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Antidepressants: Are they safe during pregnancy?
Taking antidepressants during pregnancy may pose risks for your baby — but stopping may pose risks for you. Get the answers to important questions about antidepressants and pregnancy.
By Mayo Clinic staffAntidepressants 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. In fact, an estimated 10 percent of women experience depression during pregnancy. 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. And the price may be high, including premature birth, low birth weight, developmental problems and an increased risk of postpartum depression.
Are antidepressants an option during pregnancy?
Few medications have been proved safe without question during pregnancy. Research continues, however, and the latest studies on antidepressants and pregnancy offer some reassurance. Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. Still, some types of antidepressants are safer than others.
Here's an overview, arranged alphabetically by specific type of antidepressant:
| Antidepressant name | Risks | Recommendations |
|---|---|---|
| Selective serotonin reuptake inhibitors (SSRIs) | ||
| Citalopram (Celexa) | 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 | Consider as an option during pregnancy |
| Fluoxetine (Prozac, Sarafem) | Associated with PPHN when taken during the last half of pregnancy | Consider as an option during pregnancy |
| Paroxetine (Paxil) | Associated with fetal heart defects when taken during the first three months of pregnancy | Avoid during pregnancy |
| Sertraline (Zoloft) | Associated with PPHN when taken during the last half of pregnancy | Consider as an option during pregnancy |
| Tricyclic antidpressants | ||
| Amitriptyline | Suggested risk of limb malformation in early studies, but not confirmed with newer studies | Consider as an option during pregnancy |
| Nortriptyline (Pamelor) | Suggested risk of limb malformation in early studies, but not confirmed with newer studies | Consider as an option during pregnancy |
| Monoamine oxidase inhibitors (MAOIs) | ||
| Phenelzine (Nardil) | May cause a severe increase in blood pressure that triggers a stroke | Avoid during pregnancy |
| Tranylcypromine (Parnate) | May cause a severe increase in blood pressure that triggers a stroke | Avoid during pregnancy |
| Other antidepressants | ||
| Bupropion (Wellbutrin) | No established risks during pregnancy | Consider as an option during pregnancy |
Note: Persistent pulmonary hypertension of the newborn is a rare condition. Even if you take an SSRI during pregnancy, the ultimate risk remains extremely low.
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