SSRIs Remain Safe to Use During Pregnancy, Experts Affirm

With so many headlines about what is and isn’t safe in pregnancy, it can be hard to separate fact from fear. For parents managing depression or anxiety with antidepressants, the recent debate over selective serotonin reuptake inhibitors (SSRIs) may feel especially unsettling. Luckily, professional medical organizations and those dedicated to postpartum support are stepping in to set the record straight.

A recent Food and Drug Administration (FDA) panel sparked controversy after several presenters raised alarms about using one of the most common types of antidepressants, SSRIs, during pregnancy. While the meeting was intended to review existing research, many panelists—most without backgrounds in perinatal mental health—focused on potential risks in ways advocates worry could scare parents away from safe, effective treatment.

Both Postpartum Support International (PSI) and the American College of Obstetricians and Gynecologists (ACOG) say the discussion left out critical context and could cause confusion. ACOG called the panel “alarmingly unbalanced,” noting that “on a panel of 10 experts, only one spoke to the importance of SSRIs in pregnancy as a critical tool, among others, in preventing the potentially devastating effects of anxiety and depression when left untreated during pregnancy.”

ACOG stressed that the risks of untreated depression can be severe, from preterm birth and preeclampsia to impaired bonding and even suicide. “For pregnant people who need SSRIs, they are life-changing and lifesaving. Mental health conditions are already the most frequent cause of pregnancy-related death. Unfortunately, the many outlandish and unfounded claims made by the panelists regarding SSRIs will only serve to incite fear and cause patients to come to false conclusions that could prevent them from getting the treatment they need,” the organization said.

PSI echoed those concerns, emphasizing that “extensive data from more than 30 years of research support the use of SSRIs in pregnancy.” The group added that “downplaying the effects of mental health disorders during the perinatal period is short-sighted and alarming.”

Experts agree the risks of untreated depression or anxiety are often far greater than any possible risks from medication. Jay Gingrich, MD, PhD, of Columbia University, who presented his own research on SSRI effects in adolescence, called SSRIs a “lifesaver” for people with severe depression, obsessive-compulsive disorder and panic attacks. “I wouldn’t change anything until we have more evidence,” he told Journal American Medical Assocation Medical (JAMA) News.

Within the JAMA review, Kay Roussos-Ross, MD, of the University of Florida Health, reminded parents that mental health care is just as important as managing any other condition, noting, “We’re not asking women to stop their diabetes medications. We should not be withholding SSRIs as a possible treatment for women who need it.” Marlene Freeman, MD, of Harvard Medical School, added that research has been reassuring, explaining that SSRIs are not linked to major birth defects or autism once maternal mental health is taken into account.

Both ACOG and PSI remind families that medication is often just one part of a mental health plan, but it can be a critical one. Parents looking for mental health support can call or text PSI’s free helpline at 1-800-944-4773 or visit Postpartum.net.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.