Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 10/17/2022
Depression, its symptoms and even the medication used to treat it can get in the way of life. If you’re taking a medication like Paxil® to care for your mental health, you might wonder whether it’s safe to continue using it while pregnant. Do Paxil and pregnancy go safely together?
It’s an understandable worry to have when a medication you take every day could potentially cause harm to your unborn baby, but there’s also the question of your mental health to consider.
In many cases, these risks have to be weighed carefully, but when it comes to Paxil (or its generic form, paroxetine), there are some substantial dangers that may make the decision a lot easier to make.
Your need for Paxil isn’t something we’re trying to understate — antidepressants are a crucial part of many people’s lives, and for millions worldwide they’re an absolute necessity for quality of life and function at work and at home.
But some risks make finding an alternative absolutely necessary. Let’s look at why the risks of Paxil meet those criteria.
Let’s get straight to the point: if you’re wondering whether you can keep taking Paxil while pregnant, the answer is that you shouldn’t unless a healthcare provider believes it’s worth the associated risks.
Paxil is a selective-serotonin reuptake inhibitor, or SSRI: an antidepressant medication that works to affect your brain chemistry to help better regulate your mood.
It’s typically used in the treatment of mental health conditions like post-traumatic stress disorder, anxiety disorders like panic disorder, obsessive-compulsive disorder and the symptoms of depression.
SSRIs are known to be relatively safe and generally have mild side effects. The side effects of paroxetine aren’t very different, they aren’t addictive and most people see benefits from taking them.
But things change when you’re pregnant. There is a seriously increased risk to a fetus when you take some of these medications during pregnancy — and Paxil is no exception.
Paxil is what is known as a Category D pregnancy medication, which carries with it specific warnings from the Food and Drug Administration (FDA).
Pregnancy risk categories range from A to X. Category A medications are generally considered safe with no demonstrated risk to fetuses after studies have explored human tests.
As you continue down the letter scale, the risk increases.
Category B shows no risk, but these medications have only been tested on animals. And Category C shows increased risks in animals (but haven’t been thoroughly tested in humans). This is usually where medical professionals tend to start hesitating with prescriptions.
At Category D, studies of pregnant women have demonstrated risk to the fetus. Those are human tests, the risks are confirmed to exist and in most cases, a healthcare provider will be hesitant to prescribe them unless they are absolutely necessary.
Paxil or paroxetine is known to cause heart defects in newborns, and taking it while pregnant creates a substantially increased risk of congenital malformations of the heart.
A few studies have looked at these potential pregnancy outcomes of paroxetine, and many found a risk factor associated with first-trimester use of paroxetine.
Evidence suggests congenital malformations — and, specifically, cardiac malformations and future heart issue risks — are greater in fetuses exposed to paroxetine in the first trimester.
There are also potential risks of pulmonary hypertension in newborns who are exposed to Paxil in utero during the third trimester.
In some rare circumstances, neonatal complications have arisen from paroxetine use in pregnant women. Complications can result in prolonged hospitalizations, tube feeding and respiratory support. In other words, very serious stuff.
Right there, you might have your mind made up about quitting Paxil. And that makes sense.
But the question of whether you should or shouldn’t isn’t quite as simple as it feels because of the dangers of untreated depression.
The reality is that your own mental health and stability can have significant implications for the health of your infant, too.
The risk of heart defects and risk for birth defects are definitely two of the factors that you should consider, but if your mental health is dangerously unreliable without medication, your healthcare provider might still potentially advise you to continue taking Paxil.
In most cases, however, that’s not going to be the case — the risks are just too high. Your healthcare provider will likely help you find another way to treat your medication during this time, up to and including changing your medication.
They may also recommend things like therapy or lifestyle changes (like your diet, exercise, etc.).
Therapy has been proven effective in treating major depression, especially cognitive behavioral therapy, which teaches someone with a depressive disorder how to control and overcome negative patterns of thought with practice.
Lifestyle changes in diet, sleep and exercise can also benefit your mental health.
And, if medication is a necessity, other medications may provide the benefits you need without the significant risks associated with Paxil.
We can’t really make those recommendations here, because your unique circumstances necessitate a tailored treatment plan.
The only recommendation we’ll make is this: talk to your healthcare provider.
Pregnant? Want to be pregnant? On Paxil? Considering Paxil? You have a lot of decisions to make, and maybe not a lot of time to make them. And if you’ve got maternal depression, things can get complicated fast.
So far, you’re doing the right thing: educating yourself, learning about the risks and, we’re guessing, realizing that Paxil is probably too dangerous to stay on while you’re on your pregnancy journey.
Knowing the risks of adverse pregnancy outcomes as a result of SSRIs during pregnancy can cause feelings of guilt to someone who needs them, and it can be overwhelming to figure out what to do next. Luckily there’s one clear and obvious right answer: speak to a healthcare provider.
With a healthcare professional, your questions can get answered, your fears can be addressed, and you can get advice from someone who understands mental health medication and pregnancy risks that can help you make the best decisions going forward.
If you’re not sure where to find that help, hers offers online therapy and other mental health resources for you to check out. We can connect you with a mental health professional quickly and conveniently on our platform to get the info you need.
Whether you work with us or another provider, take that first step and get answers today. Motherhood is supposed to be a great time in your life — don’t let mental health worries or medication risks take that away from you.