A US jury’s decision that an antidepressant caused heart defects in an unborn baby is highlighting the painful dilemma facing pregnant women with depression. The most common antidepressants have been linked to birth defects and miscarriage, yet some doctors fear that letting depressive symptoms go untreated may have long-term consequences for the mother and her unborn baby.

On 15 October, a jury in Philadelphia, Pennsylvania, ordered manufacturer GlaxoSmithKline to pay $2.5 million to the family of 3-year-old Lyam Kilker, who was born with serious heart defects. While pregnant, Kilker’s mother took the antidepressant paroxetine (Seroxat or Paxil), which belongs to …