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  • Depression: Should I Take Antidepressants While I'm Pregnant?

Depression: Should I Take Antidepressants While I'm Pregnant?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Depression: Should I Take Antidepressants While I'm Pregnant?

Get the facts

Your options

  • Take medicine for your depression.
  • Try other treatment instead.

Key points to remember

  • Some types of depression medicines are less likely to harm your baby than others. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
  • If you don't treat your depression, it could harm your baby, because people who are depressed can have a hard time caring for themselves. And after your baby is born, you may be more likely to suffer from postpartum depression, which can cause serious problems for both you and your newborn.
  • The decision about whether to take depression medicine while you are pregnant depends a lot on how bad your symptoms are. Talk to your doctor, and compare the risks of taking the medicine with the risks of living with your symptoms.
  • If you were taking medicine for depression before you got pregnant, stopping now could cause your symptoms to come back. Also, quitting antidepressants suddenly can cause you to feel like you have the flu. Talk to your doctor first.
FAQs

What is depression?

Depression is an illness that makes you feel sad and hopeless much of the time. It is different from normal feelings of sadness or low energy. It can have a very big effect on your life, your work, your health, and the people you care about. Many pregnant women struggle with depression.

What are the risks of taking antidepressants while you are pregnant?

More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. There are several types of antidepressant medicine. Some types are less likely to harm your baby than others. Some may slightly increase the risk of certain birth defects.

For pregnant women, doctors may choose SSRIs (selective serotonin reuptake inhibitors), such as Prozac or Zoloft, or tricyclic antidepressants.

You may have side effects from SSRIs or tricyclics, but they will usually go away within the first few weeks. Common side effects include:

  • Stomach upset or loss of appetite.
  • Diarrhea.
  • Feeling anxious or on edge.
  • Sleep problems or drowsiness.
  • Loss of sexual desire.
  • Headaches.

If you were taking antidepressants at the end of your pregnancy, your newborn may need to stay in the hospital for a few extra days. This is so that doctors can watch for any signs that the drug is affecting your baby. These signs sound scary, but they are usually mild and go away in a few days. They include:

  • Mild breathing problems.
  • Crying more than is usual.
  • Having trouble feeding.
  • Having seizures (in rare cases).

If you are worried about this, talk to your doctor about gradually stopping your medicine a week or two before your due date.

What are the risks of NOT taking antidepressants?

When depression is not treated during pregnancy, it can harm both mother and child. If you don't treat your depression:

  • You may not eat well or get enough sleep.
  • You may smoke and drink.
  • You may think about killing yourself.
  • You may not go to the doctor as often as you should.
  • You may deliver early and have a baby that weighs less than it should.2
  • You will be more likely to have postpartum depression after the birth. Postpartum depression may make it hard to care for and bond with your baby.

Never stop taking an antidepressant suddenly. If you have been taking medicine to treat depression and then find out you are pregnant, talk to your doctor. If you decide to stop taking the medicine, you will need to lower your dose slowly, with your doctor's help.

What other treatment is available?

Counseling is an important part of treatment for depression. If you have only mild depression, counseling alone may be enough to help you feel better.

Why might your doctor recommend taking depression medicine during pregnancy?

Your doctor may advise you to treat your depression with medicine if:

  • Your symptoms are serious enough that you can't take care of yourself the way you need to in order to stay healthy for your baby.
  • You have tried other treatment, and it hasn't helped.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take antidepressants Take antidepressants
  • You take pills or liquid medicine on a regular schedule.
  • Your symptoms are kept under control so that you can take care of yourself and stay healthy for your baby.
  • You are less likely to get postpartum depression.
  • With symptoms under control, you are less likely to have an early delivery and have a baby that weighs less than it should.2
  • Common side effects include:
    • Stomach problems.
    • Feeling anxious or on edge.
    • Sleep problems.
    • Loss of sexual desire.
    • Headaches.
  • More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
  • Newborns whose mothers took antidepressants at the end of pregnancy may need to stay in the hospital a few extra days to be watched for any problems caused by the drug.
Don't take antidepressants Don't take antidepressants
  • You treat your depression with counseling, such as cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.1 You can also help your depression with exercise and support.
  • You avoid the risk of harming your baby with medicines.
  • If you have only mild to moderate depression, counseling alone may be enough to help you feel better. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.3
  • You may not be able to control your depression, which has risks:
    • Depressed moms are less likely to take care of themselves and stay healthy for the baby.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking antidepressants during pregnancy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

It's hard to admit you're depressed, especially when you're pregnant. Everyone expects you to be happy and "glowing." I struggled with depression off and on for about 10 years, and I know that medicine works for me. I've talked to my doctor and done a lot of reading about depression and pregnancy. My doctor and I both think that it would probably hurt me and my baby more if I did not take antidepressants.

Cindy, age 27

I was sailing along with my pregnancy, doing great, until my sixth month. I started feeling tired all the time—much more than just the usual tired from being pregnant. And I was moody and just really sad. It kind of scared me, so I asked my doctor about it. He said I had depression, and he suggested I try counseling. It really helped. My counselor was great. I was able to have my beautiful baby girl without taking antidepressants.

Fala, age 19

I had always thought that if you had depression and wanted to get pregnant, you should be prepared to suffer, because doctors don't want pregnant women to take antidepressants. But my doctor said the pros outweigh the cons in my case. He kept me on my antidepressant through my pregnancy. I'm so glad. My depression stayed under control, and I had a healthy baby boy.

Nathalie, age 32

I had a bout of depression when I was 18 and was on antidepressants. When I decided to get pregnant, it was really important to me that I not take anything that could possibly hurt my baby. I started having some symptoms of depression during my second month. I talked to my doctor, and he sent me to a therapist who is helping me keep my symptoms under control, mostly. But I know I have to be careful not to let things get out of hand. And I know there's a chance I may need to take antidepressants after my baby is born.

Amaia, age 22

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants while you're pregnant

Reasons not to take antidepressants while you're pregnant

I'm worried about what my depression may do to my baby.

I am afraid to take any medicine that might possibly harm my baby.

More important
Equally important
More important

I don't think I can control my depression symptoms without the medicine.

I think I can control my symptoms by seeing my counselor and going to my doctor appointments.

More important
Equally important
More important

I think my depression symptoms would do more harm to my baby than the medicine would.

I think the medicines would harm my baby more than my depression symptoms would.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antidepressants while I'm pregnant

NOT taking antidepressants during my pregnancy

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

If I don't treat my depression, it could harm my baby.

  • TrueThat's correct. People who suffer from depression often don't take care of their health. And if you're depressed, you may not go to the doctor as often as you should.
  • FalseThat's not right. People who suffer from depression often don't take care of their health. And if you're depressed, you may not go to the doctor as often as you should.
  • I'm not sureIt may help to go back and read "Get the Facts." People who suffer from depression often don't take care of their health. So if you don't treat your depression, it could be harmful for your baby.
2.

Some depression medicines are less likely to harm my baby than others.

  • TrueThat's right. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. But some types are less likely to harm your baby than others.
  • FalseSorry, you're wrong. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. But some types are less likely to harm your baby than others.
  • I'm not sureIt may help to go back and read "Get the Facts." Although more research is needed, some types of antidepressants are considered safer for the baby than others.
3.

If I was taking antidepressants before I got pregnant, stopping could make my symptoms come back.

  • TrueThat's correct. And if the symptoms come back, that could be unhealthy for the baby.
  • FalseNo, that's wrong. Stopping the medicines could make the symptoms come back. And that could be unhealthy for the baby.
  • I'm not sureIt may help to go back and read "Get the Facts." Stopping the medicines could make the symptoms come back. And that could be unhealthy for the baby.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
Author Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry

References
Citations
  1. Kennedy S, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. Journal of Affective Disorders, 117(Suppl 1): S1–S64.
  2. Gentile S (2005). The safety of newer antidepressants in pregnancy and breastfeeding. Drug Safety, 28(2): 137–152.
  3. Hollon SD, et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62(4): 417–422.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Depression: Should I Take Antidepressants While I'm Pregnant?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Take medicine for your depression.
  • Try other treatment instead.

Key points to remember

  • Some types of depression medicines are less likely to harm your baby than others. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
  • If you don't treat your depression, it could harm your baby, because people who are depressed can have a hard time caring for themselves. And after your baby is born, you may be more likely to suffer from postpartum depression, which can cause serious problems for both you and your newborn.
  • The decision about whether to take depression medicine while you are pregnant depends a lot on how bad your symptoms are. Talk to your doctor, and compare the risks of taking the medicine with the risks of living with your symptoms.
  • If you were taking medicine for depression before you got pregnant, stopping now could cause your symptoms to come back. Also, quitting antidepressants suddenly can cause you to feel like you have the flu. Talk to your doctor first.
FAQs

What is depression?

Depression is an illness that makes you feel sad and hopeless much of the time. It is different from normal feelings of sadness or low energy. It can have a very big effect on your life, your work, your health, and the people you care about. Many pregnant women struggle with depression.

What are the risks of taking antidepressants while you are pregnant?

More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. There are several types of antidepressant medicine. Some types are less likely to harm your baby than others. Some may slightly increase the risk of certain birth defects.

For pregnant women, doctors may choose SSRIs (selective serotonin reuptake inhibitors), such as Prozac or Zoloft, or tricyclic antidepressants.

You may have side effects from SSRIs or tricyclics, but they will usually go away within the first few weeks. Common side effects include:

  • Stomach upset or loss of appetite.
  • Diarrhea.
  • Feeling anxious or on edge.
  • Sleep problems or drowsiness.
  • Loss of sexual desire.
  • Headaches.

If you were taking antidepressants at the end of your pregnancy, your newborn may need to stay in the hospital for a few extra days. This is so that doctors can watch for any signs that the drug is affecting your baby. These signs sound scary, but they are usually mild and go away in a few days. They include:

  • Mild breathing problems.
  • Crying more than is usual.
  • Having trouble feeding.
  • Having seizures (in rare cases).

If you are worried about this, talk to your doctor about gradually stopping your medicine a week or two before your due date.

What are the risks of NOT taking antidepressants?

When depression is not treated during pregnancy, it can harm both mother and child. If you don't treat your depression:

  • You may not eat well or get enough sleep.
  • You may smoke and drink.
  • You may think about killing yourself.
  • You may not go to the doctor as often as you should.
  • You may deliver early and have a baby that weighs less than it should.2
  • You will be more likely to have postpartum depression after the birth. Postpartum depression may make it hard to care for and bond with your baby.

Never stop taking an antidepressant suddenly. If you have been taking medicine to treat depression and then find out you are pregnant, talk to your doctor. If you decide to stop taking the medicine, you will need to lower your dose slowly, with your doctor's help.

What other treatment is available?

Counseling is an important part of treatment for depression. If you have only mild depression, counseling alone may be enough to help you feel better.

Why might your doctor recommend taking depression medicine during pregnancy?

Your doctor may advise you to treat your depression with medicine if:

  • Your symptoms are serious enough that you can't take care of yourself the way you need to in order to stay healthy for your baby.
  • You have tried other treatment, and it hasn't helped.

2. Compare your options

  Take antidepressants Don't take antidepressants
What is usually involved?
  • You take pills or liquid medicine on a regular schedule.
  • You treat your depression with counseling, such as cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.1 You can also help your depression with exercise and support.
What are the benefits?
  • Your symptoms are kept under control so that you can take care of yourself and stay healthy for your baby.
  • You are less likely to get postpartum depression.
  • With symptoms under control, you are less likely to have an early delivery and have a baby that weighs less than it should.2
  • You avoid the risk of harming your baby with medicines.
  • If you have only mild to moderate depression, counseling alone may be enough to help you feel better. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.3
What are the risks and side effects?
  • Common side effects include:
    • Stomach problems.
    • Feeling anxious or on edge.
    • Sleep problems.
    • Loss of sexual desire.
    • Headaches.
  • More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
  • Newborns whose mothers took antidepressants at the end of pregnancy may need to stay in the hospital a few extra days to be watched for any problems caused by the drug.
  • You may not be able to control your depression, which has risks:
    • Depressed moms are less likely to take care of themselves and stay healthy for the baby.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about taking antidepressants during pregnancy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"It's hard to admit you're depressed, especially when you're pregnant. Everyone expects you to be happy and "glowing." I struggled with depression off and on for about 10 years, and I know that medicine works for me. I've talked to my doctor and done a lot of reading about depression and pregnancy. My doctor and I both think that it would probably hurt me and my baby more if I did not take antidepressants."

— Cindy, age 27

"I was sailing along with my pregnancy, doing great, until my sixth month. I started feeling tired all the time—much more than just the usual tired from being pregnant. And I was moody and just really sad. It kind of scared me, so I asked my doctor about it. He said I had depression, and he suggested I try counseling. It really helped. My counselor was great. I was able to have my beautiful baby girl without taking antidepressants."

— Fala, age 19

"I had always thought that if you had depression and wanted to get pregnant, you should be prepared to suffer, because doctors don't want pregnant women to take antidepressants. But my doctor said the pros outweigh the cons in my case. He kept me on my antidepressant through my pregnancy. I'm so glad. My depression stayed under control, and I had a healthy baby boy."

— Nathalie, age 32

"I had a bout of depression when I was 18 and was on antidepressants. When I decided to get pregnant, it was really important to me that I not take anything that could possibly hurt my baby. I started having some symptoms of depression during my second month. I talked to my doctor, and he sent me to a therapist who is helping me keep my symptoms under control, mostly. But I know I have to be careful not to let things get out of hand. And I know there's a chance I may need to take antidepressants after my baby is born."

— Amaia, age 22

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants while you're pregnant

Reasons not to take antidepressants while you're pregnant

I'm worried about what my depression may do to my baby.

I am afraid to take any medicine that might possibly harm my baby.

             
More important
Equally important
More important

I don't think I can control my depression symptoms without the medicine.

I think I can control my symptoms by seeing my counselor and going to my doctor appointments.

             
More important
Equally important
More important

I think my depression symptoms would do more harm to my baby than the medicine would.

I think the medicines would harm my baby more than my depression symptoms would.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antidepressants while I'm pregnant

NOT taking antidepressants during my pregnancy

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If I don't treat my depression, it could harm my baby.

  • True
  • False
  • I'm not sure
That's correct. People who suffer from depression often don't take care of their health. And if you're depressed, you may not go to the doctor as often as you should.

2. Some depression medicines are less likely to harm my baby than others.

  • True
  • False
  • I'm not sure
That's right. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. But some types are less likely to harm your baby than others.

3. If I was taking antidepressants before I got pregnant, stopping could make my symptoms come back.

  • True
  • False
  • I'm not sure
That's correct. And if the symptoms come back, that could be unhealthy for the baby.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

 
Credits
By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry

References
Citations
  1. Kennedy S, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. Journal of Affective Disorders, 117(Suppl 1): S1–S64.
  2. Gentile S (2005). The safety of newer antidepressants in pregnancy and breastfeeding. Drug Safety, 28(2): 137–152.
  3. Hollon SD, et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62(4): 417–422.

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Current as of: January 11, 2013

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