Antidepressant (SSRI) Use in Pregnancy: A Guide for Patients

Antidepressants are a group of medications that are used to treat depression and other mental health conditions. They work by affecting the levels of certain chemicals in the brain, such as serotonin, that are involved in mood regulation. 

There are different types of antidepressants, but the most prescribed ones are called selective serotonin reuptake inhibitors (SSRIs). Some examples of SSRIs are citalopram (Celexa), sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac) and escitalopram (Lexapro). 

The decision to use antidepressants during pregnancy is not an easy one. There are benefits and risks to consider for both you and your baby. This guide will help you understand some of the factors that you and your healthcare provider should discuss before making a choice. 

Benefits of antidepressant use during pregnancy 

Depression is a serious condition that can affect your physical and mental health, as well as your ability to care for yourself and your baby. Untreated depression during pregnancy can increase the risk of: 

 - Premature birth 

- Low birth weight 

- Decreased fetal growth 

- Postpartum depression 

- Difficulty bonding with your baby 

Antidepressants can help relieve the symptoms of depression and improve your quality of life. They can also reduce the risk of relapse or recurrence of depression after giving birth. 

Risks of antidepressant use during pregnancy 

No medication is completely safe during pregnancy. All medications can cross the placenta and reach the baby. The effects of antidepressants on the developing baby are not fully known, but some studies have suggested that they may increase the risk of: 

- Birth defects, especially heart defects 

- Miscarriage 

- Neonatal complications, such as withdrawal symptoms, breathing problems, low blood sugar and jaundice 

- Persistent pulmonary hypertension of the newborn (PPHN), a rare but serious condition that affects the blood flow to the lungs 

The risk of these complications is generally low, but it may vary depending on the type, dose, and duration of antidepressant use, as well as other factors such as genetics, maternal health, and environmental exposures. 

 How to make a decision about antidepressant use during pregnancy 

There is no simple answer to whether you should use antidepressants during pregnancy or not. The best decision for you depends on your individual situation and preferences. You should talk to us about: 

 - The severity and history of your depression 

- The benefits and risks of continuing or stopping your medication 

- The availability and effectiveness of other treatments, such as psychotherapy or alternative therapies 

- The possibility of switching to a different antidepressant that may have fewer or less severe side effects 

- The need for close monitoring of your mood and your baby's development throughout the pregnancy and after delivery 

 You should also seek support from your family, friends, and other sources of help, such as support groups or online forums. Remember that you are not alone and that there are many people who can help you cope with depression during pregnancy. 

Complete Healthcare for Women - Obstetrics and Gynecology

509-392-6700

Richard Lorenzo, D.O.

Kortney Jones ARNP

Author

Richard Lorenzo, DO Dr. Lorenzo is also a Fellow of the American Congress of Obstetricians and Gynecologists and a Fellow of the American College of Osteopathic Obstetricians and Gynecologists. He provides gynecological and obstetric services, including prenatal care, pregnancy care, infertility, and gynecology. Dr. Lorenzo is proficient in advanced surgical techniques, including minimally-invasive procedures, as well as surgery for abnormal uterine bleeding, endometriosis, and hysterectomy. He has specialized training in high-risk obstetrics and minimally invasive surgical techniques, including minimally invasive hysterectomy.