Navigating Anxiety During Pregnancy: A Guide to Understanding SSRIs
“I’m worried. I can’t sleep. It’s anxiety.” This message from Natalie arrived just minutes after I logged into our live chat service at MotherToBaby.org. Natalie, 14 weeks pregnant, was concerned about taking a selective serotonin reuptake inhibitor (SSRI) to manage her anxiety. As a Teratogen Information Specialist, I often address concerns about exposures during pregnancy and breastfeeding, and I was ready to assist her.
Natalie had recently visited her OB/GYN, where she was diagnosed with anxiety. Experiencing trouble with eating and sleeping, racing thoughts, and constant worry, her doctor recommended starting an SSRI to manage her symptoms. However, Natalie was hesitant, fearing potential withdrawal symptoms in her baby.
Such concerns are common. In the U.S., anxiety affects 6.8 million adults, with women being twice as likely to experience it. Approximately 6% of women develop anxiety during pregnancy. Non-medication approaches like meditation, exercise, or talk therapy can be effective for some, but Natalie had tried these without success.
I explained to Natalie the importance of treating her mood disorder, highlighting that untreated anxiety can lead to preterm birth, low birth weight, and bonding difficulties. It can also increase the risk of developing postpartum mood disorders.
Natalie’s OB/GYN suggested sertraline (Zoloft), an SSRI. While SSRIs are well-studied, they can cause neonatal adaptation syndrome, affecting 10-30% of babies. Symptoms may include jitteriness, irritability, and breathing difficulties, usually resolving within two weeks. Notably, there is no dose-response relationship, meaning higher doses don’t necessarily increase withdrawal risks.
Reassured, Natalie decided to start the medication to manage her anxiety for her and her baby’s well-being. By planning ahead, she felt equipped to handle potential withdrawal symptoms.
This case highlights the complexity of managing anxiety during pregnancy. It’s crucial for expectant mothers to have access to the latest information to make informed decisions. Natalie’s story is a reminder that with support and knowledge, mothers can navigate these challenges effectively.
