Depression and Use of SSRI Medications During Pregnancy
Who has depression?
Depression occurs in about 7 of every 100 people in the United States. Depression is more common in women than in men, especially in women who are 15 to 44 years old. Pregnancy is also common during these ages. Depression can occur for the first time or get worse during pregnancy or even after the baby is born. There is no simple treatment, but for some women, especially those with severe depression, medications can help.
How do I know if I'm depressed?
These two questions will help you know if you are depressed:
- 1Over the past 2 weeks, have you ever felt down, depressed, or hopeless?
- 2Over the past 2 weeks, have you felt little interest or pleasure in doing things?
If you answer yes to both questions, contact your health care provider to discuss the possibility that you have depression. People with depression oft en say that most days they feel sad, lifeless, trapped, or hopeless and that the pleasure and joy have gone out of life. If you spend time thinking about how to kill yourself or others, you need to seek care immediately. Severe depression is linked to suicide (killing yourself).
What are SSRIs?
Selective serotonin reuptake inhibitors, also called SSRIs, are the most commonly used medications for depression. If counseling or changes in your life situation do not relieve depression, SSRIs may be a good choice for you, even during pregnancy. Some common SSRIs are:
- • citalopram (Celexa)
- • escitalopram oxalate (Lexapro)
- • fluoxetine (Prozac)
- • luvoxamine (Luvox)
- • paroxetine (Paxil)
- • sertraline (Zoloft)
How do SSRIs work?
These medications increase a brain chemical called serotonin in the areas of your brain that affect your general mood. Usually it takes a few weeks for you to notice any changes in depression, even when the medication works well. Very rarely, SSRIs can make you feel like committing suicide during the first few weeks of taking the medicine.
Should I stop taking a medication for depression if I'm planning to get pregnant or if I am pregnant?
Always contact your health care provider before stopping your medication. Pregnancy does not make depression worse, but the changes that happen to you during pregnancy can make it more difficult to cope with depression. Most women want to protect their babies by not taking medicines when pregnant, but some studies have found that women with untreated depression have a higher chance of having a premature baby and postpartum depression. In addition, stopping some depression medications too quickly can cause withdrawal symptoms.
Do SSRIs cause birth defects?
The chance that SSRIs will cause birth defects is very low. Because there is such a low chance, it is hard for scientists to study the question well. Your health care provider can give you the details of what is known at this time about SSRIs and birth defects.
Can SSRIs harm my baby after birth?
Some SSRIs, but not all, may cause a mild withdrawal reaction in the baby after it is born. If this happens, the baby can be fussy and have problems eating well during the first few days after birth. Remind the health care provider who is caring for your baby about any medications you took during pregnancy.
Are SSRIs safe to take if I'm breastfeeding?
SSRIs get into your breast milk in very low amounts and are considered safe to take while you are breastfeeding. Talk with your health care provider about the best medication to take while you are breastfeeding. You do not have to stop breastfeeding.
FOR MORE INFORMATION
General Information About Women and Depression
Women and Depression: Discovering Hope, National Institute of Mental Health
Depression: Frequently Asked Questions, The National Women's Health Information Center
Depression During Pregnancy and Postpartum Depression
Depression During and After Pregnancy, The National Women's Health Information Center
Postpartum Depression, Postpartum Support International
Postpartum Depression, American Psychological Association