Zoloft, or Sertraline is classified by the Food and Drug administration as a Category B drug when used during pregnancy. This means that “either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the first trimester and there is no evidence of a risk in later trimesters.” Zoloft is not 100% safe to take during a pregnancy.
The Mayo Clinic reports that Zoloft can be associated with a rare newborn lung problem, persistent pulmonary hypertension of the newborn, when taken during the last half of pregnancy. Women who take Zoloft the last half of their pregnancy are six times more likely to deliver a child with PPHN.
One a more positive note the use of Zoloft during pregnancy does not increase the risk of birth defects. A women taking Zoloft during her pregnancy has the same 3-5% risk of birth defects as the general population.
Zoloft is taken for depression, post traumatic stress disorder, panic disorder, obsessive compulsive disorder, and social anxiety disorder. A pregnancy will not make these problems disappear. If a person suffers from severe depression they will likely relapse if taken off of Zoloft for the sake of their pregnancy. Women with depression may lapse into a state of poor behavioral health. They may not take proper care of themselves, in turn putting their unborn child at risk. Women with depression are less likely to receive the same prenatal care as women who do not suffer from depression.
The question that needs to be asked is whether taking Zoloft outweighs the risk of not taking it during pregnancy. Only your doctor can instruct whether or not it is medically necessary to continue Zoloft during pregnancy.
If a decision is made to wean from Zoloft during pregnancy extra care needs to be taken to ensure withdrawal symptoms are not overwhelming. The doctor will often times slowly reduce the dosage to ease withdrawal symptoms such as headaches, insomnia, or severe anxiety. The patient should also be asked to attend regular visits with her prescribing doctor to ensure that she is handling being off her medication during pregnancy. The patient will also be advised to regularly visit a licensed therapist throughout her pregnancy.
The doctor will decide whether or not to reinstate the Zoloft regimen after the baby is born. Zoloft is excreted in very small doses in breastmilk so this will be taken into consideration. Women who have previously suffered from an ailment Zoloft is used to treat may be at greater risk for Post partum depression so continued contact with a licensed therapist is highly recommended.
The choice to continue Zoloft during pregnancy is a highly personal one. It is not something that can be made without looking at all of the facts. Always consult your doctor before altering your medication.
