Ultimately, Osborne says women should weigh the risks of medication against the risk of untreated illness. Medication risks are typically not greater than those of untreated mental illness. Health Home Wellness and Prevention. Antidepressants and Pregnancy Women who take antidepressants, such as selective serotonin reuptake inhibitors SSRIs , during pregnancy may worry about whether the medications can cause birth defects.
Paroxetine : Early studies on a small number of patients connected the SSRI paroxetine with cardiac defects in babies. Osborne says larger, more recent studies show no such link with cardiac defects.
Benzodiazepines : Women should avoid using tranquilizers, such as diazepam, alprazolam and clonazepam, in high doses during pregnancy because they can lead to sedation and respiratory distress in the newborn. You can still use them in small doses for short periods of time. However, Osborne will typically try to get mothers on intermediate-acting options like lorazepam. It is advisable to consider this information before taking citalopram if you are pregnant. If you have taken or are taking any medicines, it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and if so, to make sure that you are taking the lowest dose that works and only for as long as you need to.
It is very important that you do not suddenly stop taking citalopram as this could be dangerous to you, and also to your unborn baby if you are already pregnant.
Do not make any change to your medication without first talking to your doctor. It is mainly during this time that some medicines are known to cause birth defects.
Heart defects It is not yet clear whether taking citalopram during early pregnancy increases the chance of having a baby with a heart defect.
It is known that about one in every babies is born with a heart defect, regardless of whether their mother took any medicines during pregnancy. Although most of the studies carried out have shown no link between taking citalopram in early pregnancy and having a baby with a heart defect, some studies have shown a slightly increased risk.
However, the available information suggests that even if taking citalopram during early pregnancy does increase the risk of having a baby with a heart defect, nearly all women who take citalopram will have a baby with a normal heart. Heart defects have also been shown to occur slightly more frequently in babies of mothers who took SSRIs other than citalopram in the first trimester of pregnancy. Other birth defects Three studies have identified possible links between citalopram use in pregnancy and defects of the urinary system, while two studies suggest a possible link with defects of the digestive system, and a further two have suggested a possible link with neural tube defects spina bifida or defects of the brain.
More research is required to confirm these findings. A single study found a possible link between exposure to citalopram in the womb and hypospadias where the opening on the penis is on the underside rather than at the tip but a further three studies did not agree with this finding. Single studies each found links between citalopram use in pregnancy and omphalocele, and gastroschisis in the baby defects of the abdominal wall where some of the abdominal organs are outside the body , but a further study did not agree with this finding.
Single studies have also suggested possible links between taking citalopram in early pregnancy and, defects of the limbs, eye defects, and craniosynostosis where the skull bones fuse earlier than normal. No other studies have investigated any possible link between citalopram use in pregnancy and any of these defects, and it is therefore not possible to say that there are links based upon single studies.
More research is needed to assess whether taking citalopram in pregnancy increases the chance of birth defects in the baby.
No increased risk of miscarriage in women taking citalopram during early pregnancy was shown in any of the four studies that have looked at this. However, because only small number of women have been studied, more research is required before we can say whether or not taking citalopram during early pregnancy increases the chance of miscarriage.
It is unclear whether taking citalopram during pregnancy is linked to having a premature or low birth weight baby because the results of the studies carried out do not all agree. A number of studies of women taking any SSRI during pregnancy have shown links with premature delivery, although most do not shown links with low birth weight.
We do not know, however, how this relates to women specifically taking citalopram. It is also thought that other factors, including other medicines used by the mother and the effect of the medical conditions that women were taking SSRIs to treat, may explain why more of these women gave birth early. It is therefore still not clear whether SSRI use in pregnancy causes preterm birth.
No increased risk of stillbirth was seen in either of the two studies which investigated this. However because only small numbers of women have been studied, more information needs to be collected on this subject. Studies have shown that babies who were exposed to citalopram, or to any SSRI in the womb, are more likely to suffer from neonatal withdrawal. A structured telephone follow-up interview was conducted following the expected date of confinement.
Results: The total number of pregnant women enrolled in this study was women in each group. A total of women took citalopram at least in the first trimester. Fetal survival rates, mean birth weights, and duration of pregnancy were not statistically different among the 3 groups.
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