Depression Medication During Pregnancy or Breastfeeding

Is Medication Even an Option While Pregnant or Nursing?

Depression medication is easily the first treatment choice for patients who are suffering from depression. These medications can improve the quality of life and relieve symptoms for sufferers, but they are among the list of medications that can cause problems when a woman becomes pregnant or is nursing. Get the real story by checking the facts and talking with your doctor so that you don’t make a serious mistake or put yourself or your child at risk.

Pregnancy and Anti-Depressants

Pregnancy causes the body’s hormones to go into an uproar. All of the hormonal changes can easily make depression harder to cope with. Therefore, stopping medication completely is usually not the solution that is chosen by doctors and pregnant women. Instead, you should work with your doctor to find a medication that can provide the relief that you need with the safety of your unborn child in mind. The price of leaving depression untreated during pregnancy might be very high, including issues with poor self-care, drinking, smoking, binge eating, and unhealthy lifestyle choices, which can all lead to health problems for newborns.

Here is a list of anti-depressants, arranged by whether they are recommended, should be avoided, and the potential risks with use during pregnancy. This information is courtesy of the Mayo Clinic’s Pregnancy Guide.

Recommended Medications:

Celexa (Citalopram): Risks—rare but serious lung problems in newborns when taken during last half of the pregnancy; also associated with septal heart defects, birth defects that affect the brain and skull, abdominal organs, and sutures on the head.

Prozac, Sarafem (Fluoxetine): Risks—associated with PPHN (persistent pulmonary hypertension in newborns) when taken during second half of the pregnancy.

Zoloft (Sertraline): Risks—association with omphalocele and septal heart defects, as well as PPHN during second half of the pregnancy.

Amitriptyline:  Risks—no confirmed risks associated with use during pregnancy.

Pamelor (Nortryptaline): Risks—no associated risks with pregnancy.

Wellbutrin (Bupropion): Risks—no pregnancy-related risks.

*Risks of PPHN and other birth defects are very rare, and the risks associated with them are extremely low.

Medications to Avoid:

Paxil(Paroxetine): Risks—fetal heart defects when taken during first trimester, PPHN when taken during final months of pregnancy, also associated with higher risks of birth defects anencephaly, craniosynostosis, and omphalocele.

Nardil (Phenelzine): Risks—Severe blood pressure increases that can trigger strokes.

Parnate (Tranylcypromine): Risks—Severe blood pressure increases that can trigger a stroke.

Breastfeeding and Anti-Depressants

According to About.com’s Depression and Pregnancy Website, studies have shown that breastfeeding mothers can safely take anti-depressants of certain kinds. The safest types of anti-depressants are the SSRI medications, or the Selective Serotonin Reuptake Inhibitors. Paxil and Zoloft are the two that have shown the lowest blood levels in infants who are being breastfed by mothers on anti-depressants. Prozac is also a medication that can be considered post-partum, but should be used carefully because it elevates blood levels more than other SSRI medications.

Withdrawal in Infants of Mothers on Anti-Depressants

In some cases, babies might appear to be more colicky or have withdrawal symptoms when they are born or stop breastfeeding because they are no longer getting the anti-depressants that their mother is taking. To reduce these symptoms, many doctors will recommend tapering dosage or discontinuing use for the last week or two during pregnancy. With weaning, the process is usually a gradual transition to formula or milk, so the tapering process of the medication will occur naturally.

The Bottom LineDepression Medication is Circumstantial

You will need to discuss your specific situation with your doctor to ensure that you do what is best. Every situation is different, and you need to make sure that you get the antidepressant drug treatment that works for your pregnancy or breastfeeding experience.

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