What Psychiatric Medications are Safe in Pregnancy?

A follower of mine messaged me on my website recently. They remembered a previous blog that promised a certain topic and they asked me, “Dr. Mills, you promised to tell us about some medications in pregnancy. Are you still going to do that?”

Yes, and today is the day! Let’s dive right in!

First, let’s talk about some psychiatric or mental health medications that are safer in pregnancy. You might be saying, wait, Dr. Mills, did you just say saf-ER? I only want what is completely safe, no side effects possible for me or my baby.

As a reproductive psychiatrist, I want to be honest with all of you in explaining that no medication is without risk, whether one is pregnant or not. By the same token, I also want to be honest and tell you that untreated mental illness is harmful to both you and your baby while you are pregnant and after birth. What we do in my field is inform you of the risks and benefits, taking into consideration the severity of your mental health symptoms, and you can make the best decision for your mind, body, and baby. Remember, no decision to take or not take medication is ever final; you can always change your mind.

Also, I am not promoting any specific medication nor am I compensated by the pharmaceutical companies to list their medications in this video.

So, for some examples of safer medications. Let’s talk about some medications that treat depression, anxiety, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD). Sertraline that also goes by the brand name of Zoloft has a safer profile for pregnant individuals with very few risks. Citalopram, brand name Celexa, also has a safer profile for pregnant individuals. Paroxetine, brand name Paxil, is a safer medication in pregnancy. An interesting fact about paroxetine is that the early research showed there was small increased risk for heart defects, but more recent research has actually shown that it does not have increased risk for heart defects. All three of the medications listed act to increase the neurotransmitter serotonin in the brain and that improves one’s mood and calms anxiety. While generally well-tolerated by both mom and baby, there is a low risk of poor neonatal adaptation syndrome. The syndrome is characterized by baby being irritable, jittery, crying more than expected, altered sleep patterns and problems eating. Vast majority of the time, the symptoms are mild and resolve on their own within weeks.

Now, for a psychiatric medication that should be discontinued prior to pregnancy if possible. This medication is used to treat bipolar disorder, epilepsy, and migraines. Valproic acid, also known as Depakote, while quite effective, can lead to major birth defects with the heart, spinal cord and other body systems. It also is associated with the growing child having developmental delay, decreased IQ, and difficulties thinking.

The most important thing to remember is to work closely with your reproductive psychiatrist to find a balance of treatment that makes you feel comfortable.

If you would like me to be your reproductive psychiatrist, please click on the “Book Appointment” button and schedule your free 15 minute consultation with me, Dr. Mills. 

Thanks for reading, have a great week and remember, Mental Health is Freedom!