Antidepressants and Pregnancy: The Risks and Potential Harm to Normal Fetal Development

For the past several months, MIA Continuing Education has been working with a small online education company, Professoriat.org, to remake our CME/CEU lectures into full-bodied courses. Our first such course is on the risks that antidepressant use during pregnancy pose to the developing fetus. We think it covers a subject of utmost importance to our society.

When we started Mad in America Continuing Education in 2014, our goal was to present individual lectures by prominent researchers that, in one way or another, provided scientific reason to question the medical model that governs psychiatric care today in the United States (and around much of the world). Our guest lecturers included Martin Harrow, Courtenay Harding, Lex Wunderink, Irving Kirsch, Bonnie Kaplan and many others, and they presented findings that provide an “evidence-based” rationale for rethinking current beliefs about the conventional paradigm of care. But, eventually we became convinced that we needed to do more, and develop “courses” on these topics that would more fully present the relevant research.

View an introductory video to “Antidepressants and Pregnancy” below:

For some time, I’ve been arguing that MIA Continuing Education needs to move beyond “preaching to the choir,” and this new course approach is designed to do that. The regular readers of Mad in America are pretty well on board with the idea that a paradigm shift in psychiatry is in order, but we need to reach professionals and others who do not yet share this belief, and have not been exposed to the science that tells of the failures of our current paradigm of care. This is part of the core mission of Mad in America Continuing Education.

Our new course, “Antidepressants and Pregnancy: The Risks and Potential Harm to Normal Fetal Development,” is presented by Adam Urato, an OB-GYN affiliated with Tufts Medical Center, who has published reviews of the scientific literature on this topic. The course is divided into seven lessons and takes about 90 minutes to complete. The course reviews:

• The role of serotonin in normal fetal development
• The disruption of serotonin activity by SSRI antidepressants
• The research revealing that antidepressants cross the placenta and how this poses many risks to the fetus, including pre-term birth, birth defects, autism, and other long-term neurobehavioral and motor difficulties
• Why academic medicine, professional societies, and the FDA have failed to provide warnings of these risks

The course is designed to provide an interactive learning experience. In addition to Dr. Urato’s review of the science, it features excerpts from published articles, embedded source documents, media clips, and other relevant materials. We think that OB-GYNs, family doctors, women of childbearing age, and all mental health professionals will find this course to be engaging and of vital importance to their lives.

The consultants who have developed this course, Emma Fernandez and Jesse Whitworth, previously developed online courses for Harvard Business School. They have done this work for Mad in America Continuing Education in collaboration with Chris Page, MIA’s Front Page Editor and Operations Manager. The next course we plan to develop will focus on antipsychotics and their long-term effects. After that, we will develop a course on nutrition and mental health.

As you would expect, we do not receive any funding from pharmaceutical companies for Mad in America Continuing Education. The funding for this effort comes entirely from supporters of the Mad in America Foundation.

We will continue to keep all of our lectures posted on our Mad in America Continuing Education website, though they’ll soon be transitioned over to our new home. I am proud to note that the dozen lectures we’ve presented since our founding have received rave reviews. While the majority of the audience for these lectures has come from the United States, I’ve been pleasantly surprised to find that the lectures have also attracted mental health professionals and others from South Africa, Australia, the United Kingdom, and Canada. However, we will not continue to offer CEU or CME credits for most of these lectures.

Beyond the Choir

As we market our new courses, we plan on reaching out to a wider audience of professionals, as well as to a larger general audience. This presents an obvious challenge: how do we reach beyond the choir? Our general message to professions will be this:

Mad in America Continuing Education courses, which have been approved for CEU and CME credits, challenge conventional wisdom, and, by doing so, tell of ways to improve outcomes. Our courses are taught by leading researchers and practitioners around the world, and they present scientific reviews and practice-based knowledge that can help mental health providers adopt more effective approaches to helping individuals and families. Our courses will help providers become known for their innovative, cutting edge practices.

We believe that many physicians and other mental health professionals are eager to take CEU and CME courses that are free from commercial influences, and we will reach out to these groups. For instance, the National Physicians Alliance seeks to create “research and education programs that promote health and foster active engagement of physicians with their communities to achieve high quality, affordable health care for all. The NPA offers a home to physicians across medical specialties who share a commitment to professional integrity and health justice.”

In addition, we will reach out to family physicians, given that they are the primary prescribers of psychiatric medications. We have already established a working relationship with the American Academy of Family Physicians, as this is the organization that approves CME credits for our previous lectures. We will also market our new course on antidepressants and pregnancy to OB-GYNs, who need to know this information as they counsel pregnant women. In industry-funded CME courses, physicians are often informed that the real risk during pregnancy is that women won’t be treated for their depression, and that antidepressants provide a safe form of treatment; our course will be unique in focusing on the effects of antidepressant use on fetal development. Such information is critical if a pregnant woman is going to make an informed choice about her own use of antidepressants.

In return for feedback about the course, we’d like to offer the chance for some members of the MIA community to take the course for free. The first 10 individuals to write to us will be given a free coupon to the course.

We are looking forward to this next phase of the Mad in America Continuing Education project. We appreciate the support from Mad in America readers, and I encourage all to write me with any suggestions you may have about how we can better reach “beyond the choir,” and market the courses to a broader audience.