The Scoop on Antidepressants Before, During, and After Pregnancy

Ever since my latest bout with depression, I’ve been on a mission to find real, objective information about the risks and benefits of antidepressants during the preconception phase. This week I had the great fortune of attending a presentation by Beth Conover, MS, APRN, CGC, from the Nebraska Teratology Information Service. Although the presentation was designed for women’s health professionals, I slipped in as an incognito consumer and collected the uncensored, un-dumbed-down scoop.

The first piece of information that struck me is that just by being a human, every woman has a 3% chance of having a baby born with a congenital anomaly (aka something unusual or different at birth). Second, having untreated depression may up a woman’s risk for miscarriage, pregnancy-induced high blood pressure, preterm delivery, or low birth weight.

Some women require medication to treat their depression–that would be me. Medication during pregnancy carries risks. So, in my scenario, there are no zero-risk options. However, the good news is that there are low-risk options that have helped many women with depression and their babies get through and thrive through their preconception, pregnancy, and postpartum experience.

If you’re interested in the specific risks and benefits of a particular psychiatric medication during pregnancy and breast feeding, I encourage you to peruse the Organization of Teratology Information Specialists’ FAQ sheets in English and Spanish. Another tip is not to rely solely on the FDA codes that rank medications as category A, B, C, D, or X.  They aren’t 100% based on scientific evidence. For example, birth control pills are in category X not because they are likely to cause serious harm to a developing fetus, but because they aren’t prescribed during pregnancy. If a woman is pregnant, why would she need birth control, right? It can also take a long time for a medication to move to the category that best reflects the current available scientific evidence.

I feel so privileged to be exposed to this information, and I wish that more straightforward resources were made available to women. Although the speaker really rocked her presentation, she said several times that what health care professionals need to know is different than what women need to know. Maybe it would be too much for some women, but I can handle the truth. Bring it on, please.


About The Preconceptionist

Where personal experience meets clinical and cultural preconceptions about birth and women's health.
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7 Responses to The Scoop on Antidepressants Before, During, and After Pregnancy

  1. Thank you so much for this. I recently finished tapering off my Celexa (my problem is more with anxiety, though untreated it quickly turns into depression), then stopped my birth control. When my period hit, I spent a hellish two weeks crying every morning and feeling like I was losing my mind. Work didn’t help, but that’s an ongoing saga. We’re hoping to try for a baby soon, and it’s good to know that someone else is navigating the mental-health wackiness while trying to get pregnant too.

    • Your comment makes me so happy, Shannon. I’m so sorry you’re going through that. But I’m so happy to share with someone and help with the info I learned. FYI, the presenter happened to say that Celexa and Lexapro are her current favorites for treating pregnant and breastfeeding women with depression.

  2. db says:

    I just found your blog and it’s great! I am due this next week and take lexapro and never even contemplated going off to be honest. It was a non-issue. I tried weaning 2 years ago and it was a nightmare and to me, I don’t care if I am on lexapro my whole life, my quality of life is just so much better. I could care less if people judge anymore regarding staying on meds while pregnant, or breastfeeding. pregnancy is such a roller coaster of emotions, i can’t even imagine how it would have been w/o my anti-depressant. The 1st trimester was awful and very emotional and I would have been a total mess w/o it.!!!! do what you have to do.

    • How exciting! I hope the birth goes well and that you’re blessed with a healthy, happy baby. I’m still on celexa and plan to use it through my whole pregnancy. I’ve been poking around online forums and found lots of success stories from women in similar situations. Drop back and let me know how you’re enjoying new mommy-hood once you get a chance to recover!

  3. Eurika says:

    You might already be aware of this, but Kathleen Kendall-Tackett has done considerable research into depression during the various stages of motherhood, incl. breastfeeding. You might find her website useful–lots of good info there.
    I heard her speak at a conference and she presented information which just doesn’t seem to be out there anywhere else. I highly recommend reading the “Too Much Info” article to help reduce anxiety due to all the information-gathering you’re doing.
    Take care and enjoy the whole journey of growing a new human being with just your body! It’s amazing, scary, weird, miraculous and definitely a roller coaster ride. Just hang on tight, and trust your instincts.

    • Thanks, Eurika! I’ll definitely check it out. I have to say though that I’m pretty sure my information gathering isn’t the culprit of my depression. I’ve struggled with it for nearly 10 years and had a flare up recently before I was even trying to conceive. Oddly enough, I seem to be doing better now that I’m pregnant. I’m unbelievably excited about experiencing pregnancy and becoming a mother.

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