Mad in America: Rethinking Mental Health

Medical Organizations Turn Blind Eye to Harms of Maternal Antidepressant Use: A Conversation With Adam Urato and Joanna Moncrieff


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On July 21st 2025, the FDA convened a hearing on maternal use of antidepressants during pregnancy and the impact this use has on fetal development. Around 400,000 children in the United States are born each year whose mothers took antidepressants while pregnant, and so it's easy to see the societal importance of this topic. What are the risks to the fetus, the newborn, and the long-term development of that child? Adam Urato and Joanna Moncrieff were members of that FDA panel, and so too were several others well-known to MIA readers, including David Healy and Joseph Witt-Doerring.

The purpose of the panel was to assess whether the FDA needed to put a warning on antidepressants related to their use in pregnancy, and most on the panel spoke of research that told of the need to do so. However, after the panel concluded, the American Psychiatric Association and other medical associations, most notably the American College of Obstetricians and Gynecologists, responded with what can only be described as howls of outrage, issuing press releases and telling the public that the panel was biased and that the real risk during pregnancy was untreated mental illness.

These medical organizations asserted that the increased risk of adverse outcomes for children born to depressed mothers is due to the illness and not the drug, and that there was plenty of evidence that antidepressants were a helpful and even life-saving treatment for maternal depression.

Here is where we are today. That FDA hearing put two narratives on public display, and most media reports embraced the narrative put forth by the medical organizations. What we will do today is review the evidence that exists on this topic and the response by the medical guilds to a public airing of that evidence.

Dr. Adam Urato is Chief of Maternal and Fetal Medicine at the Metro West Medical Center in Framingham, Massachusetts, and he has been speaking and writing about the risk of medications used during pregnancy for years. Dr. Joanna Moncrieff is a UK psychiatrist and researcher who was a co-founder of the Critical Psychiatry Network and is well known for her research on the safety and efficacy of psychiatric drugs.

***

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To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850

© Mad in America 2025. Produced by James Moore https://www.jmaudio.org

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