"I'm currently in therapy and on antidepressants. Now that I'm trying to conceive, do I need to stop taking my meds? And can antidepressants harm my baby once I do get pregnant?"

The preconception period is a great time to put in place some new good-for-you (and your future baby) habits. But while you might think that tossing out all your prescription medications is a healthy move when you're trying to conceive, when it comes to the antidepressants in your medicine cabinet, the medications you can and can't take during pregnancy aren't always so clear-cut.

That's because if you really need antidepressants such as selective serotonin reuptake inhibitors (SSRIs), going off them due to a pregnancy and potentially slipping back into depression could do you (and your baby-to-be) more harm than good.

Studies show that women who suffer from major depression during pregnancy have a greater chance of preterm delivery and babies with low risk birth weight. They're also at increased risk for postpartum depression, which can make it difficult for them to care for their babies after they're born.

Staying on antidepressants during pregnancy needs to be weighed carefully too. In the past, there was some concern that certain types of antidepressants could be linked to birth defects, but more recent research has found that risk of birth defects for babies of moms who took antidepressants during pregnancy is low.

However, some types of antidepressants have been found to pose problems to a developing baby, so talk to your practitioner and therapist about whether it makes sense for you to stay on or go off antidepressants when you're trying to get pregnant.

Generally, certain SSRIs (like Celexa and Zoloft) are considered low risk during pregnancy, although your practitioner might discourage you from continuing Paxil, which may have a small increased risk of a fetal heart defect.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are also generally considered to be safe to take while pregnant.

If the consensus is that you should wean yourself off your meds or try different kinds, start at least three months before you start trying to conceive so you've got plenty of time to see how it goes.

If you start to notice the signs of depression coming back — sleep and appetite changes, anxiety, inability to concentrate, mood swings and lack of interest in sex — you might try alternative therapies, like psychotherapy, light therapy, meditation or yoga.

Exercise can be a great mood lifter too, as can getting support from friends and loved ones. And of course, keep in close contact with your practitioner and/or therapist, who can steer you to the safest type and dose of antidepressants should you need to stay on your meds once you do get pregnant.

May all your happiest dreams come true,


Heidi Murkoff