Is sertraline (Zoloft) safe for depression in pregnancy?

The expert view

At a time when people expect you to be at your happiest, it can be really tricky to navigate depression and the low mood it brings with it.

While the NHS does not generally recommend taking sertraline in pregnancy, there are other anti-depressants your GP can prescribe for you, so speak to him/her if you are concerned about how you are feeling, or the drugs you are currently taking.

"Sertraline is generally avoided in pregnancy," says MFM’s GP Dr Philippa Kaye. "If you are taking this medication and are planning to conceive or if you are already pregnant and taking it, please do speak to your doctor. Together you can decide on a plan which may involve changing to another antidepressant."

Sertraline is one of a range of drugs called SSRIs, and the general consensus is that there are other antidepressants of the same type, such as Prozac, which are considered safer for use during pregnancy.

However, the UK Teratology Information Service – which looks at how drugs can affect pregnancy – explains that data on the risks of sertraline can be conflicting.

There is ongoing research and in a recent study by the Columbia University Medical Center and the New York State Psychiatric Institute, 840,000 women were evaluated and they discovered there may be an association with taking SSRIs, and an a "lower risk of preterm birth and Caesarean section" and this study "confirm the results from previous research of a higher risk for several neonatal problems."

A Danish study of 400,000 children found there was a slightly increased risk of defects with the wall that separates the left and right chambers of the heart, but this was just 0.4% more likely in mums taking SSRI antidepressants, especially sertraline.

The current NHS stance is that although the Danish study suggests that 'SSRI use in early pregnancy may increase the risk of septal heart defects in the baby', it is 'important to note that the absolute increase in the risk of a child being affected is small, i.e. less than 1%'.

And it also flags up that 'depression is a serious illness and, in some cases, the benefits of antidepressant treatment may be considered to outweigh the potential risks'.

A potential alternative

Research into an alternative to pills has been led by Deborah Kim, MD, assistant professor of psychiatry, University of Pennsylvania, in Philadelphia. The small study into the use of "TMS (Transcranial Magnetic Stimulation) has shown positive results. "TMS is good for women with moderate to severe depression who don't want to go on antidepressant drugs," says Dr. Kim. Although the studies are in their early stages, it's good to see there is a potential alternative.

Mums in our MadeForMums community say

"I'm on sertraline and i have CBT as well. I find the meds help me think clearly and rationally which helps a heck of alot so with the CBT it only kind of helps because i am already taking meds so the CBT is for me only really makng me talk and think through things I already know. But I wanted to do both because I just want to get over this as quickly as possible" says Larri.

Read more...

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