Pregnancy & Medications - MGH Center for Women's Mental Health

ACOG Opinion on SSRI Use During Pregnancy

Recent reports have raised questions regarding the use of selective serotonin reuptake inhibitors (SSRI) during pregnancy. To date, no professional medical association has issued formal guidelines regarding the use of SSRIs during pregnancy. However, in December the American College of Obstetricians and Gynecologists ACOG published an opinion paper on this topic that is noteworthy for its clarity and balanced review of the existing data on the reproductive safety of SSRI antidepressants (Obstetrics and Gynecology 2006;108:1601-3). The ACOG report addressed the following issues:

By MGH Center for Women's Mental Health|2015-07-28T10:50:42-04:00November 12th, 2007|Pregnancy & Medications|Comments Off

SSRIs and Pregnancy: Putting the Risks into Perspective

Depression is common during pregnancy, affecting 10% to 15% of women. While psychotherapy is an attractive option for the treatment of depression during pregnancy, all women do not respond to this intervention and many require pharmacotherapy. Thus far, no antidepressants have yet been approved by the FDA for use during pregnancy. Although data accumulated over the past 30 years suggest that certain medications, including the serotonin reuptake inhibitors (SSRIs), may be used safely during pregnancy, several new studies have raised concerns regarding the use of these medications during pregnancy.

By MGH Center for Women's Mental Health|2015-07-28T10:29:44-04:00October 7th, 2007|Pregnancy & Medications|Comments Off

Use of Wellbutrin (Bupropion) During Pregnancy

There are data to support the use of certain antidepressants during pregnancy. Most of the research over the last decade has focused on the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and the older tricyclic antidepressants, but there is some new data supporting the use of bupropion during pregnancy.

By MGH Center for Women's Mental Health|2015-07-28T10:21:48-04:00February 20th, 2007|Pregnancy & Medications|Comments Off

Evaluating the Long-Term Effects of Prenatal Antidepressant Exposure

Over the last decade information has accumulated regarding the safety of antidepressants taken during pregnancy. While much research has addressed the effect of antidepressant drugs on risk for congenital malformation, less research has focused on the long-term effects of prenatal antidepressant exposure.

By MGH Center for Women's Mental Health|2015-07-28T10:14:44-04:00February 20th, 2007|Antidepressants, Long-Term Outcomes, Neurodevelopmental Disorders, Pregnancy & Medications|Comments Off

Use of SSRIs During Pregnancy

Q. I have been taking antidepressants on and off for the last ten years, and I am now planning a pregnancy. I am now on Effexor, and my psychiatrist recommended switching to Prozac and staying on it up until the end of the second trimester. He said that antidepressants should be avoided later on in pregnancy because they may cause problems for the baby at the time of delivery. I am concerned about having to come off my medication for such a long time. In the past, every time I have tried to stop the medication, my depression has come back within a month or so.

By MGH Center for Women's Mental Health|2015-07-28T10:01:52-04:00July 30th, 2006|Anxiety Disorders, Child Outcomes, Depressive Disorders, Outcomes, Pregnancy & Medications|Comments Off

Neurobehavioral Outcomes in Children Exposed to Lithium in Utero

Driven by concerns regarding fetal exposure to psychotropic medications, many women with psychiatric illness attempt to discontinue their pharmacologic treatment during pregnancy; however, recent studies indicate that this approach may not be appropriate for all women. Dr. Adele Viguera and her colleagues at the Center for Women’s Mental Health have reported that among pregnant women with bipolar disorder, relapse rates were very high (58%) in women who discontinued maintenance treatment with lithium during pregnancy (Viguera et al 2000). Given this risk of recurrent illness, many women may consider continuing lithium treatment during pregnancy. While the teratogenic effects of first trimester exposure to lithium have been well studied, data on the long-term outcome of children exposed to lithium during pregnancy are sparse. At the 61st Annual Meeting of the Society of Biological Psychiatry in Toronto, Dr. Viguera presented preliminary data on the neurobehavioral outcomes of children exposed to lithium in utero.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00July 30th, 2006|Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Evaluating the Safety of First-Trimester Exposure to Lamotrigine (Lamictal)

Early reports suggested that women with bipolar disorder may be at lower risk for onset or relapse of this disorder during pregnancy and that some women may be able to remain well during pregnancy despite medication discontinuation. However, more recent studies have suggested that recurrence of affective illness during pregnancy is relatively common among women with bipolar disorder. Dr. Adele Viguera and her colleagues at the Center for Women's Mental Health reported that among pregnant bipolar women, relapse rates were very high (58%) in those women who discontinued maintenance treatment with lithium during pregnancy (Viguera et al 2000).

By Ruta Nonacs, MD PhD|2025-06-26T09:07:15-04:00July 11th, 2006|Anti-Epileptic Drugs, Mood Stabilizers, Pregnancy & Medications, Risk of Malformations|Comments Off

Use of Paxil during Pregnancy

Q. I have taken Paxil for about six years for depression and obsessive-compulsive disorder. I have tried several times to stop the medication but the symptoms come back within a few weeks of stopping the medication. My husband and I are now planning a pregnancy, and my obstetrician tells me that I cannot take Paxil during pregnancy. Are there any other options?

By MGH Center for Women's Mental Health|2015-07-28T09:53:02-04:00April 24th, 2006|Antidepressants, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Withdrawal Symptoms in Newborns Exposed to SSRIs

A recent report suggests that newborns exposed to selective serotonin reuptake inhibitors (SSRI) antidepressants such as Prozac, Zoloft, Celexa and Paxil may be at risk for developing withdrawal symptoms after delivery (Levinson-Castiel 2005). However, the investigators also noted that the symptoms usually disappeared within 48 hours and did not require medical intervention.

By MGH Center for Women's Mental Health|2015-07-28T09:51:11-04:00April 24th, 2006|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

SSRIs and Persistent Pulmonary Hypertension of the Newborn

These findings are likely to generate significant anxiety among child-bearing women who suffer from depression who would like to maintain antidepressant medication during pregnancy. Future studies are needed to better understand the risk of PPHN in this setting.

By MGH Center for Women's Mental Health|2025-07-26T08:55:25-04:00April 24th, 2006|Antidepressants, Child Outcomes, Neonatal Symptoms, Pregnancy & Medications|Comments Off