Citalopram and Pregnancy (3 crucial tips)

This blogspot will respond to the question “is it safe to take citalopram in pregnancy?” and cover topics: is it difficult to get pregnant while taking citalopram? Why is it necessary to take citalopram in pregnancy? Can citalopram lead to miscarriage or preterm baby birth? What are the effects of citalopram on the fetus? What other antidepressants can be taken for depression during pregnancy? Which antidepressants are considered OK during pregnancy? Can Citalopram in pregnancy cause birth defects in babies? Can taking citalopram during pregnancy lead to stillbirth or premature birth? What are the neonatal outcomes after prenatal exposure to citalopram?

Is it safe to take citalopram (escitalopram) in pregnancy?

Citalopram (escitalopram) is an antidepressant that belongs to the selective serotonin reuptake inhibitor class. Alongside other antidepressants of the same category, it has been considered as a drug of choice during pregnancy to treat depression or related features among pregnant women due to the minimum risk to the fetus and pregnant women. 

Is it difficult to get pregnant while taking citalopram?

Citalopram has been an option for treating men and women facing depression or a related mood disorder. There have been no evidence of any cases reporting reduced fertility due to the medicine use. Rather the medicine helps in regulating daily activities among depressed women and thus aids in fulfillment of their biological, social and psychological needs. None of the tests or studies performed to date with the medicine have reported any signs of problems or problems in getting pregnant due to medicine.

Does Citalopram result in reduced fertility?

Citalopram is a selective serotonin reuptake inhibitor that has been used as a best suited option for the depressed women. Research suggests that the myths related to reduced fertility due to Citalopram  have not been tested positive.

The impact of citalopram on fertility was ruled out by a research study conducted by Nonacs (2016). No significant differences were observed in the treatment outcomes of  depressed women undergoing IVF treatments taking citalopram and the control group. Thus the evidence suggested that taking citalopram as a selective serotonin reuptake inhibitor for the treatment of depression during IVF treatment does not result in reduced fertility. Rather the study concluded that women with prescription of citalopram were not statistically different from women who had no exposure to citalopram and had no features of depression. However, depressed women with no exposure to any kind of antidepressants showed significant problems in IVF treatment with reduced fertility. There were reports of different odd experiences during the course of treatment that were majorly related to different associated features of depression that the participants were going through.

The research study hence suggested that untreated depression/ anxiety or a mood disorder has a greater tendency to result in reduced fertility rather than the selective serotonin reuptake drugs like citalopram, that are used to help women cope with the underlying features associated with depression.

Why is it necessary to take citalopram in pregnancy?

During pregnancy it is necessary to take citalopram in order to minimize the effect of depressive traits that might hinder the journey through pregnancy. Whether to take an antidepressant or not during pregnancy is usually a tough decision for a pregnant mother. However considering the minimum risk maximum benefit scenario, citalopram (selective serotonin reuptake inhibitor) is recommended as a drug of choice.

Untreated depression or related features in a pregnant woman might lead to associated pregnancy risks. Depression comes along with a passive routine, a low energy, lack of interest in life, loss of pleasure feelings, disturbed sleeping pattern, disturbed eating pattern and low socialization. With all the associated features, it becomes difficult for the pregnant lady to take care of herself and the fetus. Hence if depression is left untreated it may have severe effects in the health of the mother or the fetus. 

Taking citalopram is thus necessary inorder to minimize the risks associated with maternal and fetal health during pregnancy. Women are better able to follow their diet plans and doctor appointments. Being on citalopram, pregnant women undergoing depression are at a lesser risk of getting addicted to alcohol, smoking or any other substance abuse that  can further lead to health risks for the mother and baby.

A pregnant woman undergoing depression and taking citalopram is better able to take care of her interpersonal relationships during the course of pregnancy. Such women are less prone to have a negative view of self, the world and others when they are being treated by selective serotonin reuptake inhibitors like citalopram. There is also a reduced risk for developing suicidal tendencies among the pregnant women while taking citalopram.

Pregnancy in itself is an emotionally vulnerable time that is packed with great hormonal, biological and psychological changes among the women. Inorder to maintain the upkeep of the family and take better care of household chores a depressed pregnant woman is prescribed with citalopram. This way a depressed woman can better look after her family and nurture any kids that she already has. Otherwise the depression due to its strongly negative features, usually prevents pregnant women to carry their routine well.

Women who opt not to take antidepressants during pregnancy are usually vulnerable to fetal developmental defects. Research suggests that a woman with depression certainly has disturbed prenatal care. She is prone to substance use addiction and social media addiction. Further untreated depression among pregnant women leads to preterm babies and low weight at the time of birth. 

Can citalopram lead to miscarriage, preterm baby birth or stillbirth?

Citalopram doesnot lead to miscarriage among pregnant woem. It has been considered to be the safest drug among other selective serotonin reuptake inhibitors that can be prescribed to depressed women during the course of pregnancy. There has been no evidence of citalopram being the cause of miscarriages, preterm births or stillbirth among depressed pregnant women. 

What are the effects of citalopram on the fetus?

Citalopram being a selective serotonin reuptake inhibitor has a tendency to produce the birth condition persistent pulmonary hypertension in the fetus. The chances of occurrence of the condition are rare according to researchers. The overall chance for PPH occurrence among babies at the time of birth is only 1%.

Researchers further stated that the developmental milestones of babies whose mothers have been on citalopram ( selective serotonin reuptake inhibitors) during pregnancy are no different than the  babies who have not been exposed to citalopram.

The chances of impaired behavioral and learning patterns among newborn babies who have been exposed to citalopram are no different than those who have not been exposed to citalopram in the womb. 

The tendency of development of autism spectrum disorder and attention deficit hyperactivity disorder among babies who have been exposed to citalopram in womb is not higher as compared to other babies and the risk to develop autism or attention deficit hyperactivity disorder is not at a higher end and research has shown no significant differences between the two groups.

What other antidepressants can be taken for depression in pregnancy?

During pregnancy, the preferred  medicines for reducing depression are celexa, fluoxetine, citalopram, desipramine, amitriptyline and bupropion. These medicines have been reported to have minimum teratogenic effects in the womb, specially citalopram.

Paroxetine is however usually not recommended to pregnant women as a drug of choice due to its severe withdrawal symptoms upon abrupt discontinuation. However, if a woman gets pregnant while on paroxetine, the medicine shall not be discontinued abruptly as it may lead to relapse and development of postpartum depression symptoms.

What are the neonatal outcomes after prenatal exposure to citalopram? 

The outcomes of fetal or neonatal toxicity as a result of exposure to citalopram during pregnancy has not been supported by researchers. During the embryogenesis stage of pregnancy, the teratogenic effect of citalopram is minimum. 

However, when women take citalopram in the third trimester, there are chances of occurrence of serotonin syndrome after birth among the babies. It is a usual effect of drug discontinuation on the baby. The drug discontinuation syndrome among the babies after birth is generally apparent  at the time of birth or usually within a few days of birth.

Conclusion

The present blog responded to the question “what are the effects of taking citalopram in pregnancy?”.  We learned the various facts related to intake of citalopram during pregnancy and its outcome on the mother and child during and after birth.  Among certain other medicines, citalopram is a drug of choice for the depressed women who are trying to conceive and for the pregnant women who are undergoing depression.  

The medicine has been reported to have minimum teratogenic effects and has been reported to cause serotonin syndrome among the neonates. However, as compared to its benefits for the wellbeing, the risks associated with it are minimal. Hence taking citalopram in pregnancy is better for a pregnant woman than suffering from untreated depression leading to various odds in sustaining pregnancy.

Frequently Asked Questions: Citalopram and Pregnancy

CITATIONS

• http://bmjopen.bmj.com/content/7/1/e013372.long
• https://womensmentalhealth.org/posts/antidepressants-impact-fertility
•    Berard A, Ramos E, Rey E, et al. First trimester exposure to paroxetine and risk of cardiac malformations in infants: the importance of dosage. Birth Defects Res B Dev Reprod Toxicol 2007;80:18–27.
• Malm H. Prenatal exposure to selective serotonin reuptake inhibitors and infant outcome. Ther Drug Monit 2012;34:607–14.
• Sadler TW. Selective serotonin reuptake inhibitors (SSRIs) and heart defects: potential mechanisms for the observed associations. Reprod Toxicol 2011;32:484–9