Antidepressant Medication during Pregnancy & Postpartum
Key points
- In individuals with Major Depression, the levels of the chemical messengers serotonin and norepinephrine in the brain are lower than in nondepressed individuals.
- For women suffering from severe Major Depression during pregnancy treatment with appropriate medication remains a viable, but challenging option.
- Some studies find an increase in minor perinatal complications (such as jitteriness) associated with Fluoxetine exposure late in gestation.
- Studies of the effects of tricyclic antidepressants in pregnancy have not found any connection between the use of these medications and physical malformation in the infant.
Most commonly used Antidepressant Medication
SSRI: Selective Serotonin Reuptake Inhibitors
- Prozac (also called Fluoxetine )
- Paxil (also called Paroxetine)
- Zoloft (also called Sertraline)
TCA: Tricyclic Antidepressants
- Anafranil (also called Clomipramine)
- Elavil (also called Amitriptyline)
- Aventyl (also called Nortriptyline)
- Norpramin (also called Desipramine)
- Tofranil (also called Imipramine)
How do Antidepressants work?
In individuals with Major Depression, the levels of the chemical messengers serotonin and norepinephrine in the brain are lower than in nondepressed individuals. The Selective Serotonin Reuptake Inhibitors act by increasing the levels of serotonin in the brain. The Tricyclic Antidepressants' act by increasing the levels of both serotonin and norepinephrine in the brain. Both classes of antidepressants are highly effective but differ in their side effect profiles. Different women may have a better response to one antidepressant over another. Unfortunately, there is no way of knowing at the time of diagnosis which antidepressant will be most beneficial to a particular woman. It may take up to 3-4 weeks for the antidepressant to take effect. It is important to take the medication regularly and to take it for a period of not less than 6 months.
Use of Antidepressant Medication: During Pregnancy
For women suffering from severe Major Depression during pregnancy treatment with appropriate medication remains a viable, but challenging option. The risks of treatment must be weighed up against the consequences of no treatment. All antidepressants have side effects: the goal of treatment is to minimize these side effects. Women should be maintained on the lowest possible dose that will have an antidepressant effect. The risk of exposing your baby to the antidepressant medication (no matter how low the dose) has to be weighed against the risk of not getting treatment.
The goal of treatment is optimal health of the mother and her baby. To date, the bulk of the literature shows that the use of antidepressants during pregnancy is, for the most part, safe.
SSRI: Selective Serotonin Reuptake Inhibitors
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
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