Medication options for depression during pregnancy

Seeking treatment for mental health conditions during pregnancy is important for the health of both expecting parents and growing babies. While talk therapy is a commonly recommended method of treatment, healthcare providers often recommend additional lines of treatment like lifestyle changes or medication.

Many people take medications to treat mental health concerns, including depression. While medication often isn’t the only form of treatment for depression, and may not even be the first line of defense, it is an extremely effective tool, especially when combined with counseling. There are generally three categories of medication for depression.

  • Selective serotonin reuptake inhibitor (SSRI) antidepressants: Serotonin is a neurotransmitter that helps regulate mood, social behavior, appetite and digestion, and libido, among other things. SSRIs are commonly prescribed for depression because they increase serotonin levels in the brain. Examples of SSRIs include Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), and Vilazodone (Vibryd).
  • Non-SSRI antidepressants: Some people don’t react well to SSRIs, or have circumstances that lead them to need to try a different medication. Some non-SSRIs don’t increase serotonin, while others affect serotonin as well as a different neurotransmitter, while others don’t impact serotonin at all. Two types of these could be serotonin-norepinephrine reuptake inhibitors (SNRIs), like Duloxetine (Cymbalta), or norepinephrine-dopamine reuptake inhibitors (NDRIs), like Bupropion (Wellbutrin).
  • Other medications: It’s not uncommon for a provider to add medications to balance out the effects of an antidepressant. Some examples of medications that can be used this way are mood stabilizers and antipsychotic medication. Anti-anxiety medications might be prescribed, but it’s not recommended that they are used for an extended period of time. Tricyclic antidepressants may also be prescribed if other types of antidepressants aren’t working, but these antidepressants are often not prescribed as the first line of defense.

In addition to medication, other treatments for mental health concerns during pregnancy may include talk therapy and alternative methods like support groups, meditation, self-help materials like books or articles, and regular exercise, like yoga.

There are few hard and fast rules about antidepressants and anti-anxiety medications during pregnancy. The few that exist are similar to rules around taking medication for mental health at other points in time: it generally takes antidepressants about four to six weeks to start to take effect, some medications need extra monitoring by healthcare providers, and it’s never safe to abruptly stop taking a mental health medication without talking to a healthcare provider. Most common antidepressants are safe to take during pregnancy, but you should always speak with your healthcare provider before starting, or ending, an antidepressant regimen (or any medication). Your mental and emotional health is just as important as your physical health during pregnancy, so antidepressants can be an important part of good health during pregnancy or beyond.

Read more
  • “Depression: Treatment.” ADAA. Anxiety and Depression Association of America, 2016. Web.
  • “Depression: Care and Treatment.” ClevelandClinic. The Cleveland Clinic Foundation, 2014. Web.
  • Mayo Clinic Staff. “Treatments and Drugs.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 7 2016. Web.
  • Mayo Clinic Staff. “Selective serotonin reuptake inhibitors (SSRIs).” MayoClinic. Mayo Foundation for Medical Education and Research, Jun 24 2016. Web.
  • “Depression Treatment & Management.” Medscape. WebMD LLC., Apr 29 2016. Web.  
  • Melinda Smith, Jeanne Segal. “Types of Antidepressants and Their Side Effects.” HelpGuide., May 2016. Web.
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