From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The patient's current dose of 80 mg of Prozac (fluoxetine) can likely be continued during pregnancy, as the most recent and highest quality study suggests that dose adjustments are generally not necessary for fluoxetine during pregnancy. According to the study published in 2020 1, fluoxetine is one of the antidepressants that does not require dose adjustments during pregnancy, as its concentrations do not change significantly. This is consistent with another study published in 2017 2, which also found that fluoxetine concentrations do not change significantly during pregnancy.
When considering the management of depression during pregnancy, it is essential to balance the risks of medication exposure against the risks of untreated depression. Untreated depression can lead to poor prenatal care, inadequate nutrition, increased substance use, and potential for self-harm, all of which can have negative consequences for both the mother and the baby.
Some key points to consider when managing a patient on Prozac during pregnancy include:
- Regular monitoring of the patient's mental health and adjustment of the dose as needed to maintain stability
- Gradual dose changes to prevent withdrawal symptoms or depression relapse
- Consideration of the potential risks and benefits of medication exposure, including the risk of congenital malformations and other complications
- Collaboration with a psychiatrist and obstetrician to determine the best course of treatment for the patient
It is also important to note that fluoxetine crosses the placenta and small amounts enter breast milk, but extensive data suggests that it is one of the better-studied antidepressants in pregnancy with no consistent pattern of major congenital malformations 3, 4. Overall, the decision to continue or adjust the patient's dose of Prozac during pregnancy should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances.