Pregnancy health centre

Pregnancy and antidepressants

Deciding to continue or stop using antidepressants during pregnancy is one of the hardest decisions a woman must make. Untreated depression can have harmful effects on both the mother and the baby, but taking antidepressants while pregnant may increase the risk of problems for the baby.

When making the decision, it’s important to consider your health, the health of your unborn child and the well-being of your family, including your other children. It’s also important not to make the decision before discussing it with your doctors. 

That includes your obstetrician and your psychiatrist if you have one. Together, you can weigh the pros and cons of continuing or stopping your medicine and make the right decision for you.

Depression and pregnancy

Many women with depression need antidepressants to manage their symptoms. In the past, it was thought that pregnancy protected against depression. Scientists now realise this is not the case. More and more women are taking antidepressants while pregnant to keep their symptoms in check. One study found that between 1998 and 2005, nearly one out of every 20 women reported using an antidepressant three months before becoming pregnant or during the pregnancy.

There are questions about the safety of taking antidepressants when you are pregnant, but research is showing that many antidepressants, especially the selective serotonin reuptake inhibitors (SSRIs) and older medications, are generally safe. Birth defects and other problems are possible, but the risk is very low.

Pregnancy and antidepressants: What the experts say

Both mental health experts and obstetric experts agree that if you have depression and have been symptom-free for at least six months, you may be able to stop using antidepressants under a doctor’s supervision before getting pregnant or while you are pregnant. Psychotherapy, along with lifestyle measures, may be all that you need to manage your depression if it is mild. You may be able to get through your pregnancy without antidepressants if you:

• Talk with a therapist on a regular basis
• Exercise more
• Spend time outside
• Practise yoga and meditation
• Minimise your stress

But, the experts point out, it will be better for both you and your baby to stay on antidepressants while pregnant if any of the following is true:

• You have a history of severe or recurrent depression
• You have a history of other mental illnesses, such as bipolar disorder
• You have ever been suicidal

Pregnancy and antidepressants: Understanding the risks

Few, if any, medicines are considered absolutely safe during pregnancy. Research findings on the effects of antidepressants on the growing baby are mixed and inconclusive. One study may find a particular antidepressant causes one type of risk. Another one, though, may find that it doesn’t. Also, the risks to the baby may be different depending on the type of antidepressant and when in the pregnancy it is taken. Regardless, most risks found by researchers have been low.