Deciding whether to start or continue taking an antidepressant if you become pregnant can be a difficult decision.
Letting depression go untreated can negatively impact fetal development and your mental health.
At a Glance
Prenatal depression affects about one in ten women.
Wavebreakmedia / Getty Images
Many of these medications are considered safe during pregnancy and breastfeeding.
Depression during pregnancy (also calledantepartumor prenatal depression) is one of the most common complications during pregnancy.
Pregnancy and Antidepressants
Blood volume nearly doubles in pregnancy and this impacts the efficacy of some medications.
They may be able to adjust your dosage or start you on a different antidepressant.
Although findings have been mixed, the overall conclusion is that SSRIs are generally considered safe during pregnancy.
But they are not without risk.
Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants (TCAs) are the oldest class of antidepressants.
They work by blocking neurotransmitters and other receptors in the brain.
Though they can be effective as SSRIs in treating depression, they cause more adverse effects.
For this reason, they are not used as first-line treatment and are rarely prescribed for use during pregnancy.
Like TCAs, MAOIs class tend to have more side effects than SSRIs and SNRIs.
The second infant was born with severe physical and neurological disabilities.
The family also declined to undergo testing to investigate a genetic cause for birth defects.
They’re often prescribed when other antidepressants aren’t working.
Natural Treatments for Depression
There are also non-prescription or alternative treatments for depression such asSt.
However, anyone planning to use St. John’s wort needs to be aware of potential interactions.
Antidepressant Use While Breastfeeding
Antidepressants can be passed to your baby through your breast milk.
However, the amount that is secreted into breast milk is less than that which crosses the placenta.
For these reasons, they are considered relatively safe for use during breastfeeding.
It is important for people to remain on whichever SSRI is working during pregnancy postpartum while nursing.
There is no indication for changing from one antidepressant to another to breastfeed safely.
The Risk of Untreated Depression
It’s important to remember that untreated depression also carries risks.
The physical and emotional stressors of pregnancy can contribute to or worsen feelings of depression.
People with depression may also be more likely touse substancesto cope with their symptoms.
Do not discontinue your antidepressant without talking to your doctor or mental healthcare provider first.
Takeaways
Each class of antidepressant medication carries its own set of risks.
If you are trying to decide whether to stop taking your antidepressant during pregnancy, talk to your doctor.
Being on an antidepressant should not keep you from having a healthy pregnancy.
2016;191:62-77. doi:10.1016/j.jad.2015.11.014
American College of Obstetricians and Gynecologists.Depression during pregnancy.
2015;351:h3190.
2017;7(1):e013372.
2017;69:146-149. doi:10.1016/j.reprotox.2017.02.012
U.S. Food and Drug Administration.Nardil label.
2020;22(1).
2024;77(4):172-179.
2019;58(3):350-358.e2.
doi:10.1016/j.jaac.2018.08.016
Forray A.Substance use during pregnancy.F1000Res.
2023;141(6):1262-1288. doi:10.1097/AOG.0000000000005202
