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Antidepressant medication during pregnancy and breastfeeding

Information for pregnant women

During your pregnancy it is really important for you to have a stable mood and be comfortable on your antidepressant medication as part of providing a safe environment for your baby.

Taking antidepressant medication during your pregnancy

Mood and anxiety disorders need to be treated appropriately during pregnancy. This could include the need for antidepressant medication which is safe, effective and not addictive. Among the antidepressant medications often prescribed to treat mood and anxiety disorders are selective serotonin reuptake inhibitors (SSRI) and selective noradrenaline reuptake inhibitors (SNRI).

Antenatal management

If you are taking SSRI or SNRI antidepressant medication during your pregnancy, please ensure your doctor, and/or midwife is notified. You are encouraged to speak with your prescribing doctor about the possible risks and benefits of using antidepressant medications in pregnancy. 

Any adjustments in dose should take place under the supervision of your doctor and we strongly recommend against reducing or increasing your medication without supervision.

A pharmacist or the National Prescribing Service Medicines Information line on 1300 MEDICINE (1300 633 424) can also help answer questions you might have about the safety of your antidepressant medication during pregnancy. You may also be offered an appointment with a lactation consultant to discuss preparation for breastfeeding.

Babies can be exposed to these medications because they cross the placenta. Exposure to antidepressant medication in late pregnancy may result in your baby having something called ‘Discontinuation Syndrome’.

Symptoms of discontinuation syndrome occur in up to one in three babies who have been exposed to SSRI or SNRI medication. Symptoms are usually mild and disappear within a few days. However, moderate to severe symptoms have also been reported.

These symptoms include: 

  • respiratory problems
  • temperature changes
  • feeding difficulties
  • vomiting, tremors
  • jitteriness
  • prolonged or constant crying
  • muscle tone changes
  • irritability
  • seizures
  • settling difficulties
  • floppiness
  • rigidity
  • low blood sugars
  • jaundice

In a small proportion of babies, symptoms are severe enough to require admission to a neonatal unit for treatment.

Postnatal management

Postnatally, you should continue to take your antidepressant medication as prescribed. If you need pain relief, your doctor will prescribe treatment that is compatible with your medication. A pharmacist can also help answer any questions you may have about your medication.

Please ask for help from the midwife if you need support or assistance with breastfeeding or other baby cares. If required, a referral can be made to Mater's Consultation Liaison Psychiatry (CLP) team. 

Care of your baby

Unless there are other medical concerns, your baby will be observed during normal other/baby/midwife contact and will have regular monitoring of their temperature, heart rate and breathing. Sometimes, extra monitoring may be required to ensure other signs of mild withdrawals are not missed. Please report any concerns you may have about your baby to your midwife.

The paediatrician will check your baby during their admission and will ensure a discharge plan is in place including referral to child health or an early appointment back to your general practitioner.

 

Follow up

Please make an appointment to see your GP within one week of discharge. We also advise you to make an appointment with your prescribing doctor once you are discharged from Mater Mothers' Hospitals for the purpose of reviewing your antidepressant medication dose.

Some useful contact phone numbers:

Mental Health Services Metro South 24 hour helpline

MHCALL (1300 642 255)

Families in Mind (Mater and Metro South Perinatal Mental Health Service)

07 3163 1639

Mater Mothers parent education and support centre

07 3163 2229

Medicines Line (Mon to Fri 9am – 6 pm)

1300 MEDICINE  (1300633424)

Adverse medicine event line [AME] (Consumer Info)

1300 134 237

Beyondblue info line

1300 224 636

Australian Breastfeeding Association Helpline

1800 mum 2 mum (1800 686 268)

Child Health Services

1300 366 039

13HEALTH 

13 432584

References

Royal Australian and New Zealand College of Psychiatrists. Practice Guidelines. GUIDANCE ON THE USE OF SSRIS AND VENLAFAXINE (SNRI) IN LATE PREGNANCY. December 2005. Cited on 29/9/2008 at: https://www.ranzcp.org/Publications/Guidelines-for-clinical-practice.aspx

Beyondblue. The National depression Initiative. Emotional Health During Pregnancy and Early Parenthood. 2008. www.beyondblue.org.au

References

Royal Australian and New Zealand College of Psychiatrists. Practice Guidelines. GUIDANCE ON THE USE OF SSRIS AND VENLAFAXINE (SNRI) IN LATE PREGNANCY. December 2005. Cited on 29/9/2008 at: https://www.ranzcp.org/Publications/Guidelines-for-clinical-practice.aspx

Beyondblue. The National depression Initiative. Emotional Health During Pregnancy and Early Parenthood. 2008. www.beyondblue.org.au

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430031
Last modified 26/9/2019.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 18/1/2014
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