Depression: Should I Take Antidepressants While I'm Pregnant?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Depression: Should I Take Antidepressants While I'm Pregnant?

1

Get the
Facts

2

Compare
Options

3

Your
Feelings

4

Your
Decision

5

Quiz
Yourself

6

Your Summary

Get the facts

Your options

Take medicine for your depression.
Try other treatment instead.

Key points to remember

Some types of depression medicines are less likely to harm your baby than others. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
If you don't treat your depression, it could harm your baby, because people who are depressed can have a hard time caring for themselves. And after your baby is born, you may be more likely to suffer from postpartum depression, which can cause serious problems for both you and your newborn.
If you and your doctor feel that you could be helped by counselling, you may want to try this before you start medicines.
The decision about whether to take depression medicine while you are pregnant depends a lot on how bad your symptoms are. Talk to your doctor, and compare the risks of taking the medicine with the risks of living with your symptoms.
If you were taking medicine for depression before you got pregnant, stopping now could cause your symptoms to come back. Also, quitting antidepressants suddenly can cause you to feel like you have the flu. Talk to your doctor first.

FAQs

What is depression?

Depression is an illness that makes you feel sad or hopeless much of the time. It is different from normal feelings of sadness or low energy. It can have a very big effect on your life, your work, your health, and the people you care about. Many pregnant women struggle with depression.

What are the risks of taking antidepressants while you are pregnant?

More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. There are several types of antidepressant medicine. Some types are less likely to harm your baby than others. Some may slightly increase the risk of certain birth defects.

For pregnant women, doctors may choose SSRIs (selective serotonin reuptake inhibitors), such as Prozac or Zoloft, or tricyclic antidepressants.

You may have side effects from SSRIs or tricyclics, but they will usually go away within the first few weeks. Common side effects include:

Stomach upset or loss of appetite.
Diarrhea.
Feeling anxious or on edge.
Sleep problems or drowsiness.
Loss of sexual desire.
Headaches.

If you were taking antidepressants at the end of your pregnancy, your newborn may need to stay in the hospital for a few extra days. This is so that doctors can watch for any signs that the drug is affecting your baby. These signs sound scary, but they are usually mild and go away in a few days. They include:

Mild breathing problems.
Crying more than is usual.
Having trouble feeding.
Having seizures (in rare cases).

If you are worried about this, talk to your doctor about gradually stopping your medicine a week or two before your due date.

What are the risks of NOT taking antidepressants?

When depression is not treated during pregnancy, it can harm both mother and child. If you don't treat your depression:

You may not eat well or get enough sleep.
You may smoke and drink.
You may think about killing yourself.
You may not go to the doctor as often as you should.
You may deliver early and have a baby that weighs less than it should.^{footnote 2}
You will be more likely to have postpartum depression after the birth. Postpartum depression may make it hard to care for and bond with your baby.

Never stop taking an antidepressant suddenly. If you have been taking medicine to treat depression and then find out you are pregnant, talk to your doctor. If you decide to stop taking the medicine, you will need to lower your dose slowly, with your doctor's help.

What other treatment is available?

Counselling is an important part of treatment for depression. If you have only mild depression, counselling alone may be enough to help you feel better.

Why might your doctor recommend taking depression medicine during pregnancy?

Your doctor may advise you to treat your depression with medicine if:

Your symptoms are serious enough that you can't take care of yourself the way you need to in order to stay healthy for your baby.
You have tried other treatment, and it hasn't helped.

Compare your options

Compare


What is usually involved?
What are the benefits?
What are the risks and side effects?

Take antidepressants Take antidepressants

You take pills or liquid medicine on a regular schedule.

Your symptoms are kept under control so that you can take care of yourself and stay healthy for your baby.
You are less likely to get postpartum depression.
With symptoms under control, you are less likely to have an early delivery and have a baby that weighs less than it should.^{footnote 2}

Common side effects include:
- Stomach problems.
- Feeling anxious or on edge.
- Sleep problems.
- Loss of sexual desire.
- Headaches.
More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
Newborns whose mothers took antidepressants at the end of pregnancy may need to stay in the hospital a few extra days to be watched for any problems caused by the drug.

Don't take antidepressants Don't take antidepressants

You treat your depression with counselling, such as cognitive-behavioural therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.^{footnote 1} You can also help your depression with exercise and support.

You avoid the risk of harming your baby with medicines.
If you have only mild to moderate depression, counselling alone may be enough to help you feel better. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.^{footnote 3}

You may not be able to control your depression, which has risks:
- Depressed moms are less likely to take care of themselves and stay healthy for the baby.

Personal stories about taking antidepressants during pregnancy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

It's hard to admit you're depressed, especially when you're pregnant. Everyone expects you to be happy and "glowing." I struggled with depression off and on for about 10 years, and I know that medicine works for me. I've talked to my doctor and done a lot of reading about depression and pregnancy. My doctor and I both think that it would probably hurt me and my baby more if I did not take antidepressants.

Cindy, age 27

I was sailing along with my pregnancy, doing great, until my sixth month. I started feeling tired all the time—much more than just the usual tired from being pregnant. And I was moody and just really sad. It kind of scared me, so I asked my doctor about it. He said I had depression, and he suggested I try counselling. It really helped. My counsellor was great. I was able to have my beautiful baby girl without taking antidepressants.

Fala, age 19

I had always thought that if you had depression and wanted to get pregnant, you should be prepared to suffer, because doctors don't want pregnant women to take antidepressants. But my doctor said the pros outweigh the cons in my case. He kept me on my antidepressant through my pregnancy. I'm so glad. My depression stayed under control, and I had a healthy baby boy.

Nathalie, age 32

I had a bout of depression when I was 18 and was on antidepressants. When I decided to get pregnant, it was really important to me that I not take anything that could possibly hurt my baby. I started having some symptoms of depression during my second month. I talked to my doctor, and he sent me to a therapist who is helping me keep my symptoms under control, mostly. But I know I have to be careful not to let things get out of hand. And I know there's a chance I may need to take antidepressants after my baby is born.

Amaia, age 22

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants while you're pregnant

Reasons not to take antidepressants while you're pregnant

I'm worried about what my depression may do to my baby.

I am afraid to take any medicine that might possibly harm my baby.

More important

Equally important

More important

I don't think I can control my depression symptoms without the medicine.

I think I can control my symptoms by seeing my counsellor and going to my doctor appointments.

More important

Equally important

More important

I think my depression symptoms would do more harm to my baby than the medicine would.

I think the medicines would harm my baby more than my depression symptoms would.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antidepressants while I'm pregnant

NOT taking antidepressants during my pregnancy

Leaning toward

Undecided

Leaning toward

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Print Summary

Credits and References

Credits

Author	Healthwise Staff
Primary Medical Reviewer	Kathleen Romito MD - Family Medicine
Primary Medical Reviewer	Donald Sproule MDCM, CCFP - Family Medicine
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Lisa S. Weinstock MD - Psychiatry
Primary Medical Reviewer	Kirtly Jones MD - Obstetrics and Gynecology

References

Citations

Kennedy S, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. Journal of Affective Disorders, 117(Suppl 1): S1–S64.
Gentile S (2005). The safety of newer antidepressants in pregnancy and breastfeeding. Drug Safety, 28(2): 137–152.
Hollon SD, et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62(4): 417–422.

Depression: Should I Take Antidepressants While I'm Pregnant?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Take medicine for your depression.
Try other treatment instead.

Key points to remember

Some types of depression medicines are less likely to harm your baby than others. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby.
If you don't treat your depression, it could harm your baby, because people who are depressed can have a hard time caring for themselves. And after your baby is born, you may be more likely to suffer from postpartum depression, which can cause serious problems for both you and your newborn.
If you and your doctor feel that you could be helped by counselling, you may want to try this before you start medicines.
The decision about whether to take depression medicine while you are pregnant depends a lot on how bad your symptoms are. Talk to your doctor, and compare the risks of taking the medicine with the risks of living with your symptoms.
If you were taking medicine for depression before you got pregnant, stopping now could cause your symptoms to come back. Also, quitting antidepressants suddenly can cause you to feel like you have the flu. Talk to your doctor first.

FAQs

What is depression?

What are the risks of taking antidepressants while you are pregnant?

For pregnant women, doctors may choose SSRIs (selective serotonin reuptake inhibitors), such as Prozac or Zoloft, or tricyclic antidepressants.

You may have side effects from SSRIs or tricyclics, but they will usually go away within the first few weeks. Common side effects include:

Stomach upset or loss of appetite.
Diarrhea.
Feeling anxious or on edge.
Sleep problems or drowsiness.
Loss of sexual desire.
Headaches.

Mild breathing problems.
Crying more than is usual.
Having trouble feeding.
Having seizures (in rare cases).

If you are worried about this, talk to your doctor about gradually stopping your medicine a week or two before your due date.

What are the risks of NOT taking antidepressants?

When depression is not treated during pregnancy, it can harm both mother and child. If you don't treat your depression:

You may not eat well or get enough sleep.
You may smoke and drink.
You may think about killing yourself.
You may not go to the doctor as often as you should.
You may deliver early and have a baby that weighs less than it should.²
You will be more likely to have postpartum depression after the birth. Postpartum depression may make it hard to care for and bond with your baby.

What other treatment is available?

Counselling is an important part of treatment for depression. If you have only mild depression, counselling alone may be enough to help you feel better.

Why might your doctor recommend taking depression medicine during pregnancy?

Your doctor may advise you to treat your depression with medicine if:

Your symptoms are serious enough that you can't take care of yourself the way you need to in order to stay healthy for your baby.
You have tried other treatment, and it hasn't helped.

2. Compare your options

	Take antidepressants	Don't take antidepressants
What is usually involved?	You take pills or liquid medicine on a regular schedule.	You treat your depression with counselling, such as cognitive-behavioural therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.¹ You can also help your depression with exercise and support.
What are the benefits?	Your symptoms are kept under control so that you can take care of yourself and stay healthy for your baby. You are less likely to get postpartum depression. With symptoms under control, you are less likely to have an early delivery and have a baby that weighs less than it should.²	You avoid the risk of harming your baby with medicines. If you have only mild to moderate depression, counselling alone may be enough to help you feel better. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.³
What are the risks and side effects?	Common side effects include: Stomach problems. Feeling anxious or on edge. Sleep problems. Loss of sexual desire. Headaches. More research is needed before doctors can say for sure that any antidepressant is completely safe for the baby. Newborns whose mothers took antidepressants at the end of pregnancy may need to stay in the hospital a few extra days to be watched for any problems caused by the drug.	You may not be able to control your depression, which has risks: Depressed moms are less likely to take care of themselves and stay healthy for the baby.

Personal stories

Personal stories about taking antidepressants during pregnancy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"It's hard to admit you're depressed, especially when you're pregnant. Everyone expects you to be happy and "glowing." I struggled with depression off and on for about 10 years, and I know that medicine works for me. I've talked to my doctor and done a lot of reading about depression and pregnancy. My doctor and I both think that it would probably hurt me and my baby more if I did not take antidepressants."

— Cindy, age 27

"I was sailing along with my pregnancy, doing great, until my sixth month. I started feeling tired all the time—much more than just the usual tired from being pregnant. And I was moody and just really sad. It kind of scared me, so I asked my doctor about it. He said I had depression, and he suggested I try counselling. It really helped. My counsellor was great. I was able to have my beautiful baby girl without taking antidepressants."

— Fala, age 19

"I had always thought that if you had depression and wanted to get pregnant, you should be prepared to suffer, because doctors don't want pregnant women to take antidepressants. But my doctor said the pros outweigh the cons in my case. He kept me on my antidepressant through my pregnancy. I'm so glad. My depression stayed under control, and I had a healthy baby boy."

— Nathalie, age 32

"I had a bout of depression when I was 18 and was on antidepressants. When I decided to get pregnant, it was really important to me that I not take anything that could possibly hurt my baby. I started having some symptoms of depression during my second month. I talked to my doctor, and he sent me to a therapist who is helping me keep my symptoms under control, mostly. But I know I have to be careful not to let things get out of hand. And I know there's a chance I may need to take antidepressants after my baby is born."

— Amaia, age 22

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants while you're pregnant

Reasons not to take antidepressants while you're pregnant

I'm worried about what my depression may do to my baby.

I am afraid to take any medicine that might possibly harm my baby.

More important

Equally important

More important

I don't think I can control my depression symptoms without the medicine.

I think I can control my symptoms by seeing my counsellor and going to my doctor appointments.

More important

Equally important

More important

I think my depression symptoms would do more harm to my baby than the medicine would.

I think the medicines would harm my baby more than my depression symptoms would.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antidepressants while I'm pregnant

NOT taking antidepressants during my pregnancy

Leaning toward

Undecided

Leaning toward

Credits

By	Healthwise Staff
Primary Medical Reviewer	Kathleen Romito MD - Family Medicine
Primary Medical Reviewer	Donald Sproule MDCM, CCFP - Family Medicine
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Lisa S. Weinstock MD - Psychiatry
Primary Medical Reviewer	Kirtly Jones MD - Obstetrics and Gynecology

References

Citations

Kennedy S, et al. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. Journal of Affective Disorders, 117(Suppl 1): S1–S64.
Gentile S (2005). The safety of newer antidepressants in pregnancy and breastfeeding. Drug Safety, 28(2): 137–152.
Hollon SD, et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62(4): 417–422.

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