A woman sitting on couch wondering if antidepressants affect fertility.
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Are antidepressants safe when trying to conceive?

Yes they are. There is no evidence that any of the commonly-used antidepressants have any negative effect on fertility, however, they can reduce sex drive, which may make getting pregnant more difficult. The main concern with taking antidepressants while trying to conceive is the effect they may have once you do get pregnant.

How do antidepressants work?

There are dozens and dozens of different antidepressants on the market, but these days, most fall under the umbrella of “reuptake inhibitors”. Reuptake inhibitors work by preventing your nerve cells in the brain from absorbing certain neurotransmitters (dopamine, serotonin, or norepinephrine, depending on the medication), keeping them in the synapses between cells. This allows nerve cells in your brain to better pass along messages from one cell to another, which is believed to help regulate your mood.

SSRIs (Selective Serotonin Reuptake Inhibitors) are probably the most common antidepressants used today, including Celexa, Paxil, Prozac, and Zoloft.

How can antidepressants impact a pregnancy?

There is reason to believe that some antidepressants may affect the fetus, and the health of the pregnancy – Paxil specifically has been linked to heart problems in the fetus when taken in the first trimester, so this medication should probably be avoided. The class of antidepressants known as MAOIs (monoamine oxidase inhibitors) should also be avoided, as they are known to hamper fetal growth and development.

However, most SSRIs are not believed to impact fetal growth or development, so if your depression is more than just a minor blip on the radar, your baby is probably less likely to be affected by a safe antidepressant than he or she would be if you were massively depressed throughout pregnancy.

The bottom line

Antidepressants will in no way affect your fertility, however, you should speak with your healthcare provider about whether to stay on them when you are trying to conceive, as some may be harmful during pregnancy, and all else equal, a medication-free pregnancy is healthier than the alternative.

Most popular antidepressants these days are safe to take during pregnancy, but you should always speak with your healthcare provider before starting, or ending, an antidepressant regimen. Your mental and emotional health are just as important as your physical health during pregnancy, so if you need antidepressants to stay balanced, it’s probably beneficial.

  • Mayo Clinic Staff “Antidepressants: Safe During Pregnancy?” Mayo ClinicMayo Clinic. Feb. 28, 2018

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