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It’s natural to worry about whether it’s safe to take anti-depressants while pregnant—you don’t want to hurt your baby. The bottom line: the risks of harming your baby are small, compared to the risks associated with depression, both for you and your child.
It’s true that researchers have found more short-term breathing issues in newborns whose mothers used the commonly prescribed selective serotonin reuptake inhibitors, known as SSRIs. (Prozac, Celexa, Paxil, Zoloft and Lexapro are the familiar names.) This data came from a large study of nearly 850,000 births in Finland. Their babies were more likely to spend time in the intensive care unit, but usually just for observation as their breathing settled down. It’s likely that the infants were withdrawing from the drug after birth.
The same study also provided a case for using anti-depressants. Depressed people have higher levels of stress hormones, which the baby will pick up. This study also found that women with depression who didn’t take medication had a higher chance of a preterm delivery or C-section.
You may have read scary stories that taking anti-depressants could tip your child into autism. In a Canadian study of more than 145,000 infants, scientists did find a slightly higher number of babies with autism among mothers who took anti-depressants during the second or third trimester. For every 200 mothers who took anti-depressants while pregnant, there might be one additional children born with autism.
However, the research on this question has been mixed, and overall, more studies say anti-depressants aren’t linked to autism, says Alan Brown, MD, a professor of psychiatry and epidemiology at Columbia University Medical Center.
Some genes associated with depression are also associated with autism, so it’s still unclear whether the anti-depressants themselves were at fault, notes Bryan King, program director of Seattle Children's Autism Center and a professor of psychiatry and behavioral sciences at the University of Washington.
Overall, the low risks found in these studies might actually encourage you to stick with your medication, King suggests.
What about birth defects? Again, any risks are small. In a July 2015 study researchers concluded that there was no link between birth defects and taking Zoloft, Celexa and Lexapro. There was a small association between birth defects and taking Paxil or Prozac early in pregnancy.
An April 2015 study of 2.3 million infants born to mothers who used SSRIs or Effexor found no link to cardiac birth defects.
A November 2012 study evaluated children at three and seven years old who had been born to a mother in one of three scenarios: she took an anti-depressant while pregnant, discontinued an anti-depressant before pregnancy, or didn’t have depression. The researchers concluded that anti-depressants weren’t a problem, and children of mothers with untreated depression had the most behavioral problems.
Don't skip medication while pregnant if you've had severe bouts recently or had depression in an earlier pregnancy. You might not think so in advance, but you are more likely to smoke or drink alcohol, miss doctor’s appointments, and skip meals and sleep during the pregnancy. You'll also increase your chances of a post-partum depression.
On the other hand, if your depression isn't severe, this might be a time to evaluate if you've done all you can to manage your moods, and if the medication is helping you enough. Have you tried getting more exercise, changes in diet, and stress-relieving activities like yoga and meditation? Are you in therapy? According to a review of treatments for major depression, a team led by Vanderbilt University’s Steven Hollon concluded that psychotherapy boosts a patient's chance of lasting improvement in depressive symptoms by 20 percent. In other research, Hollon has concluded that psychotherapy should be the first line of action against depression since its effects are more enduring. Taking meds at the same time could slow recovery, he argues.
If you do decide to go off a medication, do so gradually, under the guidance of your doctor or psychiatrist, and invest energy in other ways to fight depression.
A version of this story appears on Your Care Everywhere.
