A decision to use antidepressants during pregnancy, in addition to counseling, is based on the balance between risks and benefits. The biggest concern is the risk of birth defects from exposure to antidepressants. The risk of birth defects and complications among mothers who take antidepressants during pregnancy is very low. However, some antidepressants are associated with a higher risk of complications for your baby. Health care prividers help people who take antidepressants during pregnancy by trying to minimize the baby’s exposure to the medication. This can be done by prescribing a single medication at the lowest effective dose, particularly during the first trimester.

If you take antidepressants during the last trimester of pregnancy, your baby might have temporary signs and symptoms of quitting the drug such as jitters, irritability, poor feeding and respiratory distress. However, there’s no evidence that discontinuing or tapering dosages near the end of pregnancy reduces the risk of these symptoms for your newborn. In addition, changing your treatment might increase the risk of a relapse postpartum, especially for severe depression. The connection between antidepressant use during pregnancy and the risk of autism and attention-deficit/hyperactivity disorder in offspring remains unclear. But most studies have shown that the risk is very small, and some studies have shown no risk at all. APA

A new study suggests a link between use of antidepressants during pregnancy and an increased risk of gestational diabetes. Concerns about potential risks must be weighed against the possibility that a different drug could fail and cause a depression relapse. If you have depression and are pregnant or thinking about getting pregnant, consult your health care provider. Deciding how to treat depression during pregnancy isn’t easy. The risks and benefits of taking medication during pregnancy must be weighed carefully. Work with your health care provider to make an informed choice that gives you — and your baby — the best chance for long-term health.