Feinberg, the study ultimately hopes to provide accurate treatment guidelines for practitioners working with pregnant women, or those women hoping to become pregnant, who are treated with antidepressants.

"What we know is that women who are taking antidepressants across pregnancy typically do well at the beginning, but the medication stops working as effectively halfway through," said Dr. Wisner. "It makes sense that the physical changes of pregnancy would affect the dose requirements, but the majority of physicians are not aware of the need for dosage adjustments. Without an accurate picture of changes across pregnancy, they are unable to appropriately counsel their patients on how to manage their depression during pregnancy."

Researchers hope that with OPTI-MOM they can establish a base set of guidelines for practitioners to help guide patients on antidepressants throughout their pregnancy. In the study, they will analyze plasma levels monthly as well as spinal fluid that will be collected if the patient receives a spinal-epidural during her delivery.

In order to participate in OPTI-MOM, women must be at least 18 years old, less than 18 weeks pregnant, speak English or Spanish, and have a diagnosis of depression. Women must also be taking sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa) or escitalopram (Lexapro) prior to enrolling in the study, and be planning on taking it during and after pregnancy.

Participants will agree to monthly blood draws and a monthly assessment of mood and medication side effects.