Antidepressants and Pregnancy

image001 One of the hardest decisions an expectant mother has to make is whether or not to continue taking her antidepressant medications. A lot of factors like her own health, the wellbeing of her baby, and the general welfare of her family have to be kept in mind when making this decision.

The best thing to do is to take on board both your psychiatrist and your ob-gyn and discuss antidepressants and pregnancy with them. They can guide you better as to what you should do. Together with their help and after considering the pros and cons of each, you can make the right decision. Learn more so that you can decide whether or not to take antidepressants for the anxiety and depression that comes with bearing a baby.

Why Is Depression Harmful During Pregnancy?

Being clinically depressed can be harmful for both you and your baby. The risk of birth defects, miscarriage, premature labor and delivery, intrauterine growth retardation and low birth weight baby increases. Not only during pregnancy, but after delivery too, depression can be troublesome for you and your baby. According to many studies, a child with a depressed mother is more likely to have cognitive disturbances, psychological problems and other social troubles.

If left untreated, depression can be problematic; therefore if you are pregnant and clinically depressed then you need treatment, either with medication, psychotherapy or both. Seek the help of your healthcare provider and discuss your situation with him. If you need it, he will give you a referral to a psychiatrist or a counselor.

Are Antidepressants Safe During Pregnancy?

When it comes to antidepressants and pregnancy, don't hesitate to consult your doctor. Psychiatrists and counselors can guide you better regarding your treatment and prognosis. They know what kind of antidepressants are suitable to be taken during pregnancy and whether you need them or not. Even if you are considering stopping your antidepressants, you must talk it out with your doctor because sudden stopping of medication can cause withdrawal symptoms and other side effects.

In a seven year study, between 1998 and 2005, it was found that almost one in twenty women used antidepressants either before conceiving or during the pregnancy. While the safety of most antidepressant is still in question, research has shown many old generation antidepressants and SSRIs to be safe. SSRIs are selective serotonin reuptake inhibitors that combat depression by increasing the amount of Serotonin in the brain. Although the risk of birth defects is low with these medications, the possibility is still there.

The Safety of Different Antidepressants

To make a decision regarding the use of antidepressants, it is better to weigh all the pros and cons and know the compatibility of antidepressants and pregnancy. If the benefits outweigh the risks, you can always opt for antidepressants. There are some medications that have been known to cause problems in the babies, and they must be avoided. The following tables list the medications that are considered safe and unsafe to use during pregnancy:

Antidepressants Considered Safe



TCAs (Tri-cyclic antidepressants)

These include nortriptyline (pamelor) and amitriptyline. Although they were first thought to be connected with limb malformation in babies, the recent studies have shown a decreased risk of these.

Some SSRIs (selective serotonin reuptake inhibitors)

As mentioned before, selective serotonin reuptake inhibitors like citalopram (celexa), sertraline (Zoloft) and fluoxetine (Prozac) are considered safe during pregnancy. The SSRIs are also linked to lung problems in children like PPHN or persistent pulmonary hypertension of newborn as well as heart defects. The rate of these defects, however, remains low.

Burpropion (Wellbutrin)

Although not a first line therapy drug for depression, this medicine is still an option for those patients who have not responded to the other drugs. It is used both for smoking cessation and battling depression.

Antidepressants to Be Avoided



Paroxetine (Paxil)

Paroxetine is an SSRI which has been linked to heart defects in the babies if taken during the first trimester of pregnancy.

Monoamine oxidase inhibitors

These include tranylcypromine (Parnate) and Phenelzine. Their side effects, if taken during pregnancy, include maternal hypertension and intrauterine growth retardation of the baby.

Should You Stop or Switch Antidepressant?

The decision to switch or stop taking medications depends on you and your healthcare provider. If you think that there are too many risks involved, you can either change your antidepressant or stop its use altogether. But you must keep in mind that with either scenario, there can be a relapse in the depression. Furthermore, by switching medication, you are exposing your baby to more drugs and they might have an adverse reaction and cause congenital malformations.

Make Your Own Choice

The bottom line is that you must consult your doctor if you are depressed and are considering pregnancy in near future. You doctor can advise you therapies other than pharmacotherapy like psychotherapy or other therapies to battle your depression.

It might be better for you to continue taking antidepressants if you have severe depression or if there is a greater risk of relapse. But overall this decision is not one to be made lightly. You must talk out the situation with both your ob-gyn and psychiatrist. The pros and cons of taking antidepressants should then be considered carefully and the situation should be worked out. You must make an informed decision so that neither you nor your baby suffers.