Is it safe to take Zoloft during pregnancy?

Antidepressants pose some risks to the mother and baby during pregnancy. In this SingleCare article, Mindpath Health’s Julian Lagoy, MD, discusses Zoloft and other pregnancy-safe medications used to treat anxiety and depression.

An important part of being an expectant parent is keeping your child healthy. That includes learning which prescriptions are safe to take during pregnancy—such as antidepressant medications. And while taking an antidepressant such as Sertraline (Zoloft) during pregnancy is not 100% risk-free, going through pregnancy with untreated depression may come with more risks.  

In fact, the American College of Obstetricians and Gynecologists (ACOG) says that depression during pregnancy can have adverse health effects for both the mom-to-be and the baby. This includes problems with the growth of the fetus, premature birth, low birth weight, and complications after birth. 

Is it safe to take Zoloft during pregnancy? 

Zoloft is a brand name for the drug sertraline, which belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These drugs work by increasing the amount of serotonin, a natural neurotransmitter, in the brain. SSRIs are used to treat depression, panic disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, and post-traumatic stress disorder (PTSD).  

Although the side effects of taking an SSRI while pregnant are generally minimal, Sherry Ross, MD, OB-GYN says there may be some potential side effects for the baby if taking the drug in the last trimester. These include: 

• Abnormal muscle tone 
• Hyperactive reflexes 
• Irritability 
• Jitters 
• Low blood sugar 
• Poor feeding 
• Respiratory distress during the first month of life 
• Seizures 
• Vomiting 

A U.S. Centers for Disease Control and Prevention (CDC) study found that despite a slightly increased risk of certain birth defects from some SSRIs, the actual risk among babies born to women taking one of these antidepressants is still very low.  

Should you stop taking Zoloft when you find out you’re pregnant?

If you’re considering coming off of Zoloft during pregnancy, it’s critical that you do not stop taking it suddenly. “If you’re on a high dose of Zoloft and you stop it completely, you may experience adverse side effects and withdrawal,” says Julian Lagoy, MD, a psychiatrist at Mindpath. He does not recommend stopping suddenly without talking to your provider. 

Although it is safest not to take any antidepressant medication while pregnant, Dr. Lagoy says it may be worse for both mother and baby to discontinue medications like Zoloft during pregnancy since this could potentially lead to worsening mood and anxiety symptoms.  

How much Zoloft is safe to take during pregnancy?

A safe and recommended dose of Zoloft begins at 25 mg to 50 mg per day. For moderate to severe depression, doses up to 200 mg are deemed safe to use during pregnancy. 

When managing antidepressants during pregnancy, Dr. Lagoy says he strives to give the minimum dose possible.  

Is Zoloft safe to take while breastfeeding?

It’s common to have questions and concerns about your health and how it impacts your baby during the postpartum period.  

It is generally considered safe to take Zoloft while breastfeeding. Only a small amount of the drug may pass into breast milk, so the risk to your infant is minimal. Due to documented low levels of exposure during breastfeeding, findings concluded that sertraline is a first-line drug for breastfeeding women.  

What other antidepressants are safe to take during pregnancy and while breastfeeding?

There are several antidepressants that are safe to use during pregnancy, but Dr. Lagoy says sertraline has the best research data regarding safety in pregnancy.  

In addition to Zoloft, other antidepressants prescribed during pregnancy and the postpartum period include the SSRIs Celexa, Lexapro, Paxil, and Prozac. Your doctor may also talk to you about serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, and Effexor. 

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

Read the full SingleCare article with sources.