Is It Safe for My Baby? - Antidepressants

(e.g., fluoxetine (Prozac®), paroxetine (Paxil®), sertraline (Zoloft®), venlafaxine (Effexor®))

Risks During Pregnancy

Current research suggests that there is no increased risk of birth defects from antidepressants. Some antidepressants may be safer than others, and the risk to the baby from using very new antidepressants may not yet be known. Check with your doctor and Motherisk, as new information frequently becomes available.
Deciding whether or not to continue antidepressants during pregnancy should be weighed against the risk of depression on the unborn baby, as well as post-partum depression. If you experience untreated depression during your pregnancy, your own health is at risk, and there is an increased risk of premature delivery and low birth weight for your baby.
Use of some antidepressants in the third trimester (the last three months of pregnancy) may result in the baby being born with temporary breathing difficulties and/or withdrawal symptoms (e.g., restlessness, sleep problems, feeding problems). But there are many ways to minimize and/or manage the short-term symptoms that may occur. The baby should be watched closely.

Recommendations During Pregnancy

Do NOT suddenly stop prescribed antidepressants without consulting your doctor, as you may experience a return of the depression and/or withdrawal symptoms, such as anxiety, trouble sleeping, nausea and headaches.
If you have less severe depression, you and your doctor may decide to stop your medication as long as you continue counselling or other non-drug therapies. However, you and your doctor could also decide that staying on the antidepressant is the best option, especially if you have had repeated episodes of depression or the depression is severe.
If you begin to have symptoms of depression for the first time during your pregnancy, contact your doctor or health care provider immediately. This may be the start of what’s commonly called post-partum depression. Despite the name, “post-partum” depression can actually begin during pregnancy.

Risks During Breastfeeding

While antidepressants pass to the baby through breast milk, most have been shown to be safe. Some antidepressants, however, may increase irritability in the baby.

Recommendations During Breastfeeding

Ask your doctor about current treatments for anxiety, depression and post-partum depression that are safest for you and the baby.
It may not be a possibility, but ask your doctor if you can time your dose with breastfeeding times.
Do NOT stop taking your medications. Staying healthy is especially important during the post-partum period. Keep in mind that about 10 to 16 per cent of new mothers experience post-partum depression.
Ask your health care provider about supports and services in your community.