SSRIs in Pregnancy: What You Need to Know

Feeling worried about your antidepressant while expecting? You’re not alone. Many expectant parents wonder if SSRIs (selective serotonin reuptake inhibitors) are safe for the baby and what the real risks are. Below we break down the facts, so you can make an informed decision with your doctor.

How Safe Are SSRIs for Your Baby?

SSRIs do cross the placenta, which means the fetus is exposed to small amounts of the drug. Studies show a slight increase in newborn adaptation syndrome – jitteriness, feeding problems, or a brief stay in the NICU – especially when the mother takes an SSRI in the third trimester. The risk of a rare condition called persistent pulmonary hypertension of the newborn (PPHN) is also a bit higher with some SSRIs, but the absolute numbers are low.

On the flip side, untreated depression carries its own dangers: poor nutrition, missed prenatal visits, and increased stress hormones that can affect fetal growth. So the decision isn’t just about the drug; it’s about balancing the mother’s mental health with the baby's safety.

Common SSRIs like sertraline (Zoloft), fluoxetine (Prozac), and citalopram (Celexa) have the most data behind them. Many clinicians prefer sertraline because it shows the lowest rates of newborn withdrawal symptoms. Your doctor may suggest staying on the lowest effective dose and avoiding changes in the last few weeks of pregnancy unless needed.

Managing Depression Without Harm

If you’re early in pregnancy and still deciding, consider therapy as a first step. Cognitive‑behavioral therapy (CBT) and interpersonal therapy have strong evidence for reducing depressive symptoms without medication. Some people combine therapy with a low‑dose SSRI, which can give symptom control while keeping doses minimal.

When medication is needed, ask your doctor about alternative antidepressants such as bupropion (Wellbutrin). It isn’t an SSRI, but it works differently and may have a different safety profile. However, it also crosses the placenta, so the same careful monitoring applies.

Whatever you choose, keep open communication with your obstetrician and psychiatrist. They’ll monitor your mood, blood pressure, and the baby’s growth throughout pregnancy. Regular check‑ins help catch any side effects early and allow dose adjustments before any issue becomes serious.

After delivery, many women stay on their SSRI for a few weeks to protect against postpartum depression. Your baby will be monitored for any signs of withdrawal, but most newborns do fine with routine care. Breastfeeding while on an SSRI is usually considered safe; only a tiny amount passes into breast milk.

Bottom line: SSRIs are not a free‑for‑all, but they are not a blanket danger either. Talk to your healthcare team, weigh the risks of medication against the risks of untreated depression, and choose the plan that feels right for you and your baby.