I don’t know if its ok that I reprint this, even though I put the link and everything in it so the people that DID write it get credit for this. Its just, I don’t feel there is a safe option for me to take right now. Wellbutrin is listed as safe, but it didn’t work for me in the past. I don’t like feeling this way, and the slightest thing makes me feel worthless, but I can’t risk the baby’s health. I just have to tell my doctor to have postpartum depression pill ready for me as soon as I give birth, but only if its ok to take them while I breast feed.
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 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. 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 |
-
See Also
- Low amniotic fluid: Should I worry?
- Hemorrhoids during pregnancy: What’s the best treatment?
- Early miscarriage: Is stress a factor?
- Pregorexia: A legitimate problem during pregnancy?
- Chickenpox and pregnancy: What are the concerns?
- Pregnancy bed rest: When it’s needed, what it means
- Heart problems and pregnancy: Know the risks
- High blood pressure and pregnancy: Healthy mom, healthy baby
- Epilepsy and pregnancy: What you need to know
- Pregnancy and diabetes: Why lifestyle counts
- Pregnancy loss: How to cope
- H1N1 flu (swine flu) and pregnancy: Are special precautions necessary?
- Herpes and pregnancy
- Yeast infection during pregnancy: Are over-the-counter treatments OK?
- Blighted ovum: What causes it?
- Teen pregnancy: Help your teen handle pregnancy
- Placenta previa
- Preeclampsia
- Gestational diabetes
- Premature birth
- Cholestasis of pregnancy
- Morning sickness
- Placental abruption
Hand Scheduled
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Related Links
- Stopping antidepressant use while pregnant may pose risks. National Institute of Mental Health. http://www.nimh.nih.gov/science-news/2006/stopping-antidepressant-use-while-pregnant-may-pose-risks.shtml. Accessed Aug. 20, 2009.
- How is depression treated and diagnosed? National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/women-and-depression-discovering-hope/how-is-depression-diagnosed-and-treated.shtml. Accessed Aug. 20, 2009.
- Misri S, et al. Management of depression in pregnant women. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2009.
- Louik C, et al. First-trimester use of selective serotonin reuptake inhibitors and the risk of birth defects. The New England Journal of Medicine. 2007;356:2675.
- Wisner KL, et al. Major depression and antidepressant treatment: Impact on pregnancy and neonatal outcomes. American Journal of Psychiatry. 2009;166:557.
- Chambers CD, et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. The New England Journal of Medicine. 2006;354:579.
- Freeman MP. Antenatal depression: Navigating the treatment dilemmas. The American Journal of Psychiatry. 2007;164:1162.
- Suri R, et al. Effects of antenatal depression and antidepressant treatment on gestational age at birth and preterm birth. The American Journal of Psychiatry. 2007;164:1206.
- Parry BL. Assessing risk and benefit: To treat or not to treat major depression during pregnancy with antidepressant medication. The American Journal of Psychiatry. 2009;166:512.
- Hendrick V, et al. Management of major depression during pregnancy. The American Journal of Psychiatry. 2002;159:1667.
- Yonkers KA, et al. The management of depression during pregnancy: A report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstetrics and Gynecology. 2009;114:703.
- Depression during pregnancy: Treatment recommendations. American College of Obstetricians and Gynecologists. http://www.acog.org/from_home/publications/press_releases/nr08-21-09-1.cfm. Accessed Aug. 21, 2009.
- Drugs: Treatment challenges of depression in pregnancy and the possibility of persistent pulmonary hypertension in newborns. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm124348.htm. Accessed Sept. 2, 2009.
- Sackett JC, et al. Selective serotonin reuptake inhibitor use during pregnancy and possible neonatal complications. Current Psychiatry Reports. 2009;11:253.
- Maschi S, et al. Neonatal outcome following pregnancy exposure to antidepressants: A prospective controlled cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. 2008;115:283.
- Dell D, et al. Mood and anxiety disorders. Clinical Updates in Women’s Health Care. 2008;7:1.
- The American College of Obstetricians and Gynecologists Committee on Practice Bulletins – Obstetrics. Use of psychiatric medications during pregnancy and lactation. ACOG Practice Bulletin. 2008;92:1.
- Paxil (prescribing information). Research Triangle Park, N.C.: GlaxoSmithKline; 2009. http://us.gsk.com/products/assets/us_paxil.pdf. Accessed Sept. 2, 2009.
- Prozac (prescribing information). Indianapolis, Ind.: Eli Lilly and Company; 2009. http://pi.lilly.com/us/prozac.pdf?reqNavId=undefined. Accessed Sept. 2, 2009.
- Zoloft (prescribing information). New York, N.Y.: Pfizer; 2009. http://media.pfizer.com/files/products/uspi_zoloft.pdf. Accessed Sept. 2, 2009.
- Wellbutrin (prescribing information). Research Triangle Park, N.C.: GlaxoSmithKline; 2009. http://us.gsk.com/products/assets/us_wellbutrin_tablets.pdf. Accessed Sept. 2, 2009.
- Celexa (prescribing information). St. Louis, Mo.: Forest Pharmaceuticals; 2009. http://www.frx.com/pi/celexa_pi.pdf. Accessed Sept. 2, 2009.
- Health care guideline: Major depression in adults in primary care. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/depression_5/depression__major__in_adults_in_primary_care_3.html. Accessed Sept. 3, 2009.
- Cohen LS, et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. Journal of the American Medical Association. 2006;295:499.
- Alwan S, et al. The use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. The New England Journal of Medicine. 2007;356:2684.
- Passov V (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 18, 2009.
- Pedersen LH, et al. Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: Population based cohort study. British Medical Journal. 2009;339:b3569.
- Moore KM (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 25, 2009.
- Cunningham FG, et al. Williams Obstetrics. 22nd edition. New York, N.Y.: McGraw Hill Companies Inc.:2005. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=46. Accessed Sept. 27, 2009.
- Berger MS. Neurosurgery and surgery of the pituitary. In: Doherty GM, et al. Current Surgical Diagnosis and Treatment. 12th ed. New York, N.Y.: McGraw Hill Companies Inc.: 2006. http://www.accessmedicine.com/content.aspx?aID=2068298.Accessed Sept. 27, 2009.
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