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Forum Name: Obstetrics

Question: Safe antidepressants during pregnancy?


 Mommy2B - Mon Nov 16, 2009 2:23 pm

I am 17 weeks pregnant and everything is progressing normally with the pregnancy. I was taking Celexa and Wellbutrin (for Anxiety and depression) but stopped when I discovered I was pregnant. I have been struggling with the depression considerably and while I'm nowhere near suicidal, it is definitely affecting my life. I asked my family doctor if there were any antidepressants that are safe for me to take. She told me since I am now in my second trimester, the baby's development is complete and it's just getting bigger now, and prescribed Zoloft.

I double checked online before getting it filled and saw that it is a Category C medication and I'm feeling extremely uneasy about taking it. Am I overreacting? Is Zoloft safe for me to take? Are there any antidepressants that are safe?
 Debbie Miller, RN - Fri Nov 27, 2009 3:16 pm

User avatar Hello,
The reason for the category C designation is because medications are not tested in pregnant or breastfeeding women. This does not mean they are not safe; just that we do not know by way of the usual testing with double blind studies, etc. Therefore, the drug manufacturer labels it accordingly. They can't claim safety without the FDA testing. There are teratology organizations such as otispregnancy.org that track medications in pregnancy and are able to get a good idea if they are associated with any birth defect increase among babies born to mothers who have needed and taken the medications in pregnancy. Many antidepressants have been used safely in pregnancy and no significant increase is noted in most of the medications. Zoloft is frequently prescribed but it is usually recommended that you use what was working before pregnancy, since this is most likely to continue to be effective in pregnancy. If the Zoloft works for you this is a good option. There is a slight increase noted in babies transitioning to life outside the womb in about 1% of moms taking SSRI antidepressants (such as these) in the last month of pregnancy. This is in most cases a transient effect but the baby is monitored closely if it does occur. Your doctor is aware of your medication in pregnancy and the nursery can be alerted to watch for any subtle signs of transition difficulties.

Because of this and the slight increase some newborn issues, some moms opt to wean off the medication for the last month but depression is a known risk to the baby as well as the mom so it is important to get treatment when it is needed and we must always weight the known risks of depression with the potential slight risks of the medication. At any rate, I would not expect to see any birth defects as a result of the medication. Be sure to use other treatments for your anxiety and depression such as exercise (walk daily in the sun), good nutrition (a diet heavy in refined carbs and low in vegetables has been shown to be related to depression), and perhaps see a therapist for ideas to help you deal with the problems.

Best wishes.

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