Taking Antidepressants During Pregnancy

Find out which antidepressants are safer during pregnancy and how taking antidepressants during pregnancy impacts the baby.

The standard of care when it comes to antidepressant medication treatment during pregnancy is for the doctor to weigh the risks to the mother vs. the risks to the baby. If you are depressed and pregnant, there's a concern you may not have the energy or desire to take care of yourself properly; putting not only yourself at risk, but also the health of your baby.

Research shows that while pregnancy doesn't make depression worse, hormonal changes can trigger emotions that make it more difficult to deal effectively with depression. Pregnant women with depression may not eat right, or they'll smoke cigarettes, drink or use drugs as a way or coping with the depression. This can lead to having a premature baby, developmental problems in the baby and a higher risk of postpartum depression.

Are Antidepressants Safe During Pregnancy?

For many women with depression, antidepressants help relieve depression symptoms, but there are special concerns about taking antidepressants during pregnancy. First you should know that when it comes to taking antidepressant medications during pregnancy, just like any other time, there are no guarantees that it will be risk-free. But current research does show there's a very low risk of birth defects, along with other potential problems for babies of mothers taking antidepressants during pregnancy.

Here's a list of antidepressants and their potential problems if taken during pregnancy:

SSRIs

• Celexa, Prozac (Serafem), : are considered by doctors to be a good option. If taken during the last half of pregnancy, they are all associated with a rare but serious condition called Persistent Pulmonary Hypertension of the Newborn (PPHN), which effects a newborn's lungs.
• Paxil should be avoided during pregnancy as it's been associated with fetal heart defects if taken during the first 3 months of pregnancy.

Tricyclic Antidepressants

• Amitriptyline and Nortriptyline (Pamelor) are considered by doctors to be a good option. Early studies showed risk of limb malformation, but the risk was never confirmed in later studies.

Other Antidepressants

• MAOIs should be avoided during pregnancy.
• Wellbutrin is also considered a good option as research hasn't revealed any risks if taken during pregnancy.

Antidepressant Withdrawl in Newborn Baby

There is evidence that babies born to mothers who take antidepressants during pregnancy often experience symptoms of drug withdrawal shortly after birth. In a 2006 study, about one out of three newborn infants exposed to antidepressants in the womb showed signs of neonatal drug withdrawal, which included high-pitched crying, tremors, and disturbed sleep. It's important to keep in mind though that these symptoms are temporary and disappear once the antidepressants are out of the baby's system.

What may be more important is another major study that came out about the same time as the one above. It showed that pregnant women who stop taking antidepressants run a high risk of relapsing into depression. In fact, they were five times more likely to experience a depression relapse than were pregnant women who continued taking the drugs.

The Decision to Use Antidepressants During Pregnancy...

...is not an easy one. About 10% of women are affected by depression during pregnancy and doctors say that antidepressants are an effective depression treatment option. The American College of Obstetricians and Gynecologists advised doctors in late 2006 to use SSRIs if needed during pregnancy; if the drugs are discontinued and the depression worsens.

If you are suffering from mild depression, therapy, a support group or other self-help measures may help you manage depression symptoms. But if have severe depression or a history of depression, then the risk of relapse may be greater than they risk of taking antidepressants. It's important to speak with your doctor about any concerns you may have.

Sources: The American College of Obstetricians and Gynecologists Committee Opinion: "Treatment with Selective Serotonin Reuptake Inhibitors During Pregnancy," December 2006. Louik, C. The New England Journal of Medicine, June 28, 2007; vol 356: pp 2675-2683. Greene, M. The New England Journal of Medicine, June 28, 2007; vol 356: pp 2732-2734. Alwan, S. The New England Journal of Medicine, June 28, 2007: vol 356: pp 2684-2692.