Lexapro During Pregnancy: Is it Safe?


Lexapro is the brand name for escitalopram, an anti-depression medication approved by the FDA in 2002. Escitalopram is a prescription medication which is available only under the brand name Lexapro. This medication belongs to a class of drugs known as selective serotonin reuptake inhibitors or SSRIs. Like other SSRIs, Lexapro is believed to work by increasing the brain supply of the feel-good hormone serotonin. This corrects an existing chemical imbalance improving mood and creating a feeling of well-being. Lexapro is used to treat both generalized anxiety disorder and major depressive disorder. Lexapro is available in 5, 10 and 20-milligram tablets. While it can be used to treat depression but taking this drug during pregnancy can lead to serious Lexapro side effects to both mother and the child.

Depression and lexapro

  • Depression is a major public health problem in a leading predictor functional disability in mortality. The annual economic consequences of depression have been estimated at 83 billion dollars in the united states, this is according to the general hospital psychiatry. Depression affects 3 to 5 per cent of us males and 8 to 10 per cent of adult females in the united states.
  • As previously stated as escitalopram also known as lexapro is commonly used in the treatment of depression.
  • Lexapro is a member of the class of drugs known as selective serotonin reuptake inhibitors more commonly abbreviated as ssris.
  • Some other drugs in this class include paxil, prozac, celexa and zoloft. These drugs work to block the reuptake of serotonin into brain cells. This is important because serotonin is the primary neurotransmitter involved in mood.
  • Commonly depressed patients have a lower level of free serotonin so increasing levels of serotonin with these drugs can help improve symptoms and alleviate sides of depression. The serotonin imbalance can be caused by a number of factors including genetic predisposition, environmental factors such as the death of a loved one, loss of a job and other life-altering events.
  • No one single component is linked primarily to depression but many factors are involved in this manifestation of symptoms. Fortunately with medications such as lexapro in conjunction with psychotherapy depression can be adequately treated.

Lexapro Side Effects and Risks During Pregnancy

lexapro side effects

It is important to be aware of some common lexapro side effects. Most of these lexapro side effects are self-limiting and should resolve within a few weeks of use of the medication. These include fatigue, dizziness, nausea, headache, diarrhoea, dry mouth, change in sexual ability or desire and inability to sleep. Often times the pregnant woman only adjusted the antidepressant very early in the first trimester but the damage to the developing fetus was done before she ever realized she was pregnant.

  • Times the expectant mother took the antidepressant throughout her pregnancy because she relied on the opinions of doctors who themselves were misled by big pharmaceutical companies to believe the antidepressant was safer than it actually was.
  • According to researchers babies exposed to antidepressant drugs like lexapro during the first trimester of pregnancy are at a verge of being affected by side effects of lexapro that include sixty per cent increased the risk of developing a heart defect compared to children born to mothers who did not use lexapro or another antidepressant drug.
  • During your pregnancy, if you took lexapro or another antidepressant your child might be born with a congenital birth defect.

Lexapro side effects

If the pregnant women take lexapro, then her child might suffer from some serious side effects of lexapro that include heart defects and congenital birth defects.

Cardiac (heart) birth defects

  • Atrial septal defect
  • Coarctation of the aorta
  • Hypoplastic left heart syndrome
  • Double aortic arch
  • Double inlet left ventricle
  • Pulmonary atresia
  • Tetralogy of fallot
  • Transposition of the great vessels
  • Tricuspid atresia
  • Double outlet right ventricle
  • Truncus arteriosus
  • Ventricular septal defect

Other lexapro side effects that include congenital birth defects

  • Anencephaly
  • Cleft palate
  • Cleft lip
  • Clubbed foot
  • Cranial defects
  • Genital malformations
  • Heart defects
  • Hydrocephalus
  • Hypoplasia
  • Limb malformations
  • Lung defects
  • Neural tube defects
  • Omphalocele
  • Spina bifida

Clinical research on women with and without lexapro during pregnancy

  • There’s a reason why so few drugs are recommended during pregnancy and it’s not because we have great evidence they cause harm, no, it’s because with the exception of certain drugs that were specifically designed for pregnant women.
  • Pregnant women are almost always excluded from clinical trials of new agents so if we’re looking for signals of harm we need to use observational data and that means adjustment.
  • We have a great example of this in an article appearing in the journal of the american medical association harvard where the researchers used the very large extract medicaid database which includes about four million pregnant women to evaluate the association between antidepressant use and persistent pulmonary hypertension of the newborn.
  • Pphn is a very rare but highly morbid condition whereby the fetal circulation persists after birth which leads to hypoxia respiratory failure and in about 10% of cases death.
  • Now of the four million women studied 130,000 were taking antidepressants towards the end of pregnancy and the risk of pphn in that group was about 30 per 10,000 live births compare that to 2 per 10,000 live births in the women not taking antidepressants.
  • Women weren’t randomized to take antidepressants, they took them for a reason. Depression being the most obvious one but other factors would play a role as well such as socioeconomic status, personal beliefs.
  • Lexapro side effects increase the risk of premature birth and premature birth, increases the risk of pphn.

Things to remember

Lexapro is normally titrated up to a dose of 10 or 20 milligrams every day. It is highly recommended to not take lexapro because of well-known lexapro side effects to the mother and child, but if you are still taking them then remember the following things.

  • while taking lexapro is important to take each dose at the same time.
  • this medication should not be discontinued unless under the advisement of your prescriber and should be titrated down slowly to avoid serious side effects of lexapro.
  • lexapro should be taken once a day with water preferably at the same time each day. Once you have been taking this medication regularly do not suddenly stop as serious withdrawal symptoms can occur.
  • Symptoms of abrupt discontinuation include bad mood, irritability, agitation, anxiety, insomnia and headache.
  • It is also important to know that if you miss a dose of Lexapro. Take the missed dose as soon as possible. If it is almost time for the next dose skip the missed dose in return to your regular schedule.
  • Do not develop on this medication or take extra doses.
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