Pregnancy and antidepressants
Antidepressants are not usually recommended for pregnant women, especially during the first trimester of pregnancy.
Although evidence is not conclusive about the risks, possible complications include loss of pregnancy, heart defects in babies and a rare lung condition called pulmonary hypertension, which causes breathing difficulties for babies.
However, doctors will look at a woman's individual circumstances before weighing-up whether the risks from depression or other mental health conditions outweigh any potential risks to the pregnancy.
If a woman is taking antidepressants for mild depression, and becomes pregnant or is planning a pregnancy, NHS guidance says the medication should be withdrawn gradually. The woman should be monitored to see what effect taking away the medicine has as well as alternative treatments being offered, such as guided self-help, exercise, cognitive behavioural therapy (CBT) and counselling.
If antidepressants are prescribed, or continue to be prescribed, they are likely to be selective serotonin reuptake inhibitor or SSRIs, such as fluoxetine, citalopram or sertraline. Fluoxetine is the SSRI with the lowest known risk during pregnancy, according to the National Institute for Health and Care Excellence (NICE).
In guidance for England, NICE says treatment and care for a woman with depression who becomes pregnant should take into account her individual needs and preferences. She should also have the opportunity to make informed decisions about her care and treatment in partnership with their healthcare professionals.
Women who need psychological treatment, such as counselling, should get treatment normally within one month of their initial assessment.
After the baby is born, care is still needed with antidepressants. NICE says most antidepressants do appear at some levels in breast milk, but the effects on the baby are not well understood.