Posted by Claudia Grazioso on February 22, 2012
It’s funny how being personally connected to someone with a problem makes you want to re-look at everything you thought you knew about the topic. A really cool woman I know recently started taking Zoloft. She had been through a hard time, and depression had gotten the better of her. But with Zoloft, she was vibrant again, laughing again. No doubt about it, she had her groove back. And sure, it would have been great if she could have found happiness through exercise or yoga, but when someone you like is in pain, sometimes you just celebrate what works. And then she found out she’s pregnant.
Normally to me, it’s a given: SSRIs and pregnancy are not a good thing. But I decided to look into Zoloft again, and this time, it’s personal. What would I tell my friend about Zoloft and pregnancy? First, I would tell her that places as reputable as the Mayo Clinic say that some Selective Serotonin Reuptake Inhibitors are sometimes considered okay to take during pregnancy, and that Zoloft (sertraline) is one of them. And then I would make her aware of the risks.
Babies born to moms who have taken Zoloft in the first trimester are at an increased risk for infant omphalocele – a six-fold risk. They are also four times as likely to have anal atresia or limb defects. I would stress to her that while the risk goes up if the baby is exposed to sertraline, those are all still relatively rare birth defects.
I would tell her about the risk of Persistent Pulmonary Hypertension of the Newborn (PPHN), which is also rare but serious and could require a stint in the NICU. The risk of PPHN is six times higher for infants who are exposed to Zoloft after the twentieth week. I might mention that if she takes Zoloft through her pregnancy she should be aware of infant withdrawal symptoms like respiratory difficulties, tremors, seizures, low blood oxygen and irritability.
But mostly what I would tell her is this: She should inform herself, she should talk with her doctor and make the call that works best for her. Untreated depression can have bad consequences for developing babies, too. I would reiterate that while the risk for birth defects goes up, it’s still pretty low, and she should weigh the benefits to herself against the possible risk to the baby. And I would tell her that no matter what she decides, she will be surrounded by people who support her.