antidepressants and pregnancy
Healthy Living

Antidepressants and Pregnancy: Are They Safe?

Dec 10 2022

When you’re pregnant, you do everything you can to ensure you have a safe delivery. You want a healthy, happy baby, but you also want to take great care of yourself. One question that often weighs heavily on an expectant mother’s mind is if antidepressants and pregnancy are a safe combination.

If you’re already taking antidepressants for conditions like depression, general anxiety disorder or PTSD, it’s best to talk to your doctor about how it might impact your pregnancy. But here’s a look at what we know so far.

Can I keep taking antidepressants while I’m pregnant? 

The bottom line is that, yes, you can take antidepressants while you’re pregnant. While taking any type of medication during pregnancy isn’t ideal, the risks, in this case, are pretty low. You may need to adjust the amount or type you take, but most doctors agree that you should continue.

What are the best antidepressants to take while pregnant? 

Even if you decide to combine antidepressants and pregnancy, you may need to adjust the type you take. For example, many selective serotonin reuptake inhibitors (SSRIs) – including citalopram (Celexa), sertraline (Zoloft) and escitalopram (Lexapro) – are generally considered OK. But paroxetine (Paxil) has been linked to a heart defect in babies.

It’s also generally thought to be OK to take:

  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), like duloxetine (Cymbalta) and venlafaxine (Effexor XR)
  • Bupropion (Forfivo XL, Wellbutrin SR)
  • Tricyclic antidepressants, like nortriptyline (Pamelor), nortriptyline (Pamelor) and desipramine (Norpramin)

On the other end of the spectrum, it’s best to avoid taking benzodiazepines in high doses or valproic acid.

How might taking antidepressants impact my baby? 

While the risks of antidepressants and pregnancy causing your baby any problems are generally less than 1 percent, they aren’t zero. For example, there’s a small, increased chance your baby might be born with a side effect called persistent pulmonary hypertension of the newborn (PPHN), a condition of the lungs and blood vessels. Other minor but potential risks of taking antidepressant medications like SSRIs during pregnancy include:

  • Heart defect
  • Low Apgar scores
  • Low birth weight
  • Miscarriage
  • Preterm birth before 37 weeks
  • Several other birth defects affecting the head, spine, abdominal organs and limbs

If you take antidepressants during the last trimester of your pregnancy, your baby may also experience withdrawal symptoms after birth. These are usually not long-term. They usually only last a few days up to a month. They might include the following:

  • Difficulty feeding
  • Irritability
  • Jitteriness
  • Low blood sugar
  • Poor tone
  • Trouble breathing

What happens if I stop taking antidepressants while I’m pregnant?

Many doctors encourage their pregnant patients to keep taking antidepressants. Why? Pregnancy and untreated depression aren’t a great combination. Women who suffer from depression and other mental health issues and aren’t able to manage their symptoms may not take proper care of their bodies while expecting. They may make destructive decisions, like skipping doctor’s appointments or drinking alcohol. It might also impact their relationships with their loved ones. Pregnant women with untreated depression are also more likely to give birth early or have a baby with a low birth weight.

What to discuss with your health care provider

No two situations are alike. Ultimately, every pregnancy is different, just like every pregnant mom’s mental health situation is unique. Making the decision to take medications during pregnancy is one you should always talk about with your health care provider. They can help you go over the risks and benefits and see what’s right for you.

If your mental health issue isn’t severe, your provider may help you find alternatives to medicine. These might include therapy or stress management. If it is severe, your doctor will ensure you take a safe dose of the proper medication for your and your baby’s health.

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