From the Guidelines
Lexapro (escitalopram) is generally considered relatively safe during pregnancy, but the decision to use it should be made carefully with your healthcare provider. The potential risks of untreated depression or anxiety during pregnancy often outweigh the risks of taking the medication. According to a study published in Pediatrics in 2012 1, SSRIs, including Lexapro, are now the most frequently used drugs to treat depression in pregnant women. While there have been reports of neonatal signs such as continuous crying, irritability, and jitteriness in infants exposed to SSRIs in the third trimester, these signs typically resolve within 1 to 2 weeks.
Some key points to consider when taking Lexapro during pregnancy include:
- The medication should be continued at the lowest effective dose to avoid withdrawal symptoms and harmful effects on the mother-infant dyad 1.
- Infants are at risk for manifesting clinical signs of drug toxicity or withdrawal over the first week of life, and early follow-up after hospital discharge is recommended 1.
- The benefits of treating mental health conditions during pregnancy often outweigh the potential risks, and many women continue Lexapro throughout pregnancy without complications.
- If you're currently taking Lexapro and discover you're pregnant, don't stop taking it suddenly, as this could lead to withdrawal symptoms and worsening of your mental health condition; instead, consult with your doctor immediately to discuss your specific situation 1.
From the FDA Drug Label
Taking Escitalopram late in pregnancy may lead to an increased risk of certain problems in your newborn. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy Advise patients that escitalopram use later in pregnancy may lead to increased risk for neonatal complications requiring prolonged hospitalization, respiratory support, tube feeding, and/or persistent pulmonary hypertension (PPHN) of the newborn
Lexapro (escitalopram) use during pregnancy may lead to increased risk of certain problems in the newborn, including neonatal complications. It is essential to discuss the benefits and risks of treating depression during pregnancy with a healthcare provider. If a patient becomes pregnant while taking Lexapro, they should notify their healthcare provider and consider registering with the National Pregnancy Registry for Antidepressants 2.
From the Research
Lexapro Safety During Pregnancy
The safety of Lexapro (escitalopram) during pregnancy is a concern for many expectant mothers. Here are some key points to consider:
- According to a study published in 2012, less data is available concerning fluvoxamine and escitalopram use, but current data does not indicate a specific risk 3.
- A case study published in 2008 reported a healthy outcome for a child whose mother was administered escitalopram throughout pregnancy, but emphasized the need for careful consideration and monitoring of drug levels during pregnancy 4.
- A review of the available literature on the safety profile of escitalopram during pregnancy and breastfeeding found that although some cases of major malformations have been reported, the rate of these adverse events is substantially in the range of those reported in unexposed women 5.
- However, exposure to escitalopram may be associated with an increased risk of perinatal complications, similar to other selective serotonin reuptake inhibitors (SSRIs) 5.
- A literature review published in 2017 found that there are too few studies to draw definite conclusions regarding the safety of escitalopram, but suggested that sertraline and citalopram should be first-line drug treatments for anxiety and depression in pregnant women in the SSRI class 6.
Key Findings
Some key findings from the available research include:
- Escitalopram may be considered safe during pregnancy, particularly as far as major malformations are concerned 5.
- However, the available data are limited, and no definitive conclusions can be drawn on its safety profile during breastfeeding 5.
- The decision to take escitalopram during pregnancy should be made on a case-by-case basis, taking into account the individual woman's circumstances and the potential risks and benefits of treatment 4, 7.
- Women who are pregnant or breastfeeding should be closely monitored by their healthcare provider if they are taking escitalopram or any other medication 3, 4.