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Actress Amanda Seyfried credits medication for helping her cope with obsessive-compulsive disorder.
So when the "Mamma Mia!" and "Les Misérables" star became pregnant with her first child, she kept taking Lexapro, a drug used to treat depression and anxiety, and one that’s been part of her routine for more than a decade.
“I didn’t get off my antidepressant. It’s really for anti-anxiety for me,” she recently said on Dr. Berlin’s Informed Pregnancy podcast. “I’ve been taking Lexapro for years and years and years, and I didn’t get off of it. I was on an extremely low dose.”
“A healthy parent is a healthy kid,” Seyfried, who was diagnosed with OCD at 19 and is now 31, added.
The decision whether to keep taking antidepressants can be a dilemma for expectant moms.
On one hand, it’s dangerous for anyone to suddenly stop taking the medication, especially people with a history of severe, recurrent depression, doctors note. There are consequences for babies, too: Infants born to women with depression are more likely to be irritable, less active and have fewer facial expressions, according to the American College of Obstetricians and Gynecologists.
Research is not complete, but “some studies have linked fetal malformations, cardiac defects, pulmonary hypertension, and reduced birth weight to antidepressant use during pregnancy,” ACOG says.
A 2015 study found women who took antidepressants in the later stages of pregnancy were more likely to have a child with autism. That research focused on SSRIs, or selective serotonin reuptake inhibitors, such as Prozac, Zoloft, Paxil and Lexapro, or escitalopram.
But a more recent study, published in JAMA in April, found women taking antidepressants during the first-trimester weren’t at higher risk of giving birth to children with autism or attention-deficit/hyperactivity disorder. Researchers did find a small increased risk of preterm birth.
What’s a woman to do?
If an expectant mom needs antidepressants, it's beneficial to treat her, said Dr. Iffath Hoskins, an OB/GYN at NYU Langone Health.
"If your doctor thinks you're at the stage where you need a medication of this category, then... the risk of you, the mother, not taking the medicine far outweighs any concern about the baby," Hoskins told TODAY.
"The secondary part of the answer is you have to take it with some caution. Be careful because antidepressants are known to cross the placenta and have some effects on the baby."
Newborns may show the effects of the drug: they're more jittery and their adaptation to life outside of the mother's womb can be a little bit more rocky, Hoskins said.
ACOG has these recommendations:
• Expectant moms who would like to keep taking antidepressants may be able to do so after talking with their psychiatrist and OB/GYN about the risks and benefits.
• Women who would like to stop taking antidepressants can try tapering, or slowly reducing their dosage, if they are not experiencing symptoms.
• Women with severe depression should remain on medication.