Anti-depressants during pregnancy

Mental Health & Self-Care
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Anyone have any insights into how pregnancy hormones combine with anti-depressants? Is it better to stay at your current dose or is it beneficial to increase or lower the dose?

1 Like
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im wondering the same thing

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Hi! I think this is an excellent question that will resonate with many on this forum!

Before I offer any insight, I want to make it clear that the following is NOT medical advice and does not replace the need to have a discussion with your care provider that is individualized to you and the context of your life & pregnancy.

We see both pregnancy hormones and anti-depressants affect the brain, but not in a way that is predictable from person-to-person. There are a few factors to consider when adjusting the dose of anti-depressants (or any medication, really!) in pregnancy, but the rule of thumb is to be taking the lowest effective dose.

  • For some people, the lowest effective dose during pregnancy might be more than usual for that person. This can be caused by pregnancy hormones’ effect on mood, or changes in metabolism/blood volume that lower medication levels in the bloodstream. This is only a piece of a very multifactorial puzzle!

  • For others, the lowest effective dose may be equal to or less than usual for that person. With this in mind, routine practice is not to stop or lower the dose of an anti-depressant due to pregnancy.

We know that it is not safe to stop anti-depressant medication during pregnancy without the advice of a doctor or care provider, and that untreated/under-treated anxiety/depression during pregnancy carries risk to both baby and pregnant person. Your care provider will work with you to find the safest treatment for both you and your baby - that may be a dosage adjustment, switching medications, etc.!

Here is a sample message from the SmartParent texting program if you’re interested:
"Curious about treatment options for depression during pregnancy? Talk w/ your care provider & find info here: https://postpartum.org/the-journey/what-help-is-right-for-me/ "

If you’re interested in more detailed information, you can look up the medication in mind here: https://mothertobaby.org/pregnancy-studies/whats-involved/ - this site has fact sheets for many medications and how they interact with pregnancy/breastfeeding.