Lexapro and Pregnancy: What Are the risks? (2023)

Lexapro and Pregnancy: What Are the risks? (1)Share on Pinterest

When you’re pregnant, suddenly your health becomes a little more complicated. You have a passenger who’s counting on you to make good decisions for their sake, too.

But the decisions that you make might seem harder if you’re also coping with depression. You might start to second-guess yourself and whether you should take an antidepressant while you’re pregnant.

If you take an antidepressant like Lexapro, it’s useful to understand how the medicine may affect you and your growing baby. Here’s what you need to know.

Lexapro is the brand name for escitalopram, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). Like other SSRIs, escitalopram works by increasing the activity of a chemical known as serotonin in your brain to help regulate your mood.

Lexapro is typically prescribed to people who have depression or generalized anxiety disorder (GAD). Most people who take Lexapro take 10 to 20 milligrams once per day.

Generally speaking, the first trimester is an anxious time for many pregnant women, since that’s when most miscarriages occur.

The tough reality is that taking any antidepressant at this delicate time may slightly raise your chances of having a miscarriage. Research from 2016 suggests that antidepressant use during the first trimester is associated with an increased risk of miscarriage.

(Video) Risk for newborns when moms take antidepressants while pregnant?

However, you shouldn’t just stop taking your Lexapro cold turkey when you see that second line on your pregnancy test. Suddenly discontinuing the use of an SSRI has risks, too.

One large 2014 study found that women who took an SSRI during the early weeks of pregnancy had a similar increased risk of miscarriage to women who stopped taking an SSRI before their pregnancies.

If you discover that you’re unexpectedly pregnant and you’ve been taking Lexapro, put in a call to your doctor, so you can talk about the best way to proceed.

It’s also important to look at the possible downsides of taking an SSRI like Lexapro during the last part of your pregnancy.

Withdrawal

The use of SSRIs during the third trimester can increase the likelihood that your newborn baby will show some withdrawal signs from the medication. Experts like to call these discontinuation symptoms, and they can include:

  • respiratory distress
  • irritability
  • poor feeding

Adults often have discontinuation symptoms after they stop taking an antidepressant, especially if they don’t gradually taper down. If you can experience this, it makes sense that your baby might go through it, too.

(Video) Antidepressant Use Late in Pregnancy and Effects on Newborn

Preterm birth and low birth weight

The National Alliance on Mental Illness cautions that there’s a possible risk of giving birth to your baby before they’re full term if you take Lexapro (or other types of antidepressants) during your second and third trimester.

Also, there’s some research that suggests an association between Lexapro and a greater likelihood for low birth weights.

Now that you’ve considered the potential risks of taking Lexapro while you’re pregnant, it’s time to think about what might happen if you stop taking Lexapro while you’re pregnant.

It’s not just medication that can be risky. Depression can be risky, too. A 2017 review of studies suggests that there is a very real risk to your baby if your depression goes untreated during your pregnancy. In fact, there can be both short-term and long-term effects.

You and your doctor have to weigh the potential risks of taking an antidepressant while you’re pregnant against the potential benefits.

For example, research shows that untreated maternal depression can raise your baby’s risk of being born prematurely and the risk of low birth weight.

That 2017 review also notes greater risk of premature death and admission to the neonatal intensive care unit. Your child might also be at risk for developing some behavioral, emotional, and cognitive problems later on during childhood.

There’s also evidence that forgoing treatment can put your own health at risk. Women who opt out of treatment for depression during pregnancy have a higher risk of developing postpartum depression after their babies are born.

And finally, studies have shown that untreated maternal depression makes it more likely that women will take on behaviors that may be harmful to their health, like smoking or misusing drugs.

Depression isn’t a shameful thing. It’s something that so many people deal with. Many, many pregnant women have gone through it — and come out the other side with a healthy baby — with the support of their doctors. Talk to your doctor about what’s best for you. They’re there to help.

(Video) How do SSRIs affect pregnancy?

With the risks, even if they’re small, on your mind, you might be tempted to shelve your Lexapro for the duration of your pregnancy. But don’t just ditch your Lexapro and ask for a prescription for another antidepressant. Take a look at the risk profile for some other medications first.

Recent studies have looked at the most commonly prescribed SSRIs during pregnancy to see if there are connections between their use and problems like heart or neural tube abnormalities in the developing fetus.

The overall risk of damage to your growing baby is small, most studies have found. That doesn’t mean that there’s no risk, of course.

Generally speaking, sertraline (you may know it better as Zoloft) and escitalopram seem like reasonably safe options for use during pregnancy.

One large study concluded that sertraline seems to have the least amount of risk associated with it when used during first trimester. Lexapro looks pretty good, too, as the study didn’t find any links between the use of escitalopram and any of those birth defects, either.

The news isn’t so good for two other popular SSRIs, though. That same 2015 study also found links between the use of fluoxetine (Prozac) and paroxetine (Paxil) and an increase in certain congenital abnormalities.

But the researchers qualified their findings by noting that the absolute risk that a baby would develop those any developmental issues is still low, despite the increased risk. And there’s an important limitation to consider: The study was only analyzing pregnant women’s first-trimester use of these antidepressant medications.

It may be worth considering this, too: Eventually your pregnancy will end, and you’ll give birth. What effects could your Lexapro (or other SSRI) have on the big event?

For example, another large 2015 study found that mothers-to-be who took SSRIs during pregnancy were less likely to go into preterm labor or need a C-section than women who didn’t take an SSRI for their depression. However, their babies seemed to be more likely to develop a condition called neonatal maladaptation.

(Video) Antidepressants and Pregnancy

Babies with neonatal maladaptation might seem a bit jittery or agitated right after they’re born. Some babies may even be hypoglycemic, which can require intervention, to get their blood sugar levels back to where they need to be.

There are risks to consider with any decision you make. Still uncertain? Talk to your doctor about your fears and your worries. Ask questions. Talk about what the research says. Discuss your specific situation and your options.

You and your doctor may agree that it’s better for you to continue taking Lexapro to manage your depression while you’re pregnant. Or you may decide that it’s better to taper off your Lexapro.

It might be useful to discuss situations whether it’s possible to change course.

For example, you might choose to temporarily stop taking an antidepressant during your pregnancy after weighing all the risks. But later, you might feel that the benefits outweigh the risks. Your doctor can help you take the most appropriate steps.

If you’re asking yourself, “Well, now what do I do?” the answer is “It depends.” What’s right for you might be different than what’s right for someone else who’s pregnant.

Most experts will note that there’s not a 100 percent risk-free choice when it comes to taking an SSRI (or any medication) during pregnancy. Ultimately, it has to be your decision.

Your doctor can help you weigh the different factors and go over the risk factors and answer any questions. Then you can make an informed decision that’s right for you and your baby.

(Video) What Antidepressants Are Safe While Pregnant? | Anti-Depressants for Anxiety, Depression & Pregnancy

Hang in there. Depression is tough, but you’re tougher.

FAQs

Is Lexapro harmful during pregnancy? ›

Because of the associated risk of using Lexapro and other SSRIs on the fetus and newborn baby, it is suggested women do not use these types of medications during their pregnancy.

Can Lexapro cause birth defects? ›

In addition to PPHN, abdominal defects, cranial defects, and heart defects are also associated with taking Lexapro during pregnancy. Numerous studies have shown that women who take an SSRI like Lexapro have a higher risk of giving birth to a baby with birth defects.

Does Lexapro affect baby? ›

Escitalopram can be taken during pregnancy. A few studies have suggested that escitalopram might occasionally affect the development of a baby's heart. However, if there is any risk, it is small, and the majority of babies born to women taking escitalopram will have a normal heart.

Is it safe to wean off Lexapro while pregnant? ›

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.

What is the safest antidepressant during pregnancy? ›

There are three main types of antidepressants that you can safely take during pregnancy: Selective serotonin reuptake inhibitors (SSRIs) Serotonin and norepinephrine reuptake inhibitors (SNRIs)
...
Examples include:
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
13 Apr 2022

What is the safest SSRI to take during pregnancy? ›

Certain selective serotonin reuptake inhibitors (SSRIs).

SSRIs are generally considered an option during pregnancy, including citalopram (Celexa) and sertraline (Zoloft). Potential complications include maternal weight changes and premature birth.

Is Lexapro a high risk medication? ›

Celexa and Lexapro also carry risks for much more dangerous side effects. Serious side effects include abnormal bleeding, seizures and visual problems. The FDA requires the drugs' labels to include a black box warning for an increased risk of suicide.

What can antidepressants do to a fetus? ›

There is evidence that taking SSRIs early in pregnancy slightly increases the risk of your baby developing heart defects, spina bifida or cleft lip. Increased risk of miscarriage and premature birth. Slightly increased risk of blood loss after childbirth.

Is Lexapro linked to infertility? ›

Regarding the effect of these antidepressants on female fertility, some experimental findings suggest that paroxetine and escitalopram may have a negative effect on the ability to conceive due to their stimulatory effect on fallopian tube motility.

What is the pregnancy category for Lexapro? ›

Safety of Psychiatric Medications During Pregnancy and Lactation
DrugFDA pregnancy category*
Escitalopram (Lexapro)C
Fluoxetine (Prozac)C
Fluvoxamine (Luvox)‡C
Paroxetine (Paxil)D
62 more rows
15 Sept 2008

Does Lexapro pass through placenta? ›

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, citalopram, paroxetine, sertraline, fluvoxamine, and escitalopram cross the placenta and enter the fetal circulation.

What can I take for severe anxiety while pregnant? ›

SSRIs are considered safe and effective for anxiety during pregnancy. They are first-choice medications. Most studies suggest that taking SSRIs have low risks of birth defects.
...
Examples of SSRIs include:
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
5 Apr 2022

What is pregnancy Category C mean? ›

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

How can I calm my anxiety while pregnant? ›

What else helps anxiety during pregnancy?
  1. Engage in regular physical activity. In general, it is safe to engage in physical activity during pregnancy. ...
  2. Ensure adequate sleep. ...
  3. Practice mindfulness. ...
  4. Journaling. ...
  5. Schedule worry time. ...
  6. Yoga, massage, meditation, and acupuncture.
25 Jun 2021

Is there anything you can take for depression while pregnant? ›

Antidepressants that may be used during pregnancy include: Serotonin reuptake inhibitors (also called SSRIs). SSRIs are the most commonly prescribed antidepressant medicines. SSRIs that may be used during pregnancy include citalopram (Celexa®), fluoxetine (Prozac®) and sertraline (Zoloft®).

Can you take antidepressants while pregnant NHS? ›

As a precaution, antidepressants are not usually recommended for most pregnant women, especially during the early stages of a pregnancy. This is because there might be risks for you or your baby. But it's important that depression is well treated because it can affect both you and your baby's wellbeing.

How do i taper off Lexapro? ›

Guidelines recommend short tapers, of between 2 weeks and 4 weeks, down to therapeutic minimum doses, or half-minimum doses, before complete cessation. Studies have shown that these tapers show minimal benefits over abrupt discontinuation, and are often not tolerated by patients.

Can you stay on antidepressants while pregnant? ›

So, even if you take an antidepressant during pregnancy, the overall risk of your baby having a problem is still very low. Other studies showed different levels of risk associated with antidepressants and PPHN, and 1% is on the high end. So the risk may be even lower.

How long should you be off antidepressants before getting pregnant? ›

If the consensus is that you should wean yourself off your meds or try different kinds, start at least three months before you start trying to conceive so you've got plenty of time to see how it goes.

What does pregnancy category B mean? ›

Category A: No risk in human studies (studies in pregnant women have not demonstrated a risk to the fetus during the first trimester). Category B: No risk in animal studies (there are no adequate studies in humans, but animal studies did not demonstrate a risk to the fetus). Category C: Risk cannot be ruled out.

Who should not take Lexapro? ›

Escitalopram is not approved for use by anyone younger than 12 years old. Ask your doctor about taking this medicine if you are pregnant. Taking an SSRI antidepressant during late pregnancy may cause serious medical complications in the baby.

Is Lexapro harmful long term? ›

Are There Any Risks For Taking Escitalopram For Long Periods Of Time? To date, there are no known problems associated with long term use of escitalopram. It is a safe and effective medication when used as directed.

Who is Lexapro not good for? ›

The boxed warning for Lexapro indicates that it may carry a risk of suicidal thoughts and behavior in children, adolescents, and young adults. The boxed warning also notes that the FDA has not approved Lexapro for children younger than 12 years old.

Does Lexapro affect egg quality? ›

No, there isn't any data to suggest that anti-depressants affect female fertility (so far); however, one study did find that it had an effect on male fertility.

Is it harder to get pregnant on SSRIs? ›

For women who had filled a prescription for an SSRI (n = 829), rates of pregnancy and live birth did not differ from non-exposed women.

Does Lexapro block ovulation? ›

Women taking serotonin uptake inhibitors (SSRIs) to help them cope with infertility are actually increasing their serum prolactin to an unhealthy level. This hyperprolactinemia, in turn, blocks ovulation.

Can my anxiety harm my baby? ›

High levels of stress that continue for a long time may cause health problems, like high blood pressure and heart disease. During pregnancy, stress can increase the chances of having a premature baby (born before 37 weeks of pregnancy) or a low-birthweight baby (weighing less than 5 pounds, 8 ounces).

Is it OK to take anxiety medication while pregnant? ›

Certain anxiety medications are safe to take during pregnancy. Medications like benzodiazepines and antidepressants are associated with different risks, but so is untreated anxiety. You should always weigh the risks and benefits of medications with your prescriber to determine if it is right for you.

Can anxiety attacks hurt my unborn baby? ›

Panic attacks during pregnancy can be a cause for concern because they can impact the fetus. “Blood flow to the fetus is reduced when their mothers are experiencing high anxiety, which can lead to low birth weight and premature labor,” Hassan says.

What puts you in the high risk category for pregnancy? ›

Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk. Maternal health problems. High blood pressure, obesity, diabetes, epilepsy, thyroid disease, heart or blood disorders, poorly controlled asthma, and infections can increase pregnancy risks. Pregnancy complications.

Which drug should be avoided in pregnancy? ›

Some of the over-the-counter medicines that increase the chances of birth defects are: Bismuth subsalicylate (such as Pepto-Bismol). Phenylephrine or pseudoephedrine, which are decongestants. Avoid medicines with these ingredients during the first trimester.

Is Category B safe for pregnancy? ›

Category B drugs include prenatal vitamins, acetaminophen and several other medications used routinely and safely during pregnancy. If there is a clinical need for a Category B drug, it is considered safe to use it.

Do babies feel stress in womb? ›

Most recently, some studies are suggesting that stress in the womb can affect a baby's temperament and neurobehavioral development. Infants whose mothers experienced high levels of stress while pregnant, particularly in the first trimester, show signs of more depression and irritability.

Can mothers stress affect baby? ›

Many independent prospective studies have now shown that if a mother is stressed, anxious or depressed while pregnant, her child is at increased risk for having a range of problems, including emotional problems, ADHD, conduct disorder and impaired cognitive development.

What category is Lexapro in pregnancy? ›

Safety of Psychiatric Medications During Pregnancy and Lactation
DrugFDA pregnancy category*
Escitalopram (Lexapro)C
Fluoxetine (Prozac)C
Fluvoxamine (Luvox)‡C
Paroxetine (Paxil)D
62 more rows
15 Sept 2008

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