SSRIs: Weighing the Risks and Benefits of Antidepressant Use During Pregnancy

The  New York Times recently reported on a study published in the British Journal of  Clinical Pharmacology that found SSRI anti-depressant use during pregnancy is linked to the risk of pregnancy-induced hypertension (high blood pressure). It is important to note that a causal link has not been established.

SSRIs are selective serotonin reuptake inhibitors and are used to treat depression, anxiety disorders and some personality disorders. Brand names for some of these anti-depressants are Paxil, Zoloft, Lexapro, Prozac and Celexa.

Canadian researchers looked at approximately 13,000 women, and 1,216 of these women had pregnancy-induced hypertension with no history of hypertension before pregnancy. Of these women, the overall incidence of hypertension in those taking SSRIs appeared to increase from about 2 percent to about 3.2 percent, which is a relative risk increase of 60 percent. One specific SSRI, paroxetine (Paxil), was associated with an increase in incidence of hypertension to about 3.6 percent, which is an 81 percent increase.

Pregnancy hypertension is linked to pre-eclampsia, which is a serious condition that can harm pregnant women and their unborn babies.

Should you stop taking an anti-depressant if you are trying to conceive?This is an especially tricky area because anti-depressants are one of the most commonly used medications during pregnancy with anywhere from 4 percent to 14 percent of pregnant women using the medications.

Do not stop taking your anti-depressant without consulting with your doctor. If you need anti-depressant medications, you should take them. Pregnancy hormones can trigger emotions that make it more difficult to cope with pregnancy. If you stop using your anti-depressant, you are at risk for depressive relapses and post-partum depression.

Overall, the risk of taking anti-depressants and developing hypertension during pregnancy is relatively low:

  • Taking any kind of anti-depressant, raised a pregnant woman’s absolute risk of hypertension from 2 percent to 3.1 percent.
  • Taking SSRIs raised the absolute risk from 2 percent to 3.2 percent
  • Using Paxil specifically raised the risk from 2 percent to 3.6 percent.

If you take anti-depressants and are trying to get pregnant or undergoing fertility treatment, talk to your doctor and together weigh the risks and benefits of your medications.