{"id":6188,"date":"2019-10-10T09:00:06","date_gmt":"2019-10-10T13:00:06","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=6188"},"modified":"2020-07-13T19:44:14","modified_gmt":"2020-07-13T23:44:14","slug":"antidepressants-and-pregnancy","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/antidepressants-and-pregnancy\/","title":{"rendered":"Can you take antidepressants when pregnant?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">A woman who finds out she is having a baby might expect to feel excited, nervous, elated, or slightly stressed during her pregnancy. But most expecting mothers probably don\u2019t anticipate feeling depressed. However, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3895310\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">studies show<\/span><\/a> <span style=\"font-weight: 400;\">that women who are pregnant are even more vulnerable to depression then when they aren\u2019t pregnant.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2724195\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">U.S. Preventive Services Task Force<\/span><\/a><span style=\"font-weight: 400;\"> (USPSTF) says that 1 in 7 women will experience depression either during pregnancy or in the postpartum period, and that perinatal and <\/span><span style=\"font-weight: 400;\">postpartum depression<\/span><span style=\"font-weight: 400;\"> are the most common pregnancy and postpartum complications. But is it okay to treat while expecting? Are antidepressants and pregnancy a safe combination?<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/antidepressants-breastfeeding-nursing-moms\/\" target=\"_blank\" rel=\"noopener noreferrer\"><b>Antidepressants and breastfeeding<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">What are the symptoms of depression during pregnancy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Maternal depression looks a lot like clinical depression, says Crystal Clancy, a licensed marriage and family therapist at <\/span><a href=\"https:\/\/www.irisrepro.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Iris <\/span><span style=\"font-weight: 400;\">Mental Health<\/span><span style=\"font-weight: 400;\"> Reproductive Health Services<\/span><\/a><span style=\"font-weight: 400;\"> in Minnesota. The difference between perinatal depression and clinical depression is that a pregnant mother often feels shame associated with not feeling the \u201cright\u201d feelings during her pregnancy, Clancy explains.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Signs of depression in pregnancy, according to the <\/span><a href=\"https:\/\/americanpregnancy.org\/pregnancy-health\/depression-during-pregnancy\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">American Pregnancy Association<\/span><\/a><span style=\"font-weight: 400;\">, include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Feeling persistently sad<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Difficulty concentrating, even on things that typically interest you\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Changes in appetite or sleep<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Thoughts of dying or suicide<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If you notice symptoms of depression while pregnant, the first step is seeking help. Don\u2019t let a fear of being prescribed <\/span><span style=\"font-weight: 400;\">antidepressant medication<\/span><span style=\"font-weight: 400;\"> stop you from getting care. While it&#8217;s normal to have hesitations about <\/span><span style=\"font-weight: 400;\">medication use<\/span><span style=\"font-weight: 400;\"> while pregnant, doctors generally state that the <\/span><span style=\"font-weight: 400;\">potential risks<\/span><span style=\"font-weight: 400;\"> of not taking antidepressants outweigh the risks of taking them.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Depression treatment during pregnancy<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Left untreated, depression can cause serious health risks to a pregnant mother and an unborn baby, including preterm birth and <\/span><span style=\"font-weight: 400;\">low birth weight<\/span><span style=\"font-weight: 400;\">, explains Sal Raichbach, Psy.D., a psychologist at <\/span><a href=\"https:\/\/www.ambrosiatc.com\/?ambTRK=PR\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Ambrosia Treatment Center<\/span><\/a><span style=\"font-weight: 400;\"> in Florida.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Antidepressants and pregnancy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">\u201cIt is generally safe to treat depression with <\/span><span style=\"font-weight: 400;\">selective serotonin reuptake inhibitors<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">SSRIs<\/span><span style=\"font-weight: 400;\">), such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/celexa\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Celexa<\/span><\/a><span style=\"font-weight: 400;\"> [citalopram], <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prozac\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Prozac<\/span><\/a><span style=\"font-weight: 400;\"> [fluoxetine], and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zoloft\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Zoloft<\/span><\/a><span style=\"font-weight: 400;\"> [sertraline] during pregnancy,\u201d Dr. Raichbach says. Paxil (paroxetine) is another SSRI that falls into this same class, but it is associated with a <\/span><a href=\"https:\/\/www.mayoclinic.org\/healthy-lifestyle\/pregnancy-week-by-week\/in-depth\/antidepressants\/art-20046420\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">small risk<\/span><\/a><span style=\"font-weight: 400;\"> of birth defects such as heart defects. Its use is typically discouraged during pregnancy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The USPSTF conducted a study where <\/span><span style=\"font-weight: 400;\">pregnant women<\/span><span style=\"font-weight: 400;\"> took the antidepressant <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/sertraline-hcl\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">sertraline<\/span><\/a><span style=\"font-weight: 400;\"> (an <\/span><span style=\"font-weight: 400;\">SSRI<\/span><span style=\"font-weight: 400;\"> and the generic of <\/span><span style=\"font-weight: 400;\">Zoloft<\/span><span style=\"font-weight: 400;\">) and a placebo to treat their depression. The study found that women who took <\/span><span style=\"font-weight: 400;\">Sertraline<\/span><span style=\"font-weight: 400;\"> had decreased depression recurrence compared to women taking a placebo pill.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSerotonin-norepinephrine reuptake inhibitors (<\/span><span style=\"font-weight: 400;\">SNRIs<\/span><span style=\"font-weight: 400;\">), like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/cymbalta\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Cymbalta<\/span><\/a><span style=\"font-weight: 400;\">, Khedezla, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/effexor-xr\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Effexor<\/span><\/a><span style=\"font-weight: 400;\"> are also safe for <\/span><span style=\"font-weight: 400;\">pregnant women<\/span><span style=\"font-weight: 400;\">.\u201d <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/lexapro\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Lexapro<\/span><\/a><span style=\"font-weight: 400;\"> (escitalopram) is another SNRI in this same class. <\/span><a href=\"https:\/\/www.mayoclinic.org\/healthy-lifestyle\/pregnancy-week-by-week\/in-depth\/antidepressants\/art-20046420\" target=\"_blank\" rel=\"nofollow noopener noreferrer\"><span style=\"font-weight: 400;\">Research<\/span><\/a><span style=\"font-weight: 400;\"> suggests there is an increased risk of postpartum hemorrhage when SNRIs are taken at the end of pregnancy.<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/wellbutrin-xl\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Wellbutrin<\/span><\/a><span style=\"font-weight: 400;\"> (bupropion) is an additional type of antidepressant that is sometimes also used to help people quit smoking. It\u2019s not a first-choice during pregnancy, but it is a safer option to discuss with your doctor if other antidepressants haven\u2019t worked for you.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tricyclic antidepressants, such as Pamelor (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/nortriptyline-hcl\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">nortriptyline<\/span><\/a><span style=\"font-weight: 400;\">), are another class of antidepressants considered a third-line option during pregnancy because they are associated with irritability, convulsions, or postpartum hemorrhage.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Therapies for depression<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">It\u2019s common for women to be afraid to take antidepressants during pregnancy, but it\u2019s important that each patient discusses with their medical care provider which treatment is best for their well-being. For patients who are willing to commit to an alternative treatment plan, there are non-pharmacological options. According to <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5805470\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">one study<\/span><\/a><span style=\"font-weight: 400;\">, non-pharmacological intervention strategies include (but are not limited to):\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Regular psychotherapy appointments<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Attending a support group<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cognitive behavioral therapy (CBT), in groups, as an individual, or even in the home<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For expecting mothers with <\/span><span style=\"font-weight: 400;\">severe depression<\/span><span style=\"font-weight: 400;\">, or mothers who are unable to commit to alternative plans, Clancy says, \u201cIt is so important to find someone who has specialized training in prescribing [antidepressants] for pregnant and postpartum patients.\u201d\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Side effects<\/span><span style=\"font-weight: 400;\"> of <\/span><span style=\"font-weight: 400;\">antidepressant use<\/span><span style=\"font-weight: 400;\"> during pregnancy<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There is a lot of misinformation out there about what mothers can take while pregnant and breastfeeding. The <\/span><a href=\"https:\/\/adaa.org\/living-with-anxiety\/women\/pregnancy-and-medication\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Anxiety and Depression Association of America<\/span><\/a><span style=\"font-weight: 400;\"> says that while there are risks associated with antidepressants and pregnancy, including <\/span><a href=\"https:\/\/www.cdc.gov\/pregnancy\/meds\/treatingfortwo\/features\/ssrisandbirthdefects.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">risks of <\/span><span style=\"font-weight: 400;\">birth defects<\/span><\/a><span style=\"font-weight: 400;\">, the risks are very low. The <\/span><a href=\"https:\/\/www.mayoclinic.org\/healthy-lifestyle\/pregnancy-week-by-week\/in-depth\/antidepressants\/art-20046420\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">potential side effects<\/span><\/a><span style=\"font-weight: 400;\"> of prenatal exposure during the third trimester and include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Jitteriness<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Irritability<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Poor feeding<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Respiratory distress<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Very small possible risk of autism and ADHD<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For women who find out that they are expecting and are already on antidepressants, <\/span><a href=\"https:\/\/www.hopkinsmedicine.org\/health\/wellness-and-prevention\/antidepressants-and-pregnancy-tips-from-an-expert\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">John Hopkins Medicine<\/span><\/a><span style=\"font-weight: 400;\"> advises against the <\/span><span style=\"font-weight: 400;\">discontinuation<\/span><span style=\"font-weight: 400;\"> of your medication, and recommends that you immediately consult with your healthcare provider. They also suggest that if you have a <\/span><span style=\"font-weight: 400;\">mood disorder<\/span><span style=\"font-weight: 400;\"> and are considering becoming pregnant, that you consult with a reproductive psychiatrist beforehand.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Raichbach says that \u201cWhile risks of taking antidepressants during pregnancy are minimal, doctors will usually prescribe the lowest dose of medication that works to alleviate symptoms. The alternative of <\/span><span style=\"font-weight: 400;\">untreated depression<\/span><span style=\"font-weight: 400;\"> and anxiety certainly has a negative impact on the development of a fetus.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s best to speak with your <\/span><span style=\"font-weight: 400;\">obstetrician<\/span><span style=\"font-weight: 400;\"> about the best options for your care. <\/span><a href=\"https:\/\/www.mhanational.org\/finding-therapy\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Mental Health<\/span><span style=\"font-weight: 400;\"> America<\/span><\/a><span style=\"font-weight: 400;\"> provides resources and assistance for those looking for a <\/span><span style=\"font-weight: 400;\">mental health<\/span><span style=\"font-weight: 400;\"> professional.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Pregnant women who are prescribed antidepressants during pregnancy are suggested to enroll in the National Pregnancy Registry for Antidepressants (NPRAD) by calling 844-405-6185.\u00a0<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A woman who finds out she is having a baby might expect to feel excited, nervous, elated, or slightly stressed during her pregnancy. But most expecting mothers probably don\u2019t anticipate feeling depressed. However, studies show that women who are pregnant are even more vulnerable to depression then when they aren\u2019t pregnant.\u00a0 The U.S. Preventive Services [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":6289,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589,8029],"tags":[451,8615],"coauthors":[8365],"class_list":["post-6188","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","category-health-education","tag-depression","tag-pregnancy","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Are antidepressants and pregnancy a safe combination?<\/title>\n<meta name=\"description\" content=\"Left untreated, depression can cause serious health risks to a pregnant mother and child. 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