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Antidepressants: Safe during pregnancy? Taking antidepressants during pregnancy may pose health risks for your baby — but stopping may pose risks for you. Get the facts about antidepressants and pregnancy. By Mayo Clinic staff

Antidepressants are the first line of treatment for most types of depression. Antidepressants can help relieve your symptoms and keep you feeling your best — but there’s more to the story when you’re pregnant or thinking about getting pregnant. Here’s what you need to know about antidepressants and pregnancy.

How does pregnancy affect depression?

Pregnancy hormones were once thought to protect women from depression, but researchers now say this isn’t true. Although pregnancy doesn’t make depression worse, pregnancy often triggers a range of emotions that can make it more difficult to cope with depression.

Is treatment important during pregnancy?

Yes. If you don’t take proper care of depression during pregnancy, you may put your health — and your baby’s health — at risk. If you’re depressed, you may not have the energy to take good care of yourself. You may not seek optimal prenatal care or eat the healthy foods your baby needs to thrive. You may turn to smoking or drinking alcohol. The price of untreated depression may be high, including premature birth, low birth weight, developmental problems and an increased risk of postpartum depression.

Are antidepressants an option during pregnancy?

Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is low. Still, few medications have been proved safe without question during pregnancy and some types of antidepressants have been associated with health problems in babies.

What are the risks and recommendations for each type of antidepressant?

Here’s an overview, arranged alphabetically by type of antidepressant:

Selective serotonin reuptake inhibitors (SSRIs) Citalopram (Celexa)

Risks: Has been associated with a rare but serious newborn lung problem (persistent pulmonary hypertension of the newborn, or PPHN) when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with a birth defect that affects the brain and skull (anencephaly), a birth defect that affect sutures on the head (craniosynostosis) and a birth defect that affects the abdominal organs (omphalocele)

Recommendation: Consider as an option during pregnancy

Fluoxetine (Prozac, Sarafem)

Risks: Has been associated with PPHN when taken during the last half of pregnancy

Recommendation: Consider as an option during pregnancy

Paroxetine (Paxil)

Risks: Has been associated with fetal heart defects when taken during the first three months of pregnancy; has been associated with PPHN when taken during the last half of pregnancy; has been associated with anencephaly, craniosynostosis and omphalocele

Recommendation: Avoid during pregnancy

Sertraline (Zoloft)

Risks: Has been associated with PPHN when taken during the last half of pregnancy; has been associated with septal heart defects; has been associated with omphalocele

Recommendation: Consider as an option during pregnancy

Note: Persistent pulmonary hypertension of the newborn, anencephaly, craniosynostosis and omphalocele are rare conditions. Even if you take an SSRI during pregnancy, the overall risks remain extremely low.

Tricyclic antidepressants (TCAs) Amitriptyline

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies

Recommendation: Consider as an option during pregnancy

Nortriptyline (Pamelor)

Risks: Suggested risk of limb malformation in early studies, but not confirmed by newer studies

Recommendation: Consider as an option during pregnancy

Monoamine oxidase inhibitors (MAOIs) Phenelzine (Nardil)

Risks: May cause a severe increase in blood pressure that triggers a stroke

Recommendation: Avoid during pregnancy

Tranylcypromine (Parnate)

Risks: May cause a severe increase in blood pressure that triggers a stroke

Recommendation: Avoid during pregnancy

Other antidepressants Bupropion (Wellbutrin)

Risks: No established risks during pregnancy

Recommendations: Consider as an option during pregnancy

Next page (1 of 2)

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References

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