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Sertraline During Pregnancy - Safe or Not

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Sertraline is an antidepressant that is considered to be safe during pregnancy. This article explains the side effects and other queries regarding Sertraline.

Written by

Dr. Asha. C

Medically reviewed by

Dr. Richa Agarwal

Published At November 3, 2022
Reviewed AtFebruary 20, 2023

What Is Sertraline?

Sertraline belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It treats depression, post-traumatic stress disorder, panic attacks, social anxiety disorder, and premenstrual dysphoric disorder. This drug will improve mood, appetite, sleep, and energy level and may help restore interest in daily living.

Additionally, it may decrease fear, unwanted thoughts, anxiety, and the number of panic attacks. It works by restoring the balance of a certain natural substance called serotonin in the brain.

There are different types of antidepressants available. Selective serotonin reuptake inhibitors (SSRIs) are one class of antidepressants. They are effective and most commonly prescribed antidepressants during pregnancy.

Some examples are,

  • Sertraline.

  • Citalopram (Celexa).

  • Fluoxetine (Prozac).

  • Paroxetine (Paxil).

  • Escitalopram (Celexa).

Why Is Sertraline Used During Pregnancy?

Many women fight against depression and require antidepressants to manage their symptoms. These days, more and more women are taking antidepressants during pregnancy to keep their symptoms in check. Their safety in taking antidepressants during pregnancy is questionable. But researchers say that most antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are generally considered safe.

Even though birth defects and other problems are possible, the risk is shallow. Psychiatric and gynecologist experts say that if a patient with mild depression has no symptoms for at least six months, they can stop using antidepressants under a physician's supervision or during pregnancy. Psychotherapy and lifestyle measures, maybe all that is required to manage depression.

The pregnancy can be managed without antidepressants if the following factors are practiced:

  • Practice yoga and meditation.

  • Minimize stress.

  • Talking with a therapist regularly.

  • Spend time outside.

  • Exercise more.

In some cases, doctors recommend that both the mother and the baby should stay on antidepressants while pregnant if any of the following has occurred:

  • A history of severe or recurrent depression.

  • A history of other mental illnesses, like bipolar disorder.

  • Had a suicidal tendency.

Is Taking Sertraline During Pregnancy Safe?

The family of SSRIs, especially Sertraline, is one of the safest drugs for antidepressants during pregnancy. However, for some moms-to-be, deciding to continue an SSRI during pregnancy ultimately comes down to weighing the risks versus the benefits.

The side effects of SSRIs during pregnancy are generally minimal. The baby may have side effects if the drug is taken during the last trimester. These include jitters, poor feeding, vomiting, hyperactive reflexes, low blood sugar, irritability, respiratory distress, abnormal muscle tone, and seizures during the first month of life.

The main problem with Sertraline is that it tends to be under-dosed. The normal starting dose is 50 mg, but many individuals will require 150 mg to 200 mg to effectively manage their symptoms. When Sertraline treatment has started, women with low doses find it hard to manage their symptoms. There are questions arising about the risk of miscarriage and whether using SSRIs makes it harder to get pregnant. However, any prescription medicine comes with risks, and currently, no studies address the issue of infertility.

What Are the Risks Associated With Anti-Depression Drugs?

SSRIs drugs are considered safe during pregnancy. Many studies suggest that there is little risk with taking SSRIs during pregnancy, which could still affect the baby. About 30 percent of babies born to mothers who took an SSRI during pregnancy develop adaptation syndrome (a behavioral symptom similar to temporary withdrawal symptoms that go away).

The risks for the baby include the following:

  • The newborn has persistent pulmonary hypertension (high blood pressure between the heart and lungs).

  • Birth defects include craniosynostosis (affecting the skull), anencephaly (affecting the spinal cord and brain), omphalocele (affecting the abdominal organs), and limb malformation.

  • Heart defects.

  • Preterm birth.

  • Miscarriage.

  • Low birth weight.

  • Low Apgar scores (a quick test to check the status of the newborn infant immediately after birth).

In addition, withdrawal symptoms may be experienced by babies exposed to antidepressants in the womb, such as:

  • Jitteriness.

  • Irritability.

  • Low blood sugar.

  • Breathing difficulties.

  • Trouble feeding.

  • Poor tone.

Some babies require a short stay in the neonatal intensive care unit. These symptoms do not cause long-term harm to the baby.

Is Sertraline Safe During Breastfeeding?

While breastfeeding, only a small quantity of Sertraline passes into the breast milk. Preterm babies or babies younger than a month have a less mature stomach and intestines than older babies. This may allow more drugs to enter their bloodstream. No problems for breastfed babies were reported on using Sertraline while breastfeeding. A lower chance of withdrawal after birth is seen in breastfed babies who were exposed to Sertraline in the third trimester of pregnancy. Be sure to talk to the healthcare provider about all of the breastfeeding queries.

Is It Necessary to Stop Taking Sertraline During Pregnancy?

If somebody is planning to quit Sertraline during pregnancy, it is important not to stop taking it suddenly. If they are under a high dose of Sertraline and stop it completely, they may experience adverse side effects and withdrawal syndrome from the drug. That is why not stopping suddenly is recommended without talking to the health care provider.

It is often safest not to take any antidepressant drugs during pregnancy; it may be a negative effect on both mother and baby to discontinue antidepressant medications like Sertraline during pregnancy because it can cause worsening mood and anxiety symptoms. So, it is important to discuss this issue with the healthcare team before making any decision regarding medications.

What Are the Effects of Taking Sertraline Throughout Pregnancy?

Some drugs taken during pregnancy can cause withdrawal symptoms in a newborn after delivery. Taking Sertraline during the delivery time can cause irritability, tremors (shivering), constant crying, problems with eating and controlling body temperature, jitteriness, different sleep patterns, and some problems with breathing in babies. However, in most cases, the baby experiences mild symptoms which fade off within a couple of weeks without any treatment. In some cases, babies may need to stay in the NICU until they are normal.


Selective serotonin reuptake inhibitors (SSRIs) drugs like Sertraline are commonly consumed during pregnancy. But it is crucial to know the positive and negative sides of using a drug during pregnancy. Even though there are certain risks in taking antidepressants during pregnancy, untreated depression can cause more harm for both mother and baby. So, consulting a physician for an opinion is advisable.

Frequently Asked Questions


Can Birth Defects Be Caused by Sertraline?

Sertraline is considered safe during pregnancy. Some studies reveal that it might affect the baby’s heart development. However, the risks associated are minimal.


Which Antidepressant Is Considered Safe During Pregnancy?

Some Selective Serotonin Reuptake Inhibitors (SSRIs) like Citalopram and Sertraline are considered to be safe antidepressants in pregnancy. SSRIs are considered the best options for antidepressants during pregnancy as they pose the lowest risk for the baby. These drugs do not cause a birth defect and are safe to be used in pregnancy.


What Is Sertraline’s Pregnancy Category?

The pregnancy category for Sertraline is C. It shows that the drug is safe to be taken in pregnancy. These drugs are not known to cause any birth defects. However, their risks cannot be ruled out completely.


Should Antidepressants Be Stopped in Pregnancy?

It is a misconception that taking antidepressants during pregnancy can be harmful to the baby. Drugs like Sertraline are considered pregnancy-safe. However, it is always recommended to take any medicine after consulting a doctor.


Can Antidepressants Cause Harm to Fetus?

Most studies show that SSRIs are pregnancy-safe. However, drugs like Paroxetine have a risk of affecting the baby’s heart development. Medical advice must be sought on whether to take the drug during pregnancy.


Is Sertraline a High-Risk Drug?

Sertraline can have a high suicidal tendency when started or when the dosage is altered. It can also cause bleeding due to its anti-platelet effect. Sertraline prevents platelet aggregation, causing its anti-platelet effect.


Does Sertraline Cross the Placenta?

Sertraline passes the placenta and reaches fetal circulation. However, they are considered safe during pregnancy. However, probable risks can be associated, though minor.


How Can Anxiety Be Treated During Pregnancy?

Therapy should be considered for depression. The therapist may suggest medicines and advise to start new activities that may help with the depression. Self-care should be given importance. Joint communities can help cope with depression. 


When Is the Ideal Time to Consume Sertraline?

Sertraline can be used at any time of the day, though it is suggested to take it at night if it causes sedation or fatigue. It is advised to be consumed once a day. It can be taken along with or without food. 


How to Stop Taking Sertraline?

Drugs like Sertraline should be tapered in dosage to prevent any adverse effects. Medical advice should be sought on how to taper the drug. The dosage should be changed only with a doctor’s advice.


Are Sertraline and Hcg Levels Compatible?

Studies show that Sertraline can affect Hcg levels. They can elevate the HCG levels. These rises are detectable by pregnancy kits.


How Long Does the Withdrawal From Sertraline Last?

The withdrawal symptoms can be seen within five days after the drug is stopped and may last one to two weeks. It can also be seen as the doses are tapered.


Is SertralineSedative?

Sertraline is usually not sedative but can help to sleep calmly, as it reduces anxiety. However, if it makes one feel sleepy, it is recommended to take it at night. The drug should be used once a day.


Does Sertraline Show Any Effect on the Progesterone Levels?

Sertraline is not found to have any effect on progesterone. However, it increases the serotonin levels. This elevates mood and reduces anxiety. They belong to a group of drugs called SSRIs.
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Dr. Richa Agarwal
Dr. Richa Agarwal

Obstetrics and Gynecology


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