455 Pregnant and Scared by the Headlines? What to Know About Tylenol, SSRIs, and Autism Risk

Summary

Podcast Summary: Your Anxiety Toolkit

Episode 455 – Pregnant and Scared by the Headlines? What to Know About Tylenol, SSRIs, and Autism Risk

Host: Kimberley Quinlan, LMFT
Guest: Dr. Katie Unverferth, Board-Certified Psychiatrist, Perinatal Mental Health Specialist
Original Air Date: October 13, 2025

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Episode Overview

This episode addresses the anxiety-inducing headlines surrounding the use of Tylenol (acetaminophen) and SSRIs (antidepressants) during pregnancy, specifically their purported links to autism and ADHD in children. Host Kimberley Quinlan consults with Dr. Katie Unverferth to break down the latest research, media interpretations, and actionable advice so pregnant listeners—or anyone planning pregnancy—can make science-based, empowered decisions about their health and their baby’s well-being.

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Key Topics & Insights

1. The Tylenol-Autism Headlines

[00:56–03:47]

• FDA’s Response:
  Recent studies report an association, not a causal link, between Tylenol use in pregnancy and autism. The FDA has sent advisories to physicians, but clearly states there is no established causal connection.

• Understanding the Data:
  The studies showing association are confounded; Tylenol is often used for fever, pain, or infections—conditions themselves correlated with increased neurodevelopmental risks (e.g., autism, ADHD). Sibling-controlled studies (comparing two pregnancies from the same mother with differing Tylenol use) reveal no increased neurodevelopmental risk with Tylenol.

  "What that tells me is that Tylenol use is more of a marker for an increased risk for autism, but it's not actually causing that increased risk of autism."
  — Dr. Katie Unverferth [03:36]

• Brand Name Confusion:
  Tylenol, acetaminophen, and paracetamol refer to the same medication; "Tylenol" is just the common U.S. brand name, not a unique drug.

2. Managing Pregnancy Anxiety

[05:48–11:26]

• Emotional Toll:
  Pregnancy already presents significant pressures; alarmist headlines exacerbate anxiety and can lead to self-recrimination.

• Coping Strategies:

  • Lean on trusted healthcare providers ("OB GYNs, perinatal psychiatrists, family physicians") for reliable information.
  • Use therapy—especially if anxiety generalizes and starts to overwhelm daily functioning.
  • Evidence-based treatments for perinatal anxiety include:
    • Cognitive Behavioral Therapy (CBT)
    • Interpersonal Therapy (IPT)
    • Mindfulness and flexibility practices
    • Prenatal massage, acupuncture, and exercise

  "Having some anxiety about Tylenol use right now is understandable...but when it takes on a life of its own, that's really when we know you need to seek treatment."
  — Dr. Katie Unverferth [09:46]

3. What Do We Know About Autism and ADHD Causes?

[07:48–09:24]

• The science points to a complex interplay of genetic (polygenic risk scores) and environmental factors; there is no single or simple cause identified yet.
• Conditions like migraines may be correlated due to shared genetics, not causation.
• The current administration is investing in understanding autism etiology.

4. SSRIs in Pregnancy: Media vs. Science

[13:39–19:17]

• FDA Panel Review:
  Like Tylenol, SSRI risk studies often do not account for "confounding by indication"—the underlying depression or anxiety for which SSRIs are prescribed.

• Untreated Depression Is the Real Risk:
  Depression during pregnancy independently results in numerous negative outcomes:

  • Preterm birth, low birth weight, preeclampsia
  • Negative neurodevelopmental outcomes for the child
  • Increased risk of postpartum depression

  "It does not seem like adding an SSRI increases that risk further."
  — Dr. Katie Unverferth [16:50]

• Addressing Stigma:
  Both host and guest note stigma against medication often causes moms to unnecessarily sacrifice their own well-being, sometimes worsening outcomes.

  "There's a lot of pressure on moms to give up their own mental health for the wellness of their baby. And that's what worries me."
  — Kimberley Quinlan [20:18]

• Effectiveness and safety data for SSRIs in pregnancy is robust; the key is achieving mental wellness, not staying at the lowest dose.

5. Personalized Risk Assessment and Treatment

[21:57–24:09]

• Risk assessments for antidepressant use in pregnancy focus on symptom presentation, not genetic screening (yet).
• Personal or family history of mood disorders—especially PMDD or hormonal sensitivity—increase risk for perinatal depression/anxiety.
• Critical to use the medication that works best for the individual, not just defaulting to the "safest" by blanket standard.

6. Navigating Information Overload

[24:20–26:59]

• Medical society guidelines (e.g., ACOG, Society for Maternal Fetal Medicine) strongly support continued Tylenol and SSRI use as appropriate.

• Caution against relying on media or social media for complex medical decisions.

• Find reputable sources and trusted physicians to help interpret research and provide individualized advice.

  "There is an online influencer who will say anything...So trying to seek different opinions, trying to find sources you trust, trying to find physicians you trust is really important."
  — Dr. Katie Unverferth [26:30]

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Notable Quotes

• “Tylenol use is more of a marker for an increased risk for autism, but not actually causing that increased risk.”
  — Dr. Katie Unverferth [03:36]

• "Having some anxiety about Tylenol use right now is understandable...but when it takes on a life of its own, that's really when we know you need to seek treatment."
  — Dr. Katie Unverferth [09:46]

• "It does not seem like adding an SSRI increases that risk further."
  — Dr. Katie Unverferth [16:50]

• "Stability predicts stability. One of the best things we can do is kind of protect mom's mental health the whole time."
  — Dr. Katie Unverferth [17:32]

• "There's a lot of pressure on moms to give up their own mental health for the wellness of their baby. And that's what worries me."
  — Kimberley Quinlan [20:18]

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Medication Safety Recommendations

[27:40–29:18]

• Professional organizations recommend treating depression in pregnancy when indicated.
• SSRIs (e.g., Zoloft/sertraline) have good safety profiles—not the only option, but well-studied.
• The “right” medication is the one that works best for the individual; treatment should always be tailored in partnership with your doctor.

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Actionable Takeaways

• Don’t panic at the headlines: Associations are not causation, and media stories often oversimplify.
• Prioritize mental health during pregnancy: Untreated depression/anxiety carries real risks; treatment is often safer than not treating.
• Consult with specialized healthcare providers: OB GYNs, perinatal psychiatrists, and therapists have the most current information.
• Use reputable resources: Follow medical societies’ guidelines over media or online influencers.
• Seek therapy if anxiety becomes overwhelming: Mindfulness, CBT, IPT, and other evidence-based therapies are effective and safe.
• Medication should be individualized: Don’t default to “what’s safest for everyone”—work with your provider for what’s best for you and your baby.

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Further Resources & Contact

• Dr. Katie Unverferth: Private practice in Santa Monica, Director of the UCLA Women's Life Center, Instagram @Dr.KatieND
• Previous episode on perinatal medication safety: Linked in show notes.

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Overall Tone:
Compassionate, reassuring, scientifically grounded, and supportive—emphasizing empowerment over fear-based decision making.

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This summary skips promo and outro sections as requested. For professional guidance, always consult with your own healthcare providers.

Transcript

[A]

If you are pregnant or planning to be, you've probably heard alarming headlines lately about Tylenol, SSRIs, the risk of autism or ADHD. It's enough to make anybody anxious even without a history of mental illness. So today we're cutting through all the confusion and the fear. I am joined by psychiatrist Dr. Katie Unverferth, a board certified, certified psychiatrist who specializes in perinatal mental health to discuss what we need to know and how you can make empowered, informed decisions for your mental health and your baby's well being. So thank you so much for being here again.

[B]

Yeah, thanks for having me.

[A]

So happy you're here. Truly, this has been something that I look at and I listen to the news and I kind of start to look cross eyed. And so I need somebody who knows a lot more than I do.

[B]

Yeah, happy to help.

[A]

Okay, so let's get straight to it because I want to sort of get to the point as fast as we can to help people manage this or at least be informed enough to make their own decisions. So let's talk about the recent headlines around Tylenol. What is happening there? What is the FDA responding to with these sort of new labeling discussions?

[B]

I think what the FDA is responding to is that there have been some recent studies that have associated Tylenol with an increased risk of autism in pregnancy. So the FDA recently sent like an article or a letter to physicians sort of advising them that there are some studies that show that there's an association of Tylenol with autism in pregnancy. But it does say in that letter that it's not a causal link, that a causal link has not been established. I think that when we look at this data a little bit deeper, there are studies that show an association. But what complicates this is that we know that Tylenol use in pregnancy is often used for fever. It can be used for infection, it can be used for pain conditions, and it can be used for migraine. Those conditions have each been associated with negative neurodevelopmental outcomes like ADHD and autism. And so while some studies might show an association, in my read of the data, it looks like it might be actually the conditions themselves that increase the risk rather than the Tylenol use. There are a few studies that specifically look at this. So when we have these issues in the field, in the field of, like, perinatal medicine, what we try to do sometimes is we try to separate out, you know, kind of these environmental genetic risks versus the medication risk. One way of doing this is Something called sibling controlled studies. So what you do is you look at the same mom, two different pregnancies, and you compare the exposure in each of the pregnancies. So it's sibling analyses. And so they actually have done two very large studies like that with Tylenol. So same mom, and they look, she used multiple more Tylenol in one pregnancy and maybe no Tylenol in another pregnancy. And what they found is in those studies, there was no increased risk of negative neurodevelopmental outcomes like autism or ADHD with Tylenol use. What that tells me is that Tylenol use is more of a marker for an increased risk for autism, but that it's not actually causing that increased risk of autism. It's much more likely to be related to genetic risk factors for autism, familial risk factors for autism, environmental risk factors for autism, but not really the medication itself.

[A]

Right. That's super helpful to know. One question, and this may also be my lack of knowledge, is why was it called Tylenol? And why was it all over the news the word Tylenol and not the actual name of the medication? Like in Australia, I think there's two ways you. You can say acetaminophen, and we would say acetamofen. And I was surprised. So is there a reason why it was labeled Tylenol only, or is that just because it's easier to say?

[B]

I think it's because it's easier to say. I think it's because in the US people use them interchangeably. So it's Tylenol or acetaminophen. I've seen some of the studies. They call it paracetamol. So I think. I think. I don't think it's specific with the brand name Tylenol. I think it's just. Just people switching back and forth between generic and brand name.

[A]

I understand. I was like, wait, is there something specific about that brand? Like, is there something I also do?

[B]

It's a great question. It's a great question. Yeah.

[A]

So you've already sort of helped us to understand this. Now we're here talking about a mom who is pregnant and just wants to have a healthy baby. And in today's age, there's so much on the market and pushing and pressure to eat well and breastfeed your baby, and you've got to do. You've got to kind of jump through hoops, and it does feel like a lot of pressure that it's our job to prevent these scary things from happening to our children. So in this case, let's say someone was coming to listen to this, and they were more like, oh, my God, I did take Tylenol. And, you know, that's scary. But now I'm understanding it's not that. It's more the fact that I had a fever or I had a headache or migraines. How might someone manage that, as a pregnant woman, manage the anxiety of that, do you think?

[B]

That's a great question. I think speaking with your provider, speaking with your ob gyn, I think, is always helpful. I think that everybody's doing the best they can to manage these things. Right. I understand that there can be a lot of anxiety worrying about exposures. I think specifically with Tylenol, I think that this isn't necessarily a fear that's based in reality. Right. But I do see and have seen in my practice how, you know, if we're saying that something that's generally been considered so safe in pregnancy isn't safe anymore, it can make people so worried about all of the other things they did during pregnancy. Right. So it just really can increase worry when people are already so worried. Right. I think what's really helpful is to, you know, stick to really reputable resources to get information. So I think OB GYNs are really helpful. Perinatal psychiatrists can be really helpful. Family physicians can be really helpful. You know, I think getting support from friends and family is helpful. But I do think that this is an anxious time. This is a difficult time to be pregnant because there are so many, like, mixed messages in the media right now. There are so many mixed messages, you know, coming from, like, the administration as well. And so I think, you know, finding, you know, finding an ob GYN that you trust and really relying on them to help you navigate it is important.

[A]

Yeah. Thank you. I think back to is I've had two children, and I took Tylenol for both.

[B]

Me too. Me too.

[A]

And I had a fever in my daughter, as I remember. But I don't think with my son, I had a series of, like, really bad, like, stomach flus and viruses, and it was just like, a crappy year. It actually, like, wiped out our whole Christmas. Like, everything of Christmas got ruined. And I'm hearing a lot of people online even. Even saying I have one child with autism and one not, and I didn't have a fever or anything in that pregnancy. And so I think, particularly for us anxious folks, we're all, like, trying to calculate this, like, one, one fever check. And, you know, you know what I'm saying? So now what do we know? Like, are we starting to figure out the cause of autism and adhd? Is that. Is this about us now understanding more about the actual reason we have it, or are we still a long way away?

[B]

I think. I think it's very complicated, unfortunately. I think that what we do know is that there are. What they're starting to look at is like polygenic risk scores. So it's looking at sort of a variety of genes that interact to lead to the increased risk of, like, autism or adhd. I think when I said that, you know, migraines are associated, what it seems like is that migraines are sort of associated with this genetic risk factor for autism, adhd. Not necessarily that migraines cause autism or adhd. I think a lot of these things are associations. What I do think will be good is that this administration is really shining a light on autism, and it sounds like they're about to dedicate a lot more resources to really trying to figure out what the underlying causes of autism. What we know best at the point is that it does seem to be both genetic risk factors, so meaning genes that sort of cluster within families that increases the risk for autism. And then it seems like there are some environmental risk factors, meaning, like toxins, meaning pollutants, but also environmental risk factor could be, like, certain infections. But is there a clear, you know, specific cause of autism yet? I don't think we know, and more research is needed, so I do think that will be good.

[A]

Right. And so what advice would you give a pregnant mom or families who, you know, expecting. What advice might you give them besides speaking to their doctor of navigating the anxiety of this sort of news and the way the media is handling it?

[B]

Yeah, I think therapy has a lot of evidence in this situation too. Right. Because obviously having some anxiety around this is understandable. But what I always say is when it takes on a life of its own own, that's really when we know you need to seek treatment. Right. So it's okay to have having some anxiety about Tylenol use right now is understandable if it then generalizes to every single decision you made in pregnancy or every decision you're going to make moving forward. At that point, I really want you to work with a therapist to sort of help weigh, you know, these different intrusive thoughts you might be having. So in pregnancy, we know that cognitive behavioral therapy has a lot of evidence for treating anxiety and depression. Interpersonal therapy, ipt, has a lot of evidence for treating anxiety and depression. I think really focusing on mindfulness, I tell all of my pregnant women, I really want you to work on being flexible. Right, let's be flexible during pregnancy, you know, because the pregnancy experience is really different for everybody. And one of the best things you can do is sort of be present with whatever happens and however you feel there's some evidence. I mean now we're just kind of talking about more like treatments for anxiety and depression. But massage has some evidence. So sometimes if people have resources or are able to, you know, getting intermittent prenatal massages can be helpful. Acupuncture has some evidence, exercise can be helpful. These are all just sort of evidence based things to manage anxiety in pregnancy. But I think part of it is just understanding that there is going to be anxiety around decision making in pregnancy because there have been these messages recently that like you might have done something wrong. And so understanding that, being present with that, accepting that. But then if it really does start to take on a life of its own, seeking care from someone who specializes in that.

[A]

Yeah, absolutely. I remember like having anxiety about which car seat I bought. I mean it was like.

[B]

Or strollers. There are so many strollers.

[A]

Yeah, yeah, but feeling like, but you know, should I buy the $601? Cuz what if we got in an accident and you start to calculate like, you know, it's, it's a whole thing. What I think is interesting too, and I'm noticing an increase in, in my own practice is sort of this general what we, you know, we have health anxiety. Folks who have hypochondria worrying about themselves and sort of now this like health anxiety by proxy, like their health anxiety is around the child. What could impact the child, what you know, and I think that it's so hard, the messaging is so scary and it's everywhere on social media. So I'm sure for a lot of folks that sort of health anxiety has really you increased.

[C]

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[A]

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[C]

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[A]

Big hug.

[C]

And now let's get back to the show.

[A]

Okay, let's shift because there's two main topics I wanted to discuss today. So the next one is the FDA expert panel has revisited the safety of SSRIs in pregnancy. Can you tell me. I didn't even know about this until you had reached out to me and said, let's talk about this news. And so I was a little bit like, oh, I missed this. How did I miss this? So do you want to share with me a little about what's going on there?

[B]

Yeah. So the FDA panel was revisiting SSRIs in pregnancy and relooking at their safety in pregnancy. It was a panel of different people who, you know, regularly prescribe antidepressants. But there was one person who was a reproductive psychiatrist who really focused on using these medications in pregnancy and postpartum. So what they were doing is they were sort of relooking at a body of data. Unfortunately, it did seem like they in kind of a similar way to the Tylenol studies that they were looking at. A lot of studies that showed increased risks with SSRI use. But it is a very similar story to Tylenol in that way, in that the studies that show increased risk with SSRI use are really failing to take into account both the increased risk of just being depressed in pregnancy and also familial genetic environmental factors that increase the risk for negative outcomes rather than the antidepressant itself.

[A]

Okay, let me unpack that.

[B]

Yeah.

[A]

So I think what you're saying, but please tell me if I'm wrong, is you're saying the prevalence of having depression or anxiety, which is why you're going to get that prescription.

[B]

Right.

[A]

Could be more the cause. Like there's. Because there's. Now we're showing there's genetics. It's showing up that the child is more likely to have some sort of mental health because of that.

[B]

No. So what I'm saying is that it's called confounding by indication. So it means that the indication for which the medication is used causes the negative outcome. So with SSRIs, what we know is that depression in pregnancy has negative outcomes both for the mom themselves in terms of just, you know, the burden of being depressed, but for also the pregnancy and the developing infants. And so with the pregnancy, it leads to preterm birth, low birth weight, preeclampsia, increased risk of emergent C section. Also with the developing fetus, it can lead to low birth weight, which I already said, it can lead to negative neurodevelopmental outcomes, actually. So there are some evidence that there are behavioral issues with children who are exposed to depression in pregnancy, some changes in immune regulation, some changes in stress response. And so what we know is that depression in pregnancy isn't benign. It leads to negative outcomes. It does not seem like adding an SSRI increases that risk further. So I think what can happen is you can find studies that will say SSRIs increase the risk, but often they're not very well designed studies and they're not controlling for the depression itself.

[A]

So let me understand this, and thank you for clarifying that, because I think I was saying the same thing, but I didn't articulate it very well.

[B]

Sorry.

[A]

No, no, it's. I'm trying to make sense of this in my head because I'm not a research. I'm like, I'm not a researcher. But wouldn't that then mean that we want them to go on SSRIs because we want to reduce the depression and the anxiety? Because my fear. My fear is someone might see that the SSRIs are these sort of like they've associated it, and that's not good. So then I shouldn't go on it. But isn't it what you're saying, and maybe I've got this wrong, we actually need to manage that anxiety and depression for those beneficial outcomes?

[B]

Yeah. I think what I will typically say is that stability predicts stability. So one of the best things we can do is kind of protect mom's mental health the whole time. And that really begins before pregnancy. Right. So the best thing we can do, having you go into pregnancy is feel mentally well and stable. That predicts that you'll continue to feel that way during pregnancy, and that predicts that you'll continue to feel that way in the postpartum. So certainly untreated depression anxiety have negative outcomes. Right. What I will tell people and what people really resonate with, especially if they've had sort of severe depression or anxiety before, is that it's an inflammatory state. Right. You feel off, your heart is racing, you're having all of these intrusive thoughts. It's hard to function. It's especially hard to, like, go to your therapist sometimes. It's hard to make your appointments. It can be hard to, like, Eat healthy, to exercise, to engage with friends and family. Right. So treating that with an antidepressant can really have all of these benefits. You know, separate from just treating the depression, it can really improve some of the behaviors that we know are positive for a pregnancy. What we also know is that untreated depression in pregnancy is the biggest risk factor for postpartum depression. So sometimes I'll see people in pregnancy who are depressed, clinically significant depression or anxiety, and they don't really want to take an antidepressant, which I understand. Right. But then they're so worried about postpartum depression. They're like, but, but, but I'll feel better in the postpartum, won't I? And unfortunately, that doesn't seem to be true, even though some people think they will. Most studies kind of show that there's a continuation of the depression and maybe a worsening in the postpartum. So really, I encourage people to sort of, let's treat their. Their depression or anxiety to remission. Right. We really want to. To have them feeling well and healthy.

[A]

Yeah. And as a clinician, I mean, I'm not swaying listeners who are listening either way, but I can't tell you how many times I have clients who are in the middle of pregnancy, and they are muscling through, trying so hard to use the skills and practice the tools and doing their homework so that they don't have to go on medicine. And with some benefit, too. As you said, CBT exposure and response prevention are very highly successful treatment.

[B]

Right.

[A]

Especially for. For ocd, if we're talking about exposure and response prevention. But hormonally and environmentally, they're struggling. And then when they do go on an SSRI or they sort of, you know, hit rock bottom, they're like, I wish I had have started earlier. There was such a stigma to medication, which I fear is going to be even worse now. And have just said that helped me to cross the finish line. And it was so helpful.

[B]

I.

[A]

And so I sort of just wanted to share that for folks is I see it all the time. But, you know, there's a lot of pressure on moms to give up their own mental health for the wellness of their baby. And that's what worries me.

[B]

Right. It starts in pregnancy, that. That really intense pressure. I think that makes a lot of sense. Right. What. What we do talk about and to kind of help people weigh this a little bit more is that we do talk about sort of this risk. Risk analysis. Right. So we both talk about sort of the risk of Untreated depression, anxiety, or even partially treated depression and anxiety. Right. Someone who's sort of muscling through and maybe getting like 30 or 40% better, maybe 50% better, but still having clinically significant depression and anxiety. So we talk about the risk of that versus the risk of a medication. Right. So we want to weigh those two things. What I see sometimes in my practice sort of similar to what you see, is that I'll see people who are really trying to stay on the lowest dose of antidepressant they can, but are still having a lot of depression and anxiety. In that setting, we would prefer to increase the antidepressant and decrease the symptoms because in that way we think about it as one exposure. So we would rather have them not exposed to the depression, anxiety, and just have them on the antidepressant. And so I, that's sometimes how I help people think about it, to really encourage them to treat their symptoms instead of, you know, kind of. I agree there's this self sacrificial, you know, understandable mentality, but I actually think in pregnancy it's a little bit misguided. Right. We really want you to feel the best and we know that that's the best for your pregnancy.

[A]

Right. And would it be true too that you would speak with your doctor about your genetic risks? Like I think about me with, let's say breast cancer. So I have breast cancer in my family. If you make a decision on whether to go on hormone replacement therapy or something, they're asking you all of these risk factors, like is there a history of breast cancer and that helps them to determine the prescription. Is it like that with this as well? Or, or is it more dependent on, like you said, the one risk. I think you said it was cold.

[B]

Or the one or the polygenic risk. Yeah, yeah. No, so mostly with this, what we're looking at is we're looking at symptoms. So yeah, so I think in psychiatry, we almost exclusively look at symptoms and treat symptoms. You know, hopefully in the next 10 years, 20 years, we'll be able to more specifically say, like, oh, your cluster of genes means this, which means you should use this medication, which means this is your risk and this is how you decrease it. You know, like this field, like precision medicine, I hope we get there, but we're not there right now. So really what we do think about is, I guess it depends on what we're talking about. Because if we are talking about risk for depression in pregnancy, that there are certainly very specific risk factors for. But really thinking about like Genetic risk. Not necessarily. If you had a family member, like, if your mom or sister had like severe depression in pregnancy, you're at risk for that. If they had postpartum depression, you're at increased risk of. For that. If you have a history of premenstrual dysphoric disorder. So like depression, anxiety, irritability, mood instability in the luteal phase. Right. That's pmdd. That increases your risk for depression in pregnancy and postpartum. If you have depression related to hormonal contraceptives, that increases your risk for depression in the postpartum. You know, what we sort of look for is a history of hormonal sensitivity. Right. So we know that some people have abnormal mood responses or have very intense mood responses to changing levels of hormones, and that increases the risk for depression in pregnancy and postpartum.

[A]

Okay. This has been so helpful because I feel like you've just given us a very level, good understanding, a good education of what it, what it is and all, and all of these things.

[B]

So.

[A]

Okay. The. When it comes down to it, it's almost like having more information is so helpful, but also scary.

[B]

Yeah.

[A]

Which, you know, it's sort of the same with when you have the amnio. What is it when you get the embryo synthesis. Yeah. It's like, it's so great that we have this, but it's also so anxiety that provoking that you've got to go have this test and get these results. So what advice would you give generally to a mom who is overwhelmed? Would you encourage her not to be watching the news or would you encourage her to be watching the news? Would you be encouraging her to get one or two doctors opinions like, you know, to what degree should they be proactive versus also protecting themselves from all of this?

[B]

Yeah, that's a great question. It's a really difficult time, I think. Right. It's like I. I'm an academic and I do research and so I know about sibling control analysis and I understand, you know, how that matters and how that changes sort of the landscape of data. But we can't really expect everybody to know that. I do think the data, like what I would rely on are like medical society guidelines. So, for example, the American College of Ob gyn, ACOG has said that they feel very comfortable continuing to use acetaminophen in practice pregnancy. Right. The Society for Maternal Fetal Medicine has also issued a similar statement. I do think that there's a bit of a disconnect from the messaging we're seeing in the media at this time. And also the messaging we're seeing from physician organizations. As a physician myself, I tend to follow what physician organization recommendations are making just because I trust that they have sort of the top experts in the country making those recommendations. And historically, those have really been in line with how I understand the research, how, you know, the majority of physicians understand the research. So I think that those are some good places to get information. I think, you know, choose your sources widely or wisely. You know, there are. There is an online influencer who will say anything, and you can find really, the range of different people. And so I think it's tough, right? We're all a little bit in our, like, information silos, you know, and so trying to seek different opinions, trying to find sources you trust, trying to find physicians that you trust is really important. But, yes, it is. There's no perfect way of doing it right now, and it is. It is a difficult time. It's a really difficult time.

[A]

Amazing. Thank you. I'm so grateful for this. Really, I am, because, I mean, even as I'm thinking back, like, it is so confusing, it is so scary. But I think what. I think what you're saying is go to your doctor, get very specific advice from them on what they think is best for you and your specific situation. It doesn't mean you have to muscle through a fever on your own by, you know, with no assistance, because that has, you know, that's not helpful for anybody. So I'm really grateful. One question just to clarify as well, is the boards. The. You listed a couple of boards, are they also saying the same for the SSRIs? What are they interesting?

[B]

They are, yeah. The. The similar for SSRIs. It's. It is across the board recommended to treat depression in pregnancy, and SSRIs at this point have decades of safety data to really support their use. Yeah.

[A]

Yeah. Thank you. And I think there are specific medications for pregnancy that they recommend. We've done an episode on that once before, which I'll link in the show notes, but do you want to sort of share what those are?

[B]

Yeah, of course. And so. So it really depends on in pregnancy if this is a recurrent episode of depression for you or if this is sort of a first episode. So if it's recurrent and you've tried multiple medications before and there's one that works best for you, we would recommend restarting that in pregnancy. If you were having depression in pregnancy, if it's the first time you've ever been depressed, you've never been depressed before. You've never tried medications before. Typically people would start Zola or Sertraline. That's because it has good safety data. It has low placental transfer and low levels in breastfeeding or low levels in breast milk with breastfeeding. So it is a good option. But what I don't want people to think is that that's the only medication you can take in pregnancy or it's the safest, so you have to again, muscle through even if it's not working well for you. Really what the data supports is we want to use the medication that works best for you. And across the board we have, you know, really sufficient safety data for almost all of the antidepressants at this point. And so really kind of doing personalized care, working with someone who knows you and who can help you sort of have, you know, like a personalized recommendation for your situation given the symptoms that you're experiencing.

[A]

Amazing. Thank you. Okay, tell us where people can hear you because I'm sure they want to know or reach out to you. Where can people get in contact?

[B]

Oh yeah, of course. So people can look me up. I have a website. I have a private practice in Santa Monica. I also am the director of the UCLA Women's Life Center. So if people want one time consultations or to be seen for pre pregnancy consultations, they're welcome to reach out there. I also have an Instagram where I post typically just clips of lectures I've given in the past. That's Dr. Katie and D. Yeah. And hopeful. Hopefully we can connect.

[A]

Thank you. I'm so grateful. Again, this has been so timely and I think so important for people to hear. So I'm so grateful, of course.

[B]

Thanks for having me. Thanks for doing this.

[A]

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