Which antidepressants are OK during pregnancy?

In general, these antidepressants are options during pregnancy:

• Certain selective serotonin reuptake inhibitors (SSRIs). SSRIs usually are an option during pregnancy. These include citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro) and fluoxetine (Prozac). Risks include high blood pressure for the pregnant person and premature birth. These risks are small. Your health care team watches for them during your prenatal care.

  Most studies show that SSRIs aren't linked with birth defects. But an SSRI called paroxetine (Paxil) might slightly raise the risk of heart defects in babies when used during the first trimester. For that reason, most health care professionals do not recommend paroxetine during pregnancy.

• Serotonin and norepinephrine reuptake inhibitors (SNRIs). Some SNRIs can be treatment options during pregnancy. These include duloxetine (Cymbals) and venlafaxine (Effexor XR). These medicines can lead to high blood pressure in pregnancy. Your care team watches your blood pressure closely during prenatal visits.
• Bupropion (Forfivo XL, Wellbutrin SR). Most often, bupropion isn't a first treatment for depression during pregnancy. It might be an option for pregnant people who haven't gotten enough relief from other medicines. Research suggests that taking bupropion during pregnancy might be linked with a small risk of miscarriage or heart defects.
• Tricyclic antidepressants. This class of medicines includes nortriptyline (Pamelor) and amitriptyline. Most often, tricyclic antidepressants aren't a first or second treatment for depression during pregnancy. But they might be an option for pregnant people if other medicines haven't been effective. The tricyclic antidepressant clomipramine (Anafranil) might be linked with birth defects in babies, including heart problems.