There will seldom be a time that you are more hyper aware of what is going into your body than when you are pregnant. This will include everything from lunch meats to cookie dough to hot dogs to the prescription drugs that you have been taking to get by.
In this article, we will address your concerns about antidepressants and pregnancy. As with everything related to health that you read on the internet, check with your doctor before making decisions.
Will Depression Go Away During Pregnancy?
Unfortunately, this will not be the case. In fact, with the hormonal changes in a mother’s body, she may find things ramp up in that department. Treating depression during this time is essential. The concern with stopping antidepressants during pregnancy is that the mother may start using other behaviors to cope with destructive thoughts. The behaviors can be as innocent as not eating healthy to as terrible as smoking. Depending on the mother’s choice of coping mechanism, there could be consequences for the baby’s health.
Additionally, if the mother is not treating the depression during the pregnancy, there is a serious risk of postpartum depression after giving birth. In some cases, a mother can have a difficult time bonding with their baby because of the range of emotions that are being experienced. To be clear, every mother will have a range of emotions during pregnancy and after birth. Some sad days, and some happy. However, if previous to pregnancy a woman had exhibited enough characteristics to require antidepressants for treatment, these “normal” emotions can quickly snowball into some serious problems.
Are Antidepressants An Option During Pregnancy?
Yes. Yes! I will shout it from the rooftops.
The best bet is to meet with the doctor to do a risks vs. benefits analysis in regards to continuing your medications. From the information I have seen, the risk of birth defects and other problems for mother and baby are very low. Can I tell you that without a doubt you and your baby will be fine? No. Could I tell you that even if you weren’t on antidepressants? No.
Are All Antidepressants Considered The Same In Pregnancy?
Nope. There are some medications that are safer to take during pregnancy than others. Studies have shown that some have more risk for the babies, so again it’s important to discuss with a doctor.
What Kinds Of Antidepressants Are There And How Safe Are They?
They are generally broken into 4 categories for pregnant women:
- Certain selective serotonin reuptake inhibitors (SSRIs) — Generally considered safe for pregnancy (will include Zoloft, Prozac, and Celexa).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) — Also considered safe for pregnancy (will include Cymbalta and Effexor XR).
- Bupropion (Wellbutrin) — This can be safe, but it’s not the typical first choice during pregnancy. If other medications are not working for the patient, this can be an option to try.
- Tricyclic antidepressants — These also are not the typical first choice during pregnancy. They can be effective if the other choices have not been effective for the woman (will include Pamelor).
What Are The Possible Complications?
Based on research, use of citalopram, fluoxetine, and sertraline can create a serious newborn lung problem (persistent pulmonary hypertension) when taken during the last half of pregnancy. Some other rare birth defects have been suggested, but studies were inconclusive.
The overall risk is very, very low.
Which Antidepressants Should Be Avoided?
Studies with Paxil show it may correspond with a small increase in heart defects.
Additionally, monoamine oxidase inhibitors (MAOIs) (Nardil and Parnate) are generally discouraged during pregnancy. MAOIs might limit fetal growth.
Will The Baby Have Withdrawals?
Tapering dosages at the end of pregnancy could help to curb any side effects the baby could have after birth. Talk to your doctor before doing any tapering because this will also affect your mood and ability to handle the postpartum period.
If I Stop Taking My Antidepressants, What Will Happen?
Physically, you can have chills, fatigue, irritability, anxiety, and nausea/vomiting. Mentally, obviously any of the things that caused you to go on the medication will still be there.
A Final Word
Only the mother and doctor can know the right course of action. It is worth doing a risks and benefits analysis to see where things end up. At every point in the process, please make sure the communication is constant with the doctor. Trying to go without does not mean a mother can not reevaluate feelings as the pregnancy progresses.
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