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Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
When you’re expecting, you do everything you possibly can to take care of the little person growing inside you. Often, that means altering what you eat and drink to ensure that everything going into your body is safe for your precious cargo.
Cutting out things like deli meat or stopping your gallon of coffee a day habit? Not that hard. But cutting out the medications you take that help keep your mental health in tip-top shape can be much harder. So, after discovering you are pregnant, you may wonder if you can continue to take antidepressants, specifically Zoloft.
It’s worth noting that you are likely not alone in your concern. It’s estimated that half a million pregnant women in the United States either have a psychiatric condition or will develop one while pregnant. Which means many pregnant people face the question of whether or not they can take Zoloft while expecting.
While it’s always important to discuss this kind of thing with your healthcare provider, we have some useful information that can help to inform your decision.
It is considered to be a safe and effective prescription medication to help with symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), social anxiety disorder and panic disorder or panic attacks.
But what if you’re pregnant? To be honest, the research is a bit mixed.
One study done in 2015 in Canada looked at 18,493 pregnant women who took antidepressants — of these women, 366 took sertraline. The study concluded that sertraline use during the first trimester of pregnancy (weeks one through 12) was associated with an increased risk of atrial/ventricular defects and craniosynostosis — fancy terms for issues with the baby’s heart or the bones in their skull.
However, another report released in 2015 reviewed many of the studies that have been done on SSRIs and birth defects. That research concluded that it couldn’t confirm an association between taking sertraline and birth defects reported in previous studies.
More good news — according to a small study done in 2021, sertraline is one of the most commonly used antidepressants during pregnancy. It looked at nine mothers (we said small!) and found that there was very little placental passage of sertraline to the baby. Translation: Not much of the medication made its way to the baby in utero. It’s also important to note that this study was not conducted in the United States.
So, what does this all mean? For the most part, sertraline is considered relatively safe to take during pregnancy — but you should always speak to a healthcare provider before making any final decision.
But just because something is considered generally safe doesn’t mean it’s totally risk-free — and that is true of taking Zoloft while pregnant.
We’ve already gone over the study above that found a slight risk of babies being born with heart or skull issues.
It’s also believed that around 30 percent of babies born to moms who took a SSRI while pregnant may experience something called neonatal adaptation syndrome. This can lead to the baby being jittery, irritable or having respiratory distress.
A systematic review and meta-analysis of research also found there could be a very slight increase in the risk that a baby could be born with pulmonary hypertension if the mom took a SSRI medication while pregnant.
The best thing you can do is talk to a healthcare provider to review the potential risks of taking Zoloft while pregnant and determine what is right for you and your baby.
If you do decide to take Zoloft while pregnant, chances are your dosage will stay the same as it was before you were pregnant.
When it comes to treating major depressive disorder or OCD, the dosage range tends to be between a low dose of 50mg a day and maximum dose of 200mg a day.
For panic disorder, PTSD or social anxiety disorder, the recommended dosage of Zoloft tends to be between 25mg a day and 200mg a day.
Similar to dosage, the side effects associated with taking Zoloft don’t really change when you're pregnant.
For the most part, they are mild and usually go away after you’ve been taking the medication for a few weeks.
The most common side effects are:
Diarrhea or constipation
Nausea or vomiting
Sexual side effects
Sometimes, you may experience more serious adverse effects. If you notice any of the below, contact a medical professional as soon as you can:
Muscle stiffness or twitching
There is also a higher risk of serotonin syndrome if you take Zoloft or sertraline during pregnancy with another serotonergic medication.
More research needs to be done on how Zoloft may or may not pass through breast milk to a baby.
The little research that has been completed suggests that a small amount of medication may pass through breast milk. In certain studies, low levels of Zoloft were found in some babies who breastfed from moms taking the medication, while other babies in the same circumstance showed no traces. Because of this, Zoloft is actually thought to be a “first-line” antidepressant medication for breastfeeding women.
However, if you have a premature birth, you may be advised that Zoloft could pass to your baby through breastfeeding. This is because preterm infants sometimes have impaired metabolic activity and in rare cases can experience withdrawal symptoms from exposure to sertraline in breast milk.
When you become pregnant, mental health issues don’t just disappear. You can experience depression, as well as anxiety disorders or any other psychiatric illness, during pregnancy.
And while you may change a lot of the things you consume while pregnant, you don’t always have to stop taking medications during pregnancy. In fact, in some cases untreated depression or anxiety can be more harmful to your baby than taking an antidepressant.
Zoloft is considered to be one of the safer antidepressants to take when you are expecting. The risk to your baby is generally thought to be low — though in rare instances there may be slight risk, depending on what trimester of pregnancy you are in.
If you’re expecting, it is best to speak with a healthcare professional about continuing to take Zoloft or any other psychiatric medication. They will be able to talk to you about whether you should continue to take Zoloft as a treatment during pregnancy and whether there could be any adverse effects.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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