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Antidepressants and Pregnancy: Keeping Risks in Perspective

It‘s important to keep the risks associated with antidepressant use in pregnancy in perspective. All pregnant women have an average 3% risk of having a baby with any type of birth defect in most cases. When researchers say antidepressants may increase the risk of certain birth defects, they are talking about just a slight increase. For example, one study showed that antidepressants increased the risk that the baby would be born with PPHN by 1%. So, even if you take an antidepressant during pregnancy, the overall risk of your baby having a problem is still very low. Other studies showed different levels of risk associated with antidepressants and PPHN, and 1% is on the high end. So the risk may be even lower.

Pregnancy and Antidepressants: Medication Options

Some antidepressants are considered safer for pregnant women than others. Antidepressants that are considered safer include:

But if you are pregnant and taking an antidepressant that is not on this list, do not worry. Even the more controversial ones, including paroxetine (Paxil), have relatively low risk. Changing medications mid-pregnancy poses its own set of problems. Talk to your doctor and see what he or she thinks would be best for you.

If you are not pregnant but planning on becoming pregnant, it may be worth trying a different medication if you are concerned about the safety of your current antidepressant. Again, talk to your doctor to see if this is a good option for you.

Pregnancy and Antidepressants: What to Do?

No matter how small the risk, no mother wants to unnecessarily expose her baby to medicine. Making the decision to take or stop taking antidepressants in pregnancy is not easy. There is no right answer. You must look at your own set of circumstances and make the decision based on the risks and benefits unique to you. If you and your doctor think you may be able to stop your medication during pregnancy, it is certainly worth a try. But, never stop taking your medication without talking to your doctor first. Most antidepressants require weaning to safely stop the drug. If you need to stay on an antidepressant while you are pregnant, don't panic. Remember, the risks associated with most of the antidepressants in pregnancy are extremely low. Untreated depression could pose a greater risk.

Whatever you finally decide to do, do not second-guess yourself. Once you make the decision, accept it and move on. Trust yourself and your doctors. Like you, your doctors want the very best possible outcome -- a healthy mom and baby.

WebMD Medical Reference

Reviewed by Trina Pagano, MD on October 04, 2014
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