Antidepressants pose some risks to the mother and baby during pregnancy. In this SingleCare article, Mindpath Health’s Priyanka, MD, and Leela R. Magavi, MD, discuss Prozac and other pregnancy-safe medications used to treat anxiety and depression. 

Pregnancy expands your health considerations to include your growing baby. That’s why finding a pregnancy-safe medication to treat depression and anxiety is a top priority for many expectant parents — especially since several drugs, including antidepressants, pose some risk to mother and baby during pregnancy. 

According to the American College of Obstetricians and Gynecologists (ACOG), depression during pregnancy can have adverse health effects on both the mom-to-be and the baby. Problems can include growth of the fetus, premature birth, low birth weight, and complications after birth.  

What is Prozac?

Prozac is a brand name for the drug fluoxetine, which belongs to a class of antidepressants called selective serotonin reuptake inhibitors or SSRIs.  

SSRIs work by increasing the amount of serotonin, a normal chemical found in the brain. Providers often prescribe it for depression, panic disorder, obsessive-compulsive disorder, anxiety disorders, and post-traumatic stress disorder.  

Prozac and pregnancy: Is it safe?

Many expectant parents taking Prozac worry about the risk of birth defects. Despite a slight increased risk of certain birth defects from some SSRIs, including fluoxetine, the actual risk among babies born to women taking one of these antidepressants is very low, according to the U.S. Centers for Disease Control and Prevention (CDC). 

Fluoxetine during pregnancy is associated with a slightly increased risk of cardiovascular malformations in infants. Although the risk is small, Priyanka, MD, a psychiatrist and medical director at Mindpath Health, says it’s important to talk with your doctor about the pros and cons of taking Prozac during pregnancy.  

Can you suddenly stop taking Prozac when you find out you’re pregnant?

If you’re considering coming off of Prozac during pregnancy, it’s critical that you do not stop taking it suddenly. It’s also important to discuss this with your provider before making any decision regarding medications. They will be able to advise you on the safest options for your pregnancy.  

The sudden discontinuation of antidepressants during pregnancy is not recommended. “This could potentially lead to worsening mood and anxiety symptoms, which could adversely affect both mom and baby,” explains Leela R. Magavi, MD, a psychiatrist and regional medical director at Mindpath Health. 

Dr. Magavi points to research that indicates that Prozac is one of the safest antidepressants you can take during pregnancy and breastfeeding. If you would rather discontinue medications during pregnancy, Dr. Magavi recommends consulting with a physician who can evaluate your mood state as the dose is gradually decreased over time. 

How much Prozac is safe to take during pregnancy?

In general, the recommended dose of Prozac ranges from 10 mg per day for panic disorder, 60 mg per day for bulimia nervosa, and 20 mg per day for the initial dose for depression. Your provider may adjust that dosage up or down depending on symptoms.  

According to Dr. Priyanka, the general recommendation is to stay on the dose that provides good control of symptoms of depression. If you take a higher dose, there may be a reason to adjust the dose during pregnancy, but this should be discussed with your provider before making any decisions.  

Is Prozac safe to take while breastfeeding?

Medications that are relatively safe during pregnancy are often safe to take while breastfeeding. Antidepressants, like Prozac, are generally considered safe to take while breastfeeding. However, research shows that the average amount of the drug in breastmilk is higher with Prozac than with most other SSRIs such as Zoloft

Adverse effects from taking Prozac while breastfeeding include increased: 

  • Colic 
  • Drowsiness 
  • Fussiness 

What antidepressants are safe to take during pregnancy and breastfeeding?

The SSRIs Celexa, Zoloft, and Prozac are often the go-to antidepressants to use during pregnancy. Your doctor may also talk to you about serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, Lexapro, and Effexor. 

You should always discuss the risks and benefits with your doctor about any of these medications while pregnant or during the postpartum period. 

Read the full SingleCare article with sources. 

Priyanka Priyanka, M.D.

Fresno, CA

Dr. Priyanka is a board-certified psychiatrist. She attended medical school in India and came to the United States in 2006 to continue her education. She first attended the Nutrition and Dietetics program at Syracuse University and then joined the psychiatry residency program at the University of Rochester Medical Center in Rochester, New York. She joined Mindpath Health after finishing her ... Read Full Bio »

Leela Magavi, M.D.

Newport Beach, CA

Dr. Leela Magavi is a native Californian and Hopkins-trained psychiatrist committed to providing compassionate, evidence-based care to individuals of all cultural, political, religious, sexual, and socioeconomic backgrounds. She completed her adult psychiatry residency at Georgetown University Hospital, during which time she also had the invaluable experience of caring for veterans at Washington, D.C. VA. As a resident, she was awarded ... Read Full Bio »

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