Depression and Pregnancy

Major Depressive Disorder (MDD) occurs twice as often in women as in men, with an age of onset that coincides with the childbearing years.

As over 20% of reproductive-age women experience an episode of depression, identifying safe and effective treatments for depression before, during and after pregnancy has become a critical public health issue.

Historically, pregnancy has been viewed as a protective time with respect to risk for psychiatric illnesses, which has resulted in a lack of prospective systematic investigations on the subject of acute treatment and prevention of MDD while women are planning to conceive and during pregnancy. Contrary to previous assumptions, recent large-scale studies demonstrate that new onset and recurrence of depressive episodes occur commonly during pregnancy and the postpartum periods.

Although Antidepressants  are frequently used during pregnancy, concerns remain regarding a spectrum of adverse outcomes associated with fetal exposure to these medications including:
  • Increased risk for teratogenicity compromised obstetrical outcomes.
  • A variety of negative neonatal clinical syndromes.

Given these concerns, reproductive age women treated with Antidepressants frequently elect to discontinue their medications proximate to pregnancy, or immediately after becoming pregnant, despite the known increased risk for relapse or recurrence.

This leaves women who are successfully treated with ADs and want to become pregnant caught in the difficult clinical dilemma of weighing the risks of fetal exposure to medication against the potential impact of untreated maternal depression during pregnancy.

There is compelling evidence that treatment with a methylfolate agent, like EnBrace HR, would not only avoid the potential risks of antidepressants in pregnancy, but would also confer important benefits to pregnancy and child outcomes as well, such as prevention of major birth defects and longer term neurodevelopmental outcomes.

Initial studies indicate that methylfolate may be a safe and effective option for the treatment of depression, especially in populations that are vulnerable to medication-related adverse events, and those who are folate deficient or whose folate needs are elevated, such as the case in pregnant women.

EnBrace HR™ meets the above criteria as a potential ideal candidate for the prevention of depression in pregnancy.

EnBrace HR (FDA IND# 129890) is a once a day, prescription prenatal/postnatal dietary supplement that contains vitamin coenzymes, mineral cofactors, and a unique Omega 3 phospholipid. It includes L-methylfolate, folinic acid, reduced folates.

EnBrace HR is optimal for a population with high rates of MTHFR Polymorphism that affect folic acid metabolism.

EnBrace HR also contains omega 3 fatty acids primarilyeicosapentaenoic acid, which shows promise for the treatment of depression.

 
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New! Harvard/Mass General Study Underway 

Potential Treatment Option for Women Deciding to Discontinue Antidepressants During Pregnancy

Click Here To Read On ClinicalTrials.Gov

“We are excited to study treatment options for depression other than standard antidepressant medications because it is important to be able to offer a range of treatments to women with depression during pregnancy. “ - Marlene Freeman MD, Associate Professor of Psychiatry, Harvard Medical School and Associate Director, Center For Women’s Mental Health, Massachusetts General Hospital, who is the study’s Principal Investigator.

The components in EnBrace HR are crucial for healthy pregnancies. Folates supplementation has been associated with reduced risk of neural tube defects and is recommended for use in women of reproductive potential to reduce the risks of birth defects. A substantial proportion of the population are poor folic acid metabolizers and Methylfolate compounds, like EnBrace HR specifically, provide a more efficient delivery of folate-related compounds.

References For Homocysteine and Folate Levels as Related to Depression

According to the American College of Obstetrics and Gynecologists: “It is important to identify pregnant and postpartum women with depression because untreated perinatal depression and other mood disorders can have devastating effects on women, infants, and families.” May, 2015 Read more here.

Aishwarya et al. 2013 Reports: Homocysteinemia is associated with postpartum depression and lower serotonin levels. Also PPD in the mother is related to low APGAR score in infants born to these mothers emphasizing the significance of both mental as well as nutritional status of the mother.

Abou-Saleh et al. 1999 Reports: A strong association between low folate levels and depressed mood at day 7 after delivery.

Lewis et al. 2012 Found: Evidence to suggest that folic acid supplements during pregnancy protected against depression 21 months postpartum, and that this effect was more pronounced in those with the MTHFR C677T TT genotype polymorphism.