If you have depression and are pregnant or planning to be, it is natural to wonder whether your depression medication may be safe for you and the baby.
In general, antidepressants are safe to take during pregnancy, although your healthcare professional may want to adjust the type of drug or the dosage.
In all cases, continuing with your depression treatment is key to preventing the worsening of symptoms and reducing the chance of postpartum depression.
The risks of untreated depression often outweigh those of antidepressant use during pregnancy and may include an increased chance of preterm labor, low birth weight, and health challenges for the baby.
Depression is a treatable condition, and relief is possible.
Is taking antidepressants safe during pregnancy?
Most antidepressants may be safe for you and the baby during pregnancy, including some types of:
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin and norepinephrine reuptake inhibitors (SNRIs)
- tricyclic antidepressants (TCAs)
Every case is different, though. Your healthcare professional may still want to assess your individual risk factors, overall health, and depression symptoms before recommending or switching you to one or the other.
Antidepressant drugs may reach the fetus but have a low chance of affecting brain development and infant behavior.
Research from 2017 suggests that taking SSRI and SNRI antidepressants during pregnancy may lead to a low probability of:
- low birth weight
- respiratory challenges in the baby
- premature birth
Neonatal adaptation syndrome may also be possible. This involves symptoms like jitteriness, respiratory challenges, and high blood sugar in newborns.
In general, the use of antidepressants during pregnancy outweighs the risks of untreated depression, which may include slowed intrauterine growth, low birth weight, and challenges in the parent-newborn emotional connection.
What are the safest antidepressants in pregnancy?
Most antidepressants are safe to take during pregnancy, but SSRIs are considered among the safest and most commonly prescribed depression medications for people who are pregnant or nursing.
Research from 2015, including this large study of more than 3.7 million pregnant women and this study of more than 18,000 mothers of infants with and without birth defects, suggests that SSRIs are mostly safe to use during pregnancy.
Some of the SSRI antidepressants that may have lower chances of complications, including congenital disorders, miscarriages, and other fetal development concerns include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- sertraline (Zoloft)
SNRIs like duloxetine (Cymbalta) may also have lower risks of pregnancy and birth complications.
TCAs that are commonly prescribed during pregnancy include desipramine (Norpramin) and nortriptyline (Pamelor). They may have a lower chance of side effects in pregnant people and fewer possibilities of developmental issues compared with other drugs of the same class.
Safety considerations are based on available data, though. Studies on the possible risks of each of these drugs on the pregnant parent and fetus are limited.
Discussing your possible concerns and questions with your healthcare professional is highly advised before stopping or changing your medication. They may want to revise your dosage or change brands, but it is likely they will recommend you continue your depression treatment.
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Get free cardWhich antidepressants are not recommended during pregnancy?
Although every case is different, research suggests that pregnant people may want to avoid these antidepressants:
- fluoxetine (Prozac)
- paroxetine (Paxil)
- venlafaxine (Effexor)
- monoamine oxidase inhibitors (MAOIs) like isocarboxazid, phenelzine, and selegiline
SSRIs like fluoxetine and paroxetine have been associated with a higher risk of birth defects. This is because they are more likely to be passed to the fetus, according to 2013 research.
Research from 2015 also suggests that babies born from mothers who took paroxetine or fluoxetine early in their pregnancies were 2–3.5 times more likely to have birth defects and developmental problems.
A 2020 study found that venlafaxine is also linked to a high number of developmental issues and complications, including respiratory problems.
MAOIs are associated with an increased chance of adverse effects in newborns, including high blood pressure, according to the 2013 research mentioned previously.
The stage of pregnancy may also be associated with potential adverse effects. A 2016 study found that taking antidepressants during the first 3 months of pregnancy may increase the chance of a miscarriage.
Side effects of antidepressants in pregnancy
As with most drugs, antidepressants may lead to side effects, including:
- indigestion and stomach pain
- diarrhea
- dizziness
- sleep disturbances like insomnia or daytime drowsiness
- headaches
- feelings of agitation and anxiety
Summary
Taking antidepressants during pregnancy is possible and safe and may outweigh the risks of untreated depression.
Among the safest antidepressants to take during pregnancy are SSRIs like Zoloft.
Still, side effects may occur, and a low risk of complications is possible for both the birthing parent and the baby.
Discussing your antidepressant options with a healthcare professional may help you explore possible side effects and find drug alternatives that may better fit your needs during pregnancy. Discontinuing antidepressant use without medical supervision may lead to unwanted effects.
Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.