Depression is an illness that makes you feel sad and 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.
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:
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:
If you are worried about this, talk to your doctor about gradually stopping your medicine a week or two before your due date.
When depression is not treated during pregnancy, it can harm both mother and child. If you don't treat your depression:
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.
Counseling is an important part of treatment for depression. If you have only mild depression, counseling alone may be enough to help you feel better.
Your doctor may advise you to treat your depression with medicine if:
|Take antidepressants||Don't take antidepressants|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
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 counseling. It really helped. My counselor 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
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.
I don't think I can control my depression symptoms without the medicine.
I think I can control my symptoms by seeing my counselor and going to my doctor appointments.
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.
My other important reasons:
My other important reasons:
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
1. If I don't treat my depression, it could harm my baby.
2. Some depression medicines are less likely to harm my baby than others.
3. If I was taking antidepressants before I got pregnant, stopping could make my symptoms come back.
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Specialist Medical Reviewer||Lisa S. Weinstock, MD - Psychiatry|
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.