What You Need To Know About Antidepressants During Pregnancy

According to the American Psychological Association, 16.5% of women in the U.S. take antidepressant medication–more than twice as often as men. If you take antidepressants (or any other mood-stabilizing medication), you're not alone, and you're part of a growing number of people who use their medication to live a balanced, fulfilling life.

Selective Serotonin Reuptake Inhibitors (also called SSRIs) are some of the most readily prescribed antidepressants. You may be familiar with some common medications like Lexapro, Celexa, Zoloft, and Prozac. There are other types of antidepressants, like SNRIs and MAOIs, but they're less commonly prescribed.

If you're taking an SSRI and thinking about having a baby, you've probably had some concerns. There's a slew of articles online touting the dangers of SSRIs during pregnancy, and telling us that babies born to mothers who took these drugs are more likely to have birth defects.

Where did this all start?

It started in Denmark. Between 1996 and 2003, researchers collected data on women who gave birth, their prescriptions filled at pharmacies, and hospital diagnoses after birth. The study found that heart defects were 0.4% more common in the women who had filled prescriptions for SSRIs.

So is this reason to avoid SSRIs? Not necessarily. Although the study looked at a large sample of women and children, it was an observational study, which means it wasn't able to control for other variables that could've affected birth outcomes. They also weren't able to track which women were actually taking SSRIs during pregnancy. And perhaps most importantly, we have to take into account that the absolute risk is less than 1%–meaning that although this study indicated a small increase, that increased chance was of something that is already highly unlikely to occur.

And more studies followed...

As SSRI use became more common, researchers conducted studies tracking whether babies were more likely to have autism, ADHD, allergies, and birth defects. Many of the results sounded scary, but many of their claims didn't hold water.

A recent meta-analysis (a zoomed-out look at lots of studies) determined that a mother's SSRI use didn't increase her child's chance of developing autism. They found that the previous research failed to account for ascertainment bias, which is when one group is tested more than others.

So, should I keep taking my antidepressants?

By and large, yes. If you're already taking an SSRI, coming off your medication before such a large life change isn't considered to be a smart choice, but you should speak to your doctor if you're concerned.

Despite the marginal risks that come with taking an SSRI during your pregnancy, studies have found that taking them had a "protective" effect on women's mental health, and they were less likely to suffer from Postpartum Depression after giving birth. And this is a major point to consider: if you've struggled with your mental health in the past, you're at an increased risk of developing Postpartum Depression.

Coming off an SSRI poses risks

You probably know that you can't just go off your antidepressants cold turkey. Doing so causes serious withdrawal symptoms like dizziness, irritability, trouble sleeping and eating, and feeling like you have the flu. If you are going to stop an SSRI, you should do so gradually by reducing your dose, and this should be done under the supervision of your doctor.

Your SSRI can help you take better care of yourself and your baby

If you have untreated depression, you might not seek optimal prenatal care or eat the healthy foods you and your baby need. Experiencing major depression during pregnancy is associated with an increased risk of premature birth, low birth weight, decreased fetal growth or other problems for the baby. Unstable depression during pregnancy also increases the risk of postpartum depression and difficulty bonding with your baby.

If you're currently taking an SSRI, you probably know that it helps you to go about your day-to-day life in a productive, functional way and that you take better care of yourself when your depression is well-managed. However, if your depression is left untreated, you likely won't take the best care of yourself. You may find it difficult to sleep properly, eat balanced meals, take part in regular exercise, and seek optimal prenatal care for your baby.

You know your body and mind better than anyone else

As you head into this exciting new chapter of your life, it's important to make the decision that's best for you and your long term health–both mental and physical. Talk to your doctor, therapist, and partner about what you're thinking and feeling, and don't feel pressure to yield to the opinions of others. You know yourself best, and your body and mind deserve your love and respect.

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