Escitalopram Use During Pregnancy

Introduction to Escitalopram

The American College of Obstetricians and Gynecologists recommends that escitalopram should be continued during pregnancy at the lowest effective dose rather than discontinued, as the risks of untreated maternal depression outweigh the small fetal risks associated with SSRI exposure 1

Up to 25% of neonates exposed to escitalopram late in the third trimester may develop transient complications, including crying, irritability, tremors, poor feeding, hypertonia, tachypnea, sleep disturbance, and hypoglycemia, according to the American Academy of Pediatrics 1
Multiple reviews have not identified adverse neurodevelopmental outcomes among infants born to women treated with SSRIs during pregnancy, as stated by the National Institute of Mental Health 1

The risk associated with treatment discontinuation, such as higher frequency of relapse and postpartum depression, appears to outweigh the fetal and neonatal risks of maternal treatment, according to the American Psychiatric Association 1

Continue escitalopram at the lowest effective dose throughout pregnancy rather than discontinuing or switching medications, as recommended by the American College of Obstetricians and Gynecologists 1

Do not discontinue SSRIs abruptly due to concerns about neonatal effects, as maternal relapse poses greater risks, according to the American Academy of Family Physicians 1
Do not switch to alternative antidepressants without clear indication, as this introduces uncertainty about the safety profile of the new medication, as stated by the National Institute of Mental Health 1

The history of prior cesarean section does not alter the safety profile of escitalopram, according to the American College of Obstetricians and Gynecologists 2
Multiparity does not increase risks associated with escitalopram use, as stated by the European Society of Cardiology 4