Sertraline and pregnancy-Sertraline (Zoloft) Use During Pregnancy

This is called her background risk. This sheet talks about whether exposure to sertraline may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider. Sertraline is a medication that has been used to treat depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder a severe form of premenstrual syndrome , and social phobia. Sertraline belongs to the class of antidepressants known as selective serotonin reuptake inhibitors SSRIs.

Women who had prescriptions for insulin or high blood pressure medicines in the three months before the estimated date of conception were excluded. Women were considered exposed if they had two SSRI prescriptions in this period. Contact Sertraline and pregnancy. Some of the information in these databases may have been misrecorded or missed. However, this information does not tell us whether the women took the drugs or how much they took. Nonsertraline SSRIs were associated with an increased risk of craniosynostosis and musculoskeletal defects. Your baby may have Sertraline and pregnancy, vomiting, constant crying, increased muscle tone, irritability, pregnanyc sleep patterns, tremors, difficulty eating and regulating body temperature and some problems with breathing. You have questions.

Escort services in wheeling wv. Sertraline (Zoloft®)

A decision to use antidepressants during pregnancy is based on the balance between risks and benefits. These effects may be reversible. Clorazepate Tranxene. What were the results of the study? Antiepileptics and mood stabilizers. Taking Sertraline and pregnancy during pregnancy can have risks and benefits. FDA alerts for all medications. Already a member or subscriber? The researchers took measures to reduce this likelihood by taking potential confounding factors into account, but this may not totally have removed this effect. Sertraline and pregnancy What does nurse management mean study of chlorpromazine use during breastfeeding showed pregnanncy developmental deficits in children up to five years of age; however, a study of both chlorpromazine and haloperidol revealed developmental deficits in children 12 to 18 months of age. Neonates exposed to SSRIs and SNRIs late in the third trimester have uncommonly reported clinical findings including respiratory distress, cyanosis, apnea, prengancy, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. The study concluded that the SSRIs fluvoxamine, paroxetine, and sertraline did not appear to increase teratogenic risk when used in their recommended doses. If you are taking sertraline at the time of delivery, your baby may have some difficulties for the first few days of life.

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  • Zoloft is one of the most popular antidepressants in the country — more than 37 million prescriptions for the drug are filled every year.
  • This is called her background risk.
  • An estimated , pregnancies in the United States each year involve women who have or who will develop psychiatric illness during the pregnancy.
  • Taking medications during pregnancy can have risks and benefits.
  • Sertraline is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors SSRIs.
  • Back to Pregnancy and child.

Lauren M. Osborne, M. Most pregnant women want to do everything right for their baby, including eating right, exercising regularly and getting good prenatal care.

Lauren Osborne, M. She explains how women can — and should — balance their mental health needs with a healthy pregnancy. Women who take antidepressants, such as selective serotonin reuptake inhibitors SSRIs , during pregnancy may worry about whether the medications can cause birth defects.

There is good news on this front. Osborne says that there is generally no need to taper off medications during pregnancy. In fact, untreated mental illness itself poses risks to a developing fetus. Osborne also says mental illness has direct effects on newborn babies.

About 30 percent of babies whose mothers take SSRIs will experience neonatal adaptation syndrome, which can cause increased jitteriness, irritability and respiratory distress difficulty breathing , among other symptoms. If you have a mood disorder, you may benefit from speaking with a reproductive psychiatrist when you are pregnant or thinking about becoming pregnant. Meeting with a doctor after you become pregnant is not too late. Osborne says her approach with patients is to limit the number of potentially harmful exposures to the baby.

This means considering the number of medications a mother is on, as well as her psychiatric illness. Ultimately, Osborne says women should weigh the risks of medication against the risk of untreated illness.

Medication risks are typically not greater than those of untreated mental illness. Health Home Wellness and Prevention. Antidepressants and Pregnancy Women who take antidepressants, such as selective serotonin reuptake inhibitors SSRIs , during pregnancy may worry about whether the medications can cause birth defects. Paroxetine : Early studies on a small number of patients connected the SSRI paroxetine with cardiac defects in babies.

Osborne says larger, more recent studies show no such link with cardiac defects. Benzodiazepines : Women should avoid using tranquilizers, such as diazepam, alprazolam and clonazepam, in high doses during pregnancy because they can lead to sedation and respiratory distress in the newborn. You can still use them in small doses for short periods of time.

However, Osborne will typically try to get mothers on intermediate-acting options like lorazepam. Seeing a Reproductive Psychiatrist If you have a mood disorder, you may benefit from speaking with a reproductive psychiatrist when you are pregnant or thinking about becoming pregnant.

Lamotrigine Lamictal. Valproic acid Depakene. Subscribe to Drugs. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. I am taking sertraline, but I would like to stop taking it before becoming pregnant.

Sertraline and pregnancy. What is sertraline?

Get the facts about antidepressant use during pregnancy. Antidepressants are a primary treatment option for most types of depression. But there are benefits and risks to consider when taking antidepressants during pregnancy. Here's what you need to know. If you have untreated depression, you might not seek optimal prenatal care or eat the healthy foods you and your baby need.

Experiencing major depression during pregnancy is associated with an increased risk of premature birth, low birth weight, decreased fetal growth or other problems for the baby. Unstable depression during pregnancy also increases the risk of postpartum depression, early termination of breast-feeding and difficulty bonding with your baby. A decision to use antidepressants during pregnancy is based on the balance between risks and benefits.

Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low.

Still, few medications have been proved safe during pregnancy and certain types of antidepressants have been associated with a higher risk of complications for babies. If you use antidepressants during pregnancy, your health care provider will try to minimize your baby's exposure to the medication. This can be done by prescribing a single medication monotherapy at the lowest effective dose, particularly during the first trimester. Some research suggests that paroxetine might be associated with a small increase in fetal heart defects.

In addition, monoamine oxidase inhibitors MAOIs — including phenelzine Nardil and tranylcypromine Parnate — are generally discouraged during pregnancy. MAOIs might limit fetal growth. If you take antidepressants during the last trimester of pregnancy, your baby might experience temporary discontinuation symptoms — such as jitters, irritability, poor feeding and respiratory distress — for up to a month after birth. However, there's no evidence that discontinuing or tapering dosages near the end of pregnancy reduces the risk of these symptoms for your newborn.

In addition, it might increase your risk of a relapse postpartum. The connection between antidepressant use during pregnancy and the risk of autism in offspring remains inconclusive, but most studies have shown that the risk is very small and other studies have shown no risk at all.

Further research is needed. The decision to continue or change your antidepressant medication will be based on the stability of your mood disorder. Talk to your health care provider. Concerns about potential risks must be weighed against the possibility that a drug substitution could fail and cause a depression relapse. If you stop taking antidepressants during pregnancy, you risk a depression relapse with associated complications including worsening mood, the inability to take care of yourself or your pregnancy, and postpartum depression or postpartum psychosis.

If you have depression and are pregnant or thinking about getting pregnant, consult your health care provider. Deciding how to treat depression during pregnancy isn't easy. The risks and benefits of taking medication during pregnancy must be weighed carefully. Work with your health care provider to make an informed choice that gives you — and your baby — the best chance for long-term health. Mayo Clinic does not endorse companies or products.

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Make an appointment. Visit now. Explore now. Choose a degree. Most tricyclic antidepressants seem to be safe during lactation except for doxepin Sinequan , which reportedly led to an incident of infant respiratory depression.

Rates of postpartum relapse in women with bipolar disorder range from 32 to 67 percent. Perinatal episodes of the disorder tend to be depressive and are more likely to recur in subsequent pregnancies. The risk of postpartum psychosis is increased by as much as 46 percent in women with this disorder. The use of lithium during pregnancy has been associated with congenital cardiac malformations, fetal and neonatal cardiac arrhythmias, hypoglycemia, premature delivery, and other adverse outcomes.

However, neurobehavioral sequelae were not found in a five-year follow-up of 60 school-age children exposed to lithium during gestation. The decision to discontinue lithium therapy during pregnancy because of fetal risks should be weighed against the maternal risks of illness exacerbation. The physiologic changes of pregnancy may affect the absorption, distribution, metabolism, and elimination of lithium, and close monitoring of lithium levels during pregnancy and the postpartum period is recommended.

The following guidelines have been suggested for women with bipolar disorder who are taking lithium and plan to conceive: Lithium therapy should be gradually tapered before conception in women who have mild, infrequent episodes. Lithium therapy should be tapered before conception, but gradually restarted after organogenesis in women who have more severe episodes and are at moderate risk of short-term relapse.

Lithium therapy should be continued throughout the pregnancy in women who have severe, frequent episodes, and these patients should be counseled about the reproductive risks associated with therapy. The use of lithium during breastfeeding has been associated with a number of adverse effects; however, only 10 maternal-infant dyads have been studied. Effects included lethargy, hypotonia, hypothermia, cyanosis, and electrocardiography changes. No long-term studies have examined the neurobehavioral consequences of lithium therapy during breastfeeding.

Several antiepileptic drugs are used in the treatment of bipolar disorder, including valproic acid Depakene , carbamazepine Tegretol , and lamotrigine Lamictal. However, data on the fetal effects of these drugs come primarily from studies of women with seizures. It is not clear whether the underlying pathology of epilepsy contributes to the teratogenic effect of these drugs on the fetus.

Exposure to valproic acid during pregnancy is associated with an increased risk of neural tube defects, craniofacial and cardiovascular anomalies, fetal growth restriction, and cognitive impairment. Carbamazepine exposure during pregnancy is associated with facial dysmorphism and fingernail hypoplasia.

It is unclear whether carbamazepine use increases the risk of neural tube defects or developmental delay. Although these drugs are superior to lithium in the treatment of patients with mixed episodes or rapid cycling, they should be avoided during pregnancy. The use of lamotrigine during pregnancy has not been associated with any major fetal anomalies and is an option for maintenance therapy in women with bipolar disorder. Valproic acid use during lactation has been studied in 41 maternal-infant dyads; only one infant was adversely affected with thrombocytopenia and anemia.

The American Academy of Pediatrics and the World Health Organization consider valproic acid safe in breastfeeding women. Anxiety disorders are the most common psychiatric disorders, and some e.

Anxiety and stress during pregnancy are associated with spontaneous abortion, preterm delivery, and delivery complications, although a direct causal relationship has not been established. The use of benzodiazepines in women with anxiety disorders does not carry a significant teratogenic risk. Prenatal exposure to diazepam Valium increases the risk of oral cleft, but the absolute risk increases by only 0. Maternal use of benzodiazepines shortly before delivery is associated with floppy infant syndrome i.

In general, use of benzodiazepines during breastfeeding affects the infant only if he or she has an impaired ability to metabolize the drug. In this situation, the infant may demonstrate sedation and poor feeding. Adverse outcomes have been reported in women with schizophrenia, including preterm delivery, low birth weight, placental abnormalities, increased rates of congenital malformation, and a higher incidence of postnatal death.

If left untreated during pregnancy, schizophrenia can have devastating effects on the mother and child. Atypical antipsychotics have replaced typical agents as first-line therapy for psychotic disorders because these drugs are better tolerated and may be more effective in managing the negative symptoms of schizophrenia.

The reproductive safety data on atypical antipsychotics are limited, but the use of olanzapine Zyprexa , risperidone Risperdal , quetiapine Seroquel , and clozapine Clozaril has been associated with increased rates of low birth weight and therapeutic abortion. No long-term studies of children exposed to atypical antipsychotics during gestation have been conducted. Therefore, the routine use of these drugs during pregnancy and lactation is not recommended.

Typical antipsychotics have a larger reproductive safety profile; no significant teratogenic effect has been documented with chlorpromazine Thorazine , haloperidol Haldol , or perphenazine Trilafon. Doses of typical antipsychotics should be minimized during the peri-partum period to limit the necessity of using additional medications to manage extrapyramidal side effects.

Data on antipsychotic use in breastfeeding women are limited. A small study of chlorpromazine use during breastfeeding showed no developmental deficits in children up to five years of age; however, a study of both chlorpromazine and haloperidol revealed developmental deficits in children 12 to 18 months of age.

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Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Sep 15, Issue. Yes Evidence rating system used? Major Depression Ten to 16 percent of pregnant women meet diagnostic criteria for depression, and up to 70 percent of pregnant women have symptoms of depression.

Bipolar Disorder Rates of postpartum relapse in women with bipolar disorder range from 32 to 67 percent. Fetal echocardiography should be considered in women exposed to lithium in the first trimester. Anxiety Disorders Anxiety disorders are the most common psychiatric disorders, and some e. Schizophrenia Adverse outcomes have been reported in women with schizophrenia, including preterm delivery, low birth weight, placental abnormalities, increased rates of congenital malformation, and a higher incidence of postnatal death.

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Link Between Depression Treatments and Birth Defects | Key Findings | Pregnancy | CDC

Back to Pregnancy and child. It reported on a Danish study that looked at over , children born between and This research investigated whether taking antidepressants called selective serotonin re-uptake inhibitors SSRIs in the first trimester of pregnancy affected the rate of malformations. It found that defects in the wall separating the left and right chambers of the heart were 0. No other malformations were associated with SSRI use.

However, depression is a serious illness and in some cases, the benefits of antidepressant treatment may be considered to outweigh the potential risks. The study was published in the peer-reviewed British Medical Journal.

This cohort study investigated the effects of taking selective serotonin re-uptake inhibitors SSRIs during pregnancy on the risk of major malformations in a newborn. SSRIs are a type of drug used to treat depression and certain other conditions. The researchers collected data on mothers and newborns from Danish nationwide registers on prescriptions filled at pharmacies, births and hospital diagnoses.

The database data could be linked using personal identification numbers assigned at birth to all Danish citizens. Women having multiple pregnancies e. They then examined SSRI prescriptions filled 28 days before the estimated date of conception to days after conception. Women were considered exposed if they had two SSRI prescriptions in this period.

Women who had prescriptions for insulin or high blood pressure medicines in the three months before the estimated date of conception were excluded. So were women who took other psychiatric medications during pregnancy, such as antiepileptic medication, antipsychotics and anti-anxiety medication. Antidepressants other than SSRIs, such as tricyclic antidepressants and venlafaxine, were excluded from the main analyses but were assessed in subsidiary analyses. These researchers looked at all live births between January 1 and December 31 The researchers categorised malformations in these children according to a standard categorisation system.

They then used statistical methods to look at the effect of maternal SSRI use on risk of malformations. They took into account various factors that could affect the outcome, including maternal age, year of birth, marital status, income and smoking. Of the , children, 15, 3. Women taking SSRIs were more likely to be older, living alone, unmarried and smokers. However, it was associated with an increased risk of defects of the septum, the wall separating the left and right chambers of the heart 0.

These figures meant that for every mothers taking SSRIs during early pregnancy, there would be one extra child with a septal heart defect. Of the individual SSRI drugs, sertraline 1.

The numbers of women taking the SSRI paroxetine were too small for reliable analysis, as were the numbers of women taking non-SSRI antidepressants tricyclic antidepressants or venlafaxine.

Women taking more than one SSRI in early pregnancy were at even greater risk of having a child with septal heart defects, with 2. These figures meant that for every 62 mothers taking more than one SSRI during early pregnancy, there would be one extra child with a septal heart defect.

This large study has shown an association between SSRI prescriptions in early pregnancy and one type of birth defect affecting the wall between the chambers of the heart. There are a number of points to note:. In general, doctors try to avoid prescribing drugs for women who are pregnant in case they have effects on the baby. However, depression is a serious illness and, in some cases, the benefits of antidepressant treatment may be considered to outweigh the potential risks.

Although this study suggests that SSRI use in early pregnancy may increase the risk of septal heart defects in the baby, it is important to note that the absolute increase in the risk of a child being affected is small, i. Anti-depressants pregnancy 'risk'. Anti-depressants 'can increase risk of heart defect'. Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study. Antidepressants and pregnancy Friday 25 September Where did the story come from?

What kind of scientific study was this? What were the results of the study? What interpretations did the researchers draw from these results? There are a number of points to note: As with all studies of this type observational studies , there is the possibility that these differences may be due to factors other than the one tested.

The researchers took measures to reduce this likelihood by taking potential confounding factors into account, but this may not totally have removed this effect. Due to ethical concerns, it is unlikely that a randomised controlled trial testing the effects of SSRIs in pregnancy would be carried out. In addition, because these events are so rare, studies would have to be very large to be able to detect them.

This means that large population-based observation studies such as this one are likely to be the best forms of evidence available about this question. This study was not able to remove the possible effects of depression itself, as it was not able to identify and compare pregnant women with depression who were not taking antidepressants. The study was based on national databases of records about prescriptions, births and medical diagnoses.

Some of the information in these databases may have been misrecorded or missed. It is possible that the newborns of those women known to be taking prescription drugs may have been more thoroughly examined for defects at birth, which would tend to bias towards finding more defects in this group. However, the overall proportion of malformations found in exposed and unexposed children suggests that this is not the case.

The women categorised as exposed had collected at least two prescriptions for SSRIs in early pregnancy. However, this information does not tell us whether the women took the drugs or how much they took.

The inclusion of only women who filled at least two prescriptions for the medication should increase the likelihood that they were in fact taking the drug, making these findings more robust. BMJ ; b