An estimated 500,000 pregnancies in the United States each year involve women who have or who will develop psychiatric illness during the pregnancy. The use of psychotropic medications in these women is a concern because of the risks of adverse perinatal and postnatal outcomes. However, advising these women to discontinue medication presents new risks associated with untreated or inadequately treated mental illness, such as poor adherence to prenatal care, inadequate nutrition, and increased alcohol and tobacco use. Use of psychiatric medications during pregnancy and lactation. 2007;110(5):1180–1182Ten to 16 percent of pregnant women meet diagnostic criteria for depression, and up to 70 percent of pregnant women have symptoms of depression. Ideally, decisions about psychiatric medication use during and after pregnancy should be made before conception. Use of psychiatric medications during pregnancy and lactation. 2007;110(5):1180–1182*—The FDA classifies drug safety using the following categories: A = controlled studies show no risk; B = no evidence of risk in humans; C = risk cannot be ruled out; D = positive evidence of risk; X = contraindicated in pregnancy Adapted with permission from the American College of Obstetricians and Gynecologists. Studies have shown a relapse rate of 68 percent in women who discontinue antidepressant therapy during pregnancy. The use of a single medication at a higher dosage is preferred over multiple medications, and those with fewer metabolites, higher protein binding, and fewer interactions with other medications are also preferred. Food and Drug Administration has categorized medications according to risk during pregnancy *—The FDA classifies drug safety using the following categories: A = controlled studies show no risk; B = no evidence of risk in humans; C = risk cannot be ruled out; D = positive evidence of risk; X = contraindicated in pregnancy Adapted with permission from the American College of Obstetricians and Gynecologists. Untreated maternal depression is associated with increased rates of adverse outcomes (e.g., premature birth, low birth weight, fetal growth restriction, postnatal complications), especially when depression occurs in the late second to early third trimesters. All psychotropic medications cross the placenta, are present in amniotic fluid, and can enter breast milk. There is limited evidence of teratogenic effects from the use of antidepressants in pregnancy and adverse effects from exposure during breastfeeding. Exposure to selective serotonin reuptake inhibitors (SSRIs) late in pregnancy has been associated with transient neonatal complications; however, the potential risks associated with SSRI use must be weighed against the risk of relapse if treatment is discontinued. There has recently been a lot of discussion in the news about the potential hazards of taking antidepressants while pregnant. Some researchers are concerned that they increase the risk of birth defects. Proponents of antidepressants point out, correctly, that depression during pregnancy is also risky and can lead to premature delivery and other complications. Health care providers often make treatment decisions by balancing the risks and benefits of a medication. There are several antidepressants that can be used during pregnancy and lactation, but with some risks of side effects. However, the risk of medication use must be weighed against the risk of ongoing, untreated depression for both mother and child, and the risks associated with not breastfeeding. (See Non-Drug Treatments for Depression) Below is a brief summary of research regarding how medication transfers to infants during pregnancy and lactation, and its impact on infants.
In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. 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). While everyone breaks down medication at a different rate, on average sertraline has a half-life (time it takes to eliminate one half of the drug from the body) of 26 hours. Most of the drug will be out of your system 6 days after stopping sertraline. You should always discuss any changes in your dose or stopping your dose of sertraline with your health care provider. In particular, since some people have withdrawal symptoms when they suddenly stop taking sertraline, your health care provider may suggest that you gradually decrease the dosage that you are taking before you completely stop taking the medication. Deciding to continue or stop using antidepressants during pregnancy is one of the hardest decisions a woman must make. Untreated depression can have harmful effects on both the mother and the baby. But, taking antidepressants while pregnant may increase the risk of problems for the baby. When making the decision, it’s important to consider your health, the health of your unborn child, and the well-being of your family, including your other children. It’s also important to not make the decision before discussing it with your doctors. Together, you can weigh the pros and cons of continuing or stopping your medication and make the right decision for you. Many women battle depression and need antidepressants to manage their symptoms. In the past, it was thought that pregnancy protected against depression. More and more women are taking antidepressants while pregnant to keep their symptoms in check.
Zoloft and Pregnancy Side Effects. Zoloft sertraline is a type of “SSRI,” or “selective serotonin reuptake inhibitor.” These drugs are thought to work by preventing your body from reabsorbing serotonin, increasing your levels of that neurotransmitter and improving your mood. SSRIs are the most popular type of antidepressant in the country. Sertraline, sold under the trade name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor SSRI class. It is used to treat major depressive disorder, obsessive–compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety disorder. Sertraline is taken by mouth.