Citalopram in Pregnancy — Is It Safe?
Last reviewed: · Source: US FDA drug label database
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Citalopram can be continued in pregnancy when needed — the risks of stopping antidepressants suddenly usually outweigh the small medication risks.
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Is it safe to take Citalopram with Pregnancy?
Citalopram is one of the better-studied SSRIs in pregnancy. Large studies show no consistent pattern of major birth defects, though small signals have appeared and not replicated. Third-trimester use commonly causes temporary neonatal adaptation syndrome, and SSRIs after 20 weeks carry a small increase in persistent pulmonary hypertension of the newborn. Untreated depression carries its own significant risks to mother and baby — never stop suddenly; decide the plan with your GP or perinatal mental health team.
How do Citalopram and Pregnancy interact?
Citalopram crosses the placenta and inhibits fetal SERT. Neonatal adaptation syndrome (jitteriness, feeding difficulty, mild respiratory distress) affects roughly a quarter to a third of exposed newborns and self-resolves within days. PPHN absolute risk rises from ~1-2 to ~2-3 per 1000 with late-pregnancy SSRI exposure.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA citalopram label — pregnancy section; NICE CG192.
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Women on doses above 20mg (QT considerations), those with cardiac conditions, and anyone considering stopping — relapse of depression in pregnancy is common and harmful.
What if I've already taken Citalopram and Pregnancy?
Do not stop abruptly. Book a GP or midwife review to weigh continuing, dose-adjusting, or switching (sertraline is often preferred). Tell your delivery team about SSRI use so the baby is observed appropriately.
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Frequently Asked Questions
Is citalopram safe during pregnancy?
It can be used when treatment is needed. Evidence on birth defects is broadly reassuring, and untreated depression carries real risks. Decide with your doctor — don't stop suddenly.
Will my baby have withdrawal from citalopram?
About a quarter to a third of babies show temporary adaptation symptoms — jitteriness, feeding difficulties — that resolve within days without long-term harm.
Should I switch to sertraline in pregnancy?
Sertraline has the most reassuring pregnancy data and is often preferred, but switching mid-pregnancy has its own risks. Discuss individually with your prescriber.
Can I breastfeed on citalopram?
Citalopram passes into milk in small amounts; sertraline transfers least of the SSRIs. Many women breastfeed on SSRIs — plan it with your midwife.