Medically reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Last updated 9/11/2022
Becoming pregnant can be both an exciting and worrying time for a mother-to-be, and that worry can grow exponentially when you have to start worrying about the adverse effects of medications and medical conditions like mood disorders. Whether you’re currently juggling pregnancy and mental health, or soon plan to, you may be wondering about the dangers of taking antidepressants while pregnant, and whether Lexapro® and pregnancy are an alright mix.
Choices like this are hard. Lexapro and its generic version, escitalopram, are very important medications for how some of us function day to day. Without being able to take care of yourself, you won’t be much use to the little one during or after pregnancy.
And yet, there are still risks to weigh.
Weighing these risks isn’t a one-size-fits-all sort of decision, and depending on your needs, weight, situation and other factors, the Lexapro and pregnancy question might get a very different answer when you talk to a healthcare provider about it.
Let’s break down why, one question at a time.
Let’s deal with your most pressing question first: can I take Lexapro while I’m pregnant?
The short answer is that it’s not an immediate danger to your future offspring to be on this medication, from what we know. Unfortunately, what we know is comparably little.
Escitalopram is what’s called a category C pregnancy medication — these medications could pose risks to a fetus, but there is not enough evidence to say with certainty one way or another.
The value they bring to the mother may outweigh the risk danger.
Escitalopram can indeed be transferred into amniotic fluid via the placenta, but what the ultimate danger to the fetus is, is unclear and also dosage dependent.
According to The National Library of Medicine, you should tell your healthcare provider if you’re pregnant (especially if you’re in your final trimester), are planning to become pregnant or are currently breastfeeding.
So, what actually is the risk of taking Lexapro or any other selective serotonin reuptake inhibitor while pregnant? And how does that risk stack against the risks of untreated depression during pregnancy? The best place to begin unpacking that is with the risk factors associated with the use of Lexapro generally.
The maximum safe daily dosage of Lexapro is generally considered to be around 20mg (taken orally) for most adults.
Overdosing on escitalopram generally could cause more severe versions of known side effects, as well as heart issues or blood pressure problems. It also increases your chances of experiencing serotonin syndrome, which can be life-threatening.
The story for a fetus, however, is a little different. Antidepressants have been linked to an increased risk of fetal malformations and birth defects, preterm birth or premature birth and even spontaneous abortion. Certain medications like TCAs or tricyclic antidepressants, as well as Bupropion®, may contribute to increased risks for birth defects, congenital malformations, or problems like low birth weight.
Escitalopram in particular carries a Category C label, which means that there is inadequate information from studies to show the extent to which escitalopram can affect a fetus.
So, should you stop using antidepressant medications (and specifically Lexapro) during pregnancy? Not necessarily — that is a conversation pregnant women need to have with a health care provider.
But what the actual risk is — and how that risks stacks against the dangers of not caring for your own mental health — is a more nuanced discussion.
Your own mental health, arguably, might deserve first priority medical care during pregnancy.
Unwelcome withdrawal symptoms can result from sudden cessation of treatment for depression, and while those harmful effects may be tolerable, a health care professional’s support can help mitigate the serious and long-term risks associated with withdrawal.
Talk to a healthcare professional (both for your mental health and pregnancy) and let them help you choose the right course of action for your individual needs, whether it’s cutting back to the lowest dose or going off of the medication entirely.
Being an expecting mom or caring for a newborn baby is hard. Dealing with mood disorders like depressive disorder or generalized anxiety disorder is hard. Doing both at the same time with major depression, perinatal depression or postpartum depression? That’s an incredible struggle.
If you’re concerned about the potential risks of Lexapro and other drugs during pregnancy for you and your pregnancy, it’s likely time to start a conversation with a medical professional or mental health professional. They’ll be able to help you understand your risks and help you determine if changes to your existing or planned antidepressant medication treatment are necessary or advisable.
This person may also suggest other tools for the care of mental illness before, during, and after pregnancy. This might include other treatment options like therapy.
Ready to talk to someone? Our online psychiatry resources are here to clarify questions and get you the answers you need — regardless of where you are in your pregnancy plans. Consider talking to a medical professional today.