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It is generally safe to take a selective serotonin reuptake inhibitor (SSRI) during pregnancy depending on the type. As with most drugs, there are some risks to the fetus when taking these kinds of antidepressants during pregnancy. Some studies have shown that untreated moderate-to-severe depression in pregnant women can have some of the same risks as taking an SSRI.
There are several types of SSRIs available today. Those considered an option for pregnant women include sertraline, citalopram and fluoxetine, their brand names being Zoloft, Celexa, and Prozac respectively. Paroxetine, also known as Paxil or Pexeva, is not considered safe during pregnancy, and is almost never prescribed to pregnant women.
In the majority of cases, the SSRIs sertraline, citalopram, and fluoxetine pose very little risk to a developing fetus and can be beneficial to women suffering from depression during pregnancy. Many doctors believe that treating a pregnant woman's depression can allow for a much healthier pregnancy and therefore a healthier baby. It is also believed that depression during pregnancy can lead to postpartum depression (PPD) and, in rare cases, postpartum psychosis (PPP). Taking an SSRI during pregnancy can reduce the risk of a patient developing these mental health issues.
In rare cases, taking an SSRI during pregnancy can cause birth defects of the heart, brain, and skull. If taken during the third trimester, there is a slight increase in the risk of a fetus's lungs not fully developing by the time it is considered full term. Taking an SSRI during pregnancy can also cause defects in the stomach, intestines, liver, kidney, and bladder. It is important to note, however, that these types of medications may only very slightly increase the risk of these otherwise extremely rare conditions.
Taking a SSRI during pregnancy was once believed to increase the risk of premature birth, defined as a child born any time before 37 weeks gestation. Large scale studies conducted since then have found that depression, whether treated with a SSRI or left untreated, is what causes this increase. One study was conducted among three groups of pregnant women — those diagnosed with depression and taking an SSRI, those diagnosed with depression and untreated, and those not suffering from depression. Of the three groups, the pregnant women diagnosed with depression, whether taking an SSRI or not, had a 16% higher rate of premature birth than the group of women not suffering from depression.
In most cases, doctors have found that the overall benefits of taking a SSRI during pregnancy to treat moderate-to-severe depression significantly outweighs the risks. As there are still some rare side effects that warrant concern, SSRIs are seldom typically prescribed during pregnancy unless other treatment options have failed. Concern over taking any medication while pregnant is natural; discussing all options with a trusted doctor can help a woman to have the healthiest pregnancy possible.