Does taking citalopram or escitalopram increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. There have been some studies that suggested taking antidepressant medications might slightly increase the chance of miscarriage. However, a study on citalopram and escitalopram did not find an increased chance of miscarriage in individuals taking these medications.
Does taking citalopram or escitalopram increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. There are reports of more than 15,000 pregnancies exposed to citalopram/escitalopram. Overall, the available data do not suggest that citalopram/escitalopram increases the chance of birth defects. While some reports have suggested an increased chance of heart defects or other birth defects, most studies have not found an increased chance of birth defects.
Does taking citalopram or escitalopram in pregnancy increase the chance of other pregnancy-related problems?
Some studies suggest that taking citalopram/escitalopram throughout the pregnancy might increase the chance of pregnancy-related problems such as preterm birth (birth before 37 weeks of pregnancy) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, research has also shown that when depression is left untreated during pregnancy, there could be an increased chance of pregnancy complications. This makes it hard to know if it is the medication, untreated depression, or other factors that are increasing the chance for these problems.
Some, but not all, studies have suggested that when pregnant individuals take SSRIs such as escitalopram or citalopram during the second half of the pregnancy, their babies might have an higher chance for a serious lung condition called persistent pulmonary hypertension. Persistent pulmonary hypertension happens in 1 or 2 out of 1,000 births. Among the studies looking at this, the overall chance for pulmonary hypertension when an SSRI was used in pregnancy was less than 1/100 (less than 1%).
I need to take citalopram or escitalopram throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Some medications taken during pregnancy are associated with withdrawal symptoms in a newborn after delivery. If you are taking escitalopram or citalopram at the time of delivery, your baby might have irritability, jitteriness, tremors (shivering), constant crying, different sleep patterns, problems with eating and controlling body temperature, and some problems with breathing. In most cases, these symptoms are mild and go away within a couple weeks with no treatment. Some babies may need to stay in the nursery or NICU until the symptoms go away. Most babies exposed to escitalopram or citalopram in late pregnancy do not have these symptoms. It is important that your healthcare providers know you are taking these medications so that if symptoms occur your baby can get the care that is best for them.
Does taking citalopram or escitalopram in pregnancy affect future behavior or learning for the child?
One small study followed eleven babies exposed to citalopram during pregnancy. At one year of age there was no difference in their development compared to children who were not exposed to citalopram. Most studies find no increase in attention deficit hyperactivity disorder (ADHD) in children exposed to SSRIs during pregnancy. Most studies also find that SSRIs do not appear to increase the chance of autism spectrum disorder (ASD) after considering the effects of maternal depression or other factors.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects and to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you.
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