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Antidepressants in Pregnancy

By Tamera Young, RN, MSN

Antidepressants in Pregnancy

Pregnancy isn’t always a time of happy anticipation. Women who have depression will continue to struggle during pregnancy, and some women even develop depression during pregnancy. As many as 1 in 5 women may deal with depression in pregnancy, experts estimate.

If you struggle with what you think could be depression, or if you have been diagnosed with depression, talk to your healthcare provider about treatment during pregnancy. Deciding whether to use any medication during pregnancy comes down to balancing the risks with the benefits, including antidepressants.

Treating Depression in Pregnancy

You may be worried about the effects of the medication on your unborn baby. Earlier this year, research across more than 1.6 million births in the Journal of the American Medical Association demonstrated that the popular selective serotonin reuptake inhibitors (SSRIs) don’t increase stillbirth risk, as previously suspected. For your health, and for your developing baby’s health, experts at the Mayo Clinic advise treating depression through pregnancy because you may:

  • Neglect yourself and your pregnancy, including avoiding prenatal care.
  • Eat poorly, avoiding healthy foods your baby vitally needs.
  • Soothe feelings with alcohol, cigarettes or drugs, all of which could harm your baby.

As a result, your baby could be at increased risk for being born early or having a low birth weight, and you may experience postpartum depression that prevents you from bonding with or nursing your baby.
If you’re taking drugs for depression and have just learned you’re pregnant, never quit your medications “cold turkey”—this puts you at risk for significant side effects. Talk with your healthcare provider to learn if your medication needs to be changed in any way.

Other Therapies and Help

If you struggle with depression, boosting your intake of Omega-3 essential fatty acids, like those in cold-water fishes or olive or flaxseed oil; using light therapy; getting regular exercise (most days of the week); and counseling and group support are helpful for some women during this time. Left untreated, depression during pregnancy can harm both you and your baby. Tell your healthcare provider if you struggle with pre-existing depression or if you’re experiencing feelings of moodiness, isolation, withdrawal or disinterest, which can be signs of depression emerging during pregnancy. Help is available, and getting care is best for you and your baby.

 

Some studies suggest that, while rare, these medications can put the developing baby at risk for lung or heart defects. Know what’s safer to use in pregnancy:Generally considered safe:

  • SSRIs (selective serotonin reuptake inhibitors, such as Celexa or Zoloft)
  • Tricyclic antidepressants (Pamelor)
  • Bupropion (Wellbutrin)

Avoid in pregnancy:

  • MAOIs (monoamine oxidase inhibitors, such as Parnate)
  • Paxil (specific SSRI associated with 1st trimester fetal heart defects)

Tamera Young is an expert advisor to Healthy Mom&Baby.


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