sertraline and pregnancy

[Astrianex]

I have been on 200mg of sertraline for a long time and after trying other drugs I know this is the best for me. I have recently founf out im pregnant so asked my doctor for advice. I was told the risks are minimal and recommended I stay on it. Is it true the only risk is the baby might be born with a sertraline addiction? I have a midwife appointment friday to  ask questions but other than is it safe im not sure what to ask

[C_Hafsa]

I was on Zoloft for a total of three months and my doctor advised me to avoid pregnancy while taking it because it could have some negative effects on the baby including lung damage and deformed limbs.  I didn't do much research,  but I had to stop taking zoloft due to my medical insurance being terminated and the withdrawal has been pretty hard.  If you do stop taking it I would imagine it would be best for them to seem you off of it.

[nursegirl6572]

Hello, and congrats on the pregnancy!

Deciding to start, of stay on any medication during pregnancy is a very personal decision, one that must be made after weighing the risks versus benefits.  Paxiled is correct in that, whenever possible, it's better to NOT take Zoloft during pregnancy.  That being said, a lot of women take an antidepressant during their pregnancies with no issues.  Keep in mind too, that these meds are fairly new on the market, so any long term issues really cannot be determined yet.  There really aren't any definitive studies about the long term effects on children born to mothers who were taking Zoloft during pregnancy.

To give you some factual information to help you with your decision, the following is a list of pregnancy risk categories for medications:

Category A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Category N
FDA has not classified the drug.

Zoloft is categorized as a "C" risk drug, so it's kind of middle of the road, certainly not the worst regarding fetal risk, but not the best either.  Again, it comes down to whether or not the RISK outweighs the benefit.  So, for example, for something like an antidepressant, if an expectant mother would be expected to not be able to function without the medication, if her symptoms of anxiety would be debilitating, then most likely the doctor would recommend staying on the medication.  

Definitely keep asking questions, and keep your options open.  It's a little more difficult to navigate through this kind of thing when a woman is already pregnant, due to the discontinuation syndrome (aka "withdrawal") that commonly occurs when trying to come off the drug, which could possibly present its own risk.  These decisions are BEST made prior to a woman becoming pregnant, which is a moot point for you unfortunately.

Best of luck to you in your decision, and in your pregnancy.  Please let us know how you're doing, and what you decided.  Remember, in the end, it's YOUR decision.

[Paxiled]

Nursegirl is the best one to ask about this, but my understanding is that all antidepressants are best not taken when pregnant.  Many people focus on the evidence of birth defects but there's also the issue of the child without a developed nervous system being exposed to brain altering substances.  By the way, you don't get addicted to sertraline, but it does pack a withdrawal wallop for many people.  Problem is, the brain takes time to go back to working naturally without it, as it alters the way the brain naturally processes serotonin.  I'm not the most trusting guy when it comes to doctors and medication -- I don't feel they are well educated about it given that most of their education is written or funded by the pharmaceutical industry and its sales force when it comes to medication.  But others, including your doctor, will differ, and my opinion is just that, my opinion.