For nine months, the pregnant body surges with hormones meant to support the health of the mother and the developing fetus. These special hormones also cause many women to experience strong emotional ups and downs that impact their ability to care for themselves and their babies adequately. When this happens, OB/GYNs may prescribe antidepressants or other types of psychiatric medication to help women cope with the physical and mental stress of pregnancy.
Is it safe to take psychiatric medication when you are pregnant? How does a new mother know if they should seek help for anxiety, depression, or moodiness? Since anything a pregnant woman eats or drinks becomes part of the nutritional intake of the fetus, it is important to understand how psychiatric medications can or may affect fetal development.
Benefits and Risks of Common Psychiatric Meds During Pregnancy
Antidepressants
A recent study published in 2022 found that antidepressants, such as Effexor and Lexapro, do not interfere with the “future behavior or brain development of their unborn child.” The study involved comparing nearly 150,000 women who took an antidepressant while pregnant with three million pregnant women who did not take an antidepressant. The health of their children was tracked for up to 14 years. The results indicated taking antidepressants during pregnancy did not increase the risk of ADHD, developmental problems, autism, or behavioral disorders.
Benzodiazepines
Valium, Xanax, and Klonipin are benzodiazepines that treat anxiety, insomnia, panic disorder, and severe nausea and vomiting. Taking benzodiazepines during the first trimester of pregnancy should be avoided because these drugs are teratogens, or substances that could lead to one or more birth defects in the embryo or fetus.
Can an OB/GYN prescribe Xanax and other psychiatric medications to women who are pregnant? Yes, they can. An OB/GYN is a licensed doctor who specializes in obstetrics (pregnancy) and gynecology (women’s reproductive health issues). However, it isn’t unusual for an OB/GYN to refer depressed or anxious patients to a psychologist or psychiatrist for further treatment.
Lunesta and Pregnancy
Lunesta is a non-benzodiazepine, habit-forming sleep aid prescribed to treat chronic insomnia and poor sleep quality. Although insufficient research has been done regarding pregnant women taking Lunesta, animal studies indicate there seems to be no evidence of Lunesta causing birth defects. Possible adverse effects of Lunesta, such as sleepwalking, behavioral changes, and withdrawal symptoms, should be considered by pregnant women and their OB/GYNs before prescribing Lunesta.
Trintellix and Pregnancy
Trintellix (vortioxetine) is a psychiatric medication that treats major depressive disorder (MDD). Approved by the FDA in 2013, Trintellix increases serotonin levels in the brain similar to antidepressant actions. However, it is not classified as an antidepressant but as a serotonin stimulator and modulator. Doctors aren’t entirely sure how Trintellix works to relieve symptoms of MDD but think the medication acts on serotonin receptors not targeted by antidepressants.
Taking Trintellix while pregnant is not generally recommended, especially during the third trimester. Newborns may be at risk for developing side effects such as jitteriness, apnea, tremors, respiratory distress, and vomiting. The official Trintellix website also reiterates the risks to neonates if women use Trintellix after their sixth month of pregnancy.
Sometimes, the benefits of taking psychiatric medications while pregnant do outweigh the risks. For example, research shows that pregnant women with MDD, persistent depression disorder (PDD) and minor depression may be susceptible to pre-eclampsia, needing a C-section, and inadequate weight gain. Pregnant women with bipolar disorder are at risk of giving birth prematurely, hypoglycemia, and recurring bipolar episodes. Women with generalized anxiety disorder (GAD), panic disorder, and phobias are also at risk for preterm birth and pre-eclampsia. In other words, the overall benefits of taking psychiatric medications to treat a mental illness may eclipse the possible risks associated with antidepressants or benzodiazepines.
Learning to Balance Mental Health and Pregnancy: Dealing with Rollercoaster Emotions Naturally
Occasional depression and anxiety are normal during pregnancy. There will be times when new mothers worry about being the “perfect” mother, whether their pregnancy and labor will be free of complications, or if they can successfully manage such dramatic changes to their life and work schedule.
Some women are more vulnerable to experiencing more persistent and troublesome mental health issues if they:
- Have a previous history of anxiety or depression prior to pregnancy
- Have had difficulty with past pregnancies
- Are experiencing relationship issues with their significant other
- Receive minimal support from family regarding the pregnancy
- Are coping with an unplanned pregnancy
Before considering medications to help stabilize emotions, pregnant women can try the following methods for relieving depression and anxiety:
Talk to a Counselor
Prenatal counselors specialize in helping women understand and manage mental health concerns associated with their pregnancy.
Join an Online or Local Support Group
Talking to other women who experience depression and anxiety about their pregnancy is a great way to express and work through your uncertainty and stress. Knowing there are other soon-to-be-moms who feel exactly like you do can reassure and encourage you through the remaining months of your pregnancy.
Indulge in Plenty of “Me Time”
Never feel guilty for pampering yourself, taking naps in the afternoon, watching favorite movies, or spending hours decorating your baby’s room.
Eat Healthy and Exercise
Research shows that eating a balanced diet, exercising, and getting plenty of quality sleep improve mood, alleviate anxiety, and boost optimism. Walking every day and doing stretching exercises can be safely done by women in their second and third trimesters.
Communicating with Healthcare Providers for Informed Decisions
Between monthly appointments with your OB/GYN, write down questions that come into your mind and take the list with you. No matter how minor the concern you have seems, make a note of it so you can ask your doctor about it.
Also, make sure your OB/GYN knows about all the medications you take, including dietary or herbal supplements. Most psychiatric medications have contraindications with other drugs or supplements. For example, since antidepressants increase serotonin levels, taking a dietary supplement like St. John’s Wort (which also increases serotonin) along with an antidepressant may cause agitation, dizziness, insomnia, and confusion. Too much serotonin may lead to serotonin syndrome, a serious condition resulting from excess serotonin in the brain.
OB/GYNs understand the dramatic changes that the pregnant body and mind undergo from day one of pregnancy throughout the postpartum period. If you are pregnant and feeling depressed and anxious, don’t hesitate to talk to your OB/GYN about your mental health concerns. After discussing your symptoms and how they are impacting your life, your doctor may refer you to a psychologist or prescribe a low-dose antidepressant to help stabilize your moods.
