Taking medication during pregnancy means carefully weighing what’s best for your own mental health against the health and safety of your growing baby.
This post explains what sertraline is, whether or not it’s safe to take sertraline during pregnancy, and the side effects of taking sertraline during pregnancy.
The information provided in this article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor, psychiatrist, or a qualified healthcare professional before starting, stopping, or making any changes to your medication regimen, especially if you are pregnant, planning to become pregnant, or breastfeeding.
What is sertraline and how does it work?
Sertraline (Zoloft) is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It works by making more serotonin available in your brain, which in turn helps to improve the symptoms of mental health conditions like depression, anxiety, panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder (OCD).
Why Managing Mental Health During Pregnancy is Important
Research shows that untreated depression is linked to a higher risk of preterm birth, low birth weight, and challenges with mother-baby bonding after delivery.
Additionally, women who stop taking their antidepressant medication during pregnancy may experience a relapse of their depressive symptoms, which can have negative consequences for both the mother and the developing fetus.
Can you take sertraline while pregnant?
When you’re pregnant, any medication can feel like a big decision. That’s why sertraline is often a first-choice antidepressant for pregnant women — it has more safety research behind it during pregnancy than almost any other antidepressant. The goal is to weigh two different types of risk: the small potential for risk from the medicine, against the significant and documented risks of leaving depression untreated during pregnancy.
What are the potential side effects of taking sertraline during pregnancy?
Based on years of research, the risk of birth defects and other problems for babies of mothers who take antidepressants is very low. However, there are some potential side effects to be aware of depending on the timing of the medication.
First Trimester
Some older studies suggest a very small link between SSRIs and certain heart defects in babies. However, most recent studies show that sertraline is not linked with birth defects. The general medical consensus today is that if any risk exists, it is very small.
Third Trimester
If you take an antidepressant during the last trimester, your baby might have short-term withdrawal symptoms. These can include jitteriness, irritability, poor feeding, or a breathing condition called newborn respiratory distress. This condition is generally mild and can last up to two weeks after birth. Studies have not shown that lowering the dose near the end of pregnancy reduces this risk, and doing so may increase your own risk of depression returning.
Does taking sertraline affect fertility?
While there is limited evidence, some studies suggest that SSRIs like sertraline might increase the risk of subfertility in men.
One case report showed that a man taking sertraline experienced decreased sperm concentration and motility (movement). Studies on other SSRIs have also shown a potential link to DNA fragmentation, which is a measure of sperm quality.
The good news is that for men, these effects appear to be reversible. In the sertraline case report, the patient’s sperm parameters returned to normal three months after he stopped taking the medication.
Can you take sertraline while breastfeeding?
Yes, sertraline is considered to be one of the preferred antidepressants to take while breastfeeding. When you take sertraline, only small amounts of the medication pass into breast milk, and it’s quickly cleared from the baby’s system.
How does sertraline compare to other antidepressants during pregnancy?
While sertraline is a preferred option, it’s helpful to know how it compares to other common antidepressants.
- Other SSRIs: Most SSRIs, such as citalopram (Celexa) and fluoxetine (Prozac), are generally considered options during pregnancy. The main exception is paroxetine (Paxil), which might be linked to a slightly higher risk of heart defects in babies and is often not recommended.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): Medicines like duloxetine (Cymbalta) and venlafaxine (Effexor XR) can be options, but they may lead to high blood pressure.
- Bupropion (Wellbutrin): This is not typically a first-line treatment during pregnancy and may be an option only if other medications have not worked. Some research suggests a possible link with a small risk of heart defects or miscarriage.
- Tricyclic antidepressants (TCA): This older class of medicine, which includes nortriptyline (Pamelor) and amitriptyline, is usually not a first or second choice during pregnancy.
Takeaway
Taking sertraline or any antidepressant during pregnancy is a personal choice. It’s important to talk to your healthcare team about it. You need to weigh the very low potential risks of the medication against the serious risks of untreated depression for you and your baby. Because it’s so well-researched, sertraline is often a preferred choice that allows for a healthy pregnancy and stable maternal mental health.
FAQs About Sertraline (Zoloft) and Fertility
Will my baby experience withdrawal from sertraline?
If you take sertraline during your last trimester, your baby might experience short-term, mild symptoms like jitteriness, irritability, or trouble feeding after birth. This is temporary and usually goes away within two weeks.
What is the recommended dose of sertraline during pregnancy?
Your doctor will decide on your dosage based on the severity of your symptoms.
Should I stop taking sertraline once I find out I’m pregnant?
No, you should not stop or change your medication dose without first talking to your healthcare provider. Stopping your medication suddenly can cause your depression to return.
Can sertraline cause birth defects?
The overall risk of birth defects for babies whose mothers take antidepressants is very low. Most studies show that SSRIs like sertraline are not associated with birth defects.
Are there alternatives to medication?
Yes. Deciding to take medication is a personal choice, and for some, other therapies can be effective, either alone or in combination with medication.
- Talk therapy: Psychotherapy, especially cognitive behavioral therapy (CBT), can be very helpful for treating depression during pregnancy.
- Regular exercise: Staying active can also help ease the symptoms of depression. Be sure to ask your doctor what types of exercise are safe for you to do during your pregnancy.
A Word From RMA
The expert team at RMA is here to provide compassionate, evidence-based guidance to support you on your journey to building a family. If you have questions about your fertility, pregnancy, and overall well-being, we invite you to schedule a consultation with one of our specialists.
