Should You Take Prozac During Pregnancy?

Should You Take Prozac During Pregnancy?

Up to 23% of women experience depression during pregnancy, which manifests in symptoms like anger, guilt, chronic irritability, lethargy and hopelessness. Meanwhile, plenty of women with depression would like to become pregnant at some point. Both of these groups may be concerned about whether it’s safe to take drugs like Prozac while carrying a baby. Here’s what you need to know.

Concerns from Recent Studies

In 2012, there were some worrying research findings regarding selective serotonin reuptake inhibitors (the drug class to which Prozac belongs). A range of studies appeared to indicate that taking Prozac, Zoloft or Paxil during pregnancy was linked to an increased risk of preterm delivery. The average woman taking SSRIs for depression will end up giving birth 3-5 days sooner than a woman who isn’t taking anti-depressants.

In addition, there is a potential connection between Prozac use and a heightened likelihood of high blood pressure in pregnant women, and some evidence pointing to a risk of fetal heart defects. This latter finding is particularly strongly associated with Paxil. However, there appears to be no relationship between SSRIS and other birth defects.

Should You Avoid Prozac During Pregnancy?

The above findings might make you think that you should abandon the use of Prozac during pregnancy, but the issue is more complicated than it first sounds. Specifically, psychiatry experts warn that poorly managed depression leads to its own risks during pregnancy, including preterm delivery and lower than average birth weight. While the general rule with all medication is that it’s better to do without it during pregnancy, this only applies if you can actually manage without medication.

How to Decide

If you’re concerned about the risks associated with taking Prozac during pregnancy, it’s smart to explore alternative medications. For example, many women transition to Wellbutrin, or try tricyclic antidepressants (though it’s worth noting that tricyclics more often come with difficult side effects). All of these drugs should be discussed with your doctor, so that you can make a collaborative decision that takes all aspects of your health situation into consideration.

There’s also the option to take Prozac for most of your pregnancy but stop around the third trimester in order to reduce the risk of preterm labor.

In addition, depression is a complex illness that can relate to contextual (not just biological) factors. For those women who feel there’s an obvious link between depression and a significant difficulty or worry in their life, psychotherapy may provide support that allows for reduced medical treatment (either temporarily or permanently). This is less likely to be a successful approach if your depression symptoms are severe, or if you have a history of struggling without medication.

If possible, make a clear plan about the use of depression medication before you actually conceive. This will allow you to adjust to any new drugs, and/or see if you may be able to tolerate a drug-free pregnancy.

Do you have any advice to share about the use of antidepressants during pregnancy? Sharing your experience with other women could help them to make this important mental health decision.