Her candid disclosure raises the question: is it safe to stay on these meds if you're expecting? We asked an MD to weigh in.

Anthea Levi
July 20, 2017

 

Amanda Seyfried has never shied away from revealing her struggles with OCD and anxiety. So it’s no surprise the Mean Girls actress was totally candid about her use of antidepressants during her pregnancy when she appeared on a recent podcast. 

“I didn’t get off my antidepressant,” Seyfried, 31, told host Elliot Berlin on his podcast, Dr. Berlin’s Informed Pregnancy. “It’s really for anti-anxiety for me, but I’ve been taking Lexapro for years and years and years and I didn’t get off of it [during pregnancy].”

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The new mother, who gave birth to her first daughter last March, said she was on an “extremely low dose” of the drug while she was expecting, and that she continued taking the medication after delivering her baby girl.

“It’s actually been wonderful,” Seyfried said of her mental health post-pregnancy. “I feel better. My hormones have been really good.” Feeling so positive came as a pleasant surprise as she adjusted to being a mom, she explained, admitting that she “thought [she] was going to fall apart being pregnant and postpartum.”

That fear is common among women, especially those who struggle with depression or other mental health conditions, such as OCD and anxiety. The cascade of hormonal changes triggered by pregnancy can amplify a woman's emotions, potentially making depression or anxiety symptoms more severe. But is staying on antidepressants a good idea?

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The consensus among experts is yes. Selective serotonin reuptake inhibitors (SSRIs), the most researched type of antidepressants and the category Lexipro falls under, “have zero or close to zero risks associated with birth defects, miscarriage or stillbirths,” says Joshua Klein, MD, reproductive endocrinologist and chief medical officer at Extend Fertility in New York City.

Some studies do raise questions about their safety for pregnant women and babies. A new study from the British Medical Journal supports a controversial link between moms who took antidepressants and autism in their children, for example. But the data in the new study didn't show that the meds were the definitive cause.

And while it's possible that an antidepressant may result in a slight increased risk of preterm delivery, says Dr. Klein, “the consensus among most medical organizations and experts is that the benefits of appropriate antidepressant therapy outweigh the risks," he explains. In fact, SSRIs are typically recommended as the first-line treatment for depression during pregnancy.

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Depression in expectant moms goes untreated about 50% of time, he says. This can lead to significant consequences for the mother (and therefore big consequences for her baby), including poor nutrition, substance use or abuse, poor compliance with prenatal care, postpartum depression, and an increased risk of suicide. 

Women who are uncomfortable continuing antidepressants during pregnancy—or who have a known elevated risk of preterm delivery or pregnancy complications and are afraid that their meds might increase the odds even more—can choose an alternative, non-drug treatment. If the depression isn't severe, a pregnant woman could treat it with psychotherapy, says Dr. Klein. Other therapies are available as well. If you're on antidepressants and are thinking about getting pregnant, talk to your doctor about your options. 

As for Seyfried, she’s thrilled she chose to stay on Lexapro while she had a baby on the way. After all, “A healthy parent is a healthy kid,” she says.