Posted by The Vigilant Mom on October 10, 2011
By now it seems to be pretty clear that antidepressants are something pregnant women should consider avoiding. There is a lot of evidence that seems to link Selective Serotonin Reuptake Inhibitors (SSRIs) to birth defects like craniosynostosis, infant omphalocele, anal atresia, persistent pulmonary hypertension of the newborn (PPHN), club foot and heart defects as well as withdrawal symptoms in newborns. It certainly would be enough to scare me off of SSRIs if I were pregnant, but… then what? What options do pregnant and nursing mothers who battle depression have?
I started to hunt around to see if there is an antidepressant that just might be safe to take during pregnancy, and I came across one called Mirtazapine (also known as Remeron). And at first it looked really promising. Mirtazapine, like the SSRIs Prozac and Effexor, can be prescribed to treat depression and anxiety. But unlike Prozac and Effexor, it’s not an SSRI drug. Rather, Mirtazapine is in a class of drug that I had never looked into before: it’s a tetracyclic antidepressant (TeCa). Could this be the easy fix for expectant moms who suffer from depression?
The good news? So far it doesn’t seem to be linked to any major malformations. The bad news? Mirtazapine still doesn’t have the complete green light. Even though it hasn’t yet been linked to major birth defects, in animal studies, Mirtazapine has been linked to an increase in the occurrence of miscarriage and low birth weights. Additionally, survival rates of newborn pups in animal studies decreased when they were exposed to Mirtazapine. As a result of these disturbing findings, Mirtazapine was given a Category C label, meaning that it could potentially harm a baby in utero and there is concern that it could cause withdrawal symptoms like jitteriness, breathing and feeding difficulties, seizures and muscle stiffness. Babies whose mothers have taken Mirtazpine, especially during the last three months of pregnancy, should be watched closely after birth.
Since it has a Category C label, most doctors feel that Mirtazapine should only be taken if absolutely necessary during pregnancy. If you suffer from depression, talk with your doctor about whether it’s safe to take medication through your pregnancy.