I was diagnosed with generalized anxiety disorder (GAD) and panic disorder when I was just fourteen years old. My symptoms came to a head when my conditions began impeding on my attendance at school. Nearly every morning, I found myself practically crippled by panic attacks that left me tired and weak for the remainder of the day.
Together, my primary care physician and psychologist decided medication might be the next best route for me. I began taking Lexapro, also known as its generic name Escitalopram, and I finally found relief from my regular panic attacks and insomnia-inducing anxiety.
In the more than ten years since my initial diagnosis, I have, under the guidance and direction of my doctors, tried different dosages, switched to Zoloft then back to Lexapro, and even weaned myself off medication for a time. No matter the changes, however, my mental health and quality of life always improved when I was taking anxiety medication and seeing a therapist.
When I started trying to get pregnant, I worried that my OB/GYN would advise me to stop taking my anxiety medication. To my surprise, however, each doctor I saw at my practice told me the same thing: “It’s safer for you and the baby to stay on it.”
I was shocked. I thought for sure there would be dangerous side effects for the fetus. It turns out, however, the side effects are rare. In order to ensure the proper and healthy growth of my baby, my team of doctors had me get extra ultrasounds to monitor the proper growth of my baby’s heart, which was one possible negative side effect of staying on my SSRI.
Mental health is so incredibly important while TTC or pregnant, and if you're prone to anxiety or depression, medication can even help prevent postpartum depression and anxiety from occurring.
Which anxiety medications are safe while trying to get pregnant?
Two of the most common types of antidepressants used for anxiety, especially during pregnancy, are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).
Once prescribed, both SSRIs and SNRIs need to be taken every day to be effective, and may take a few weeks before they begin improving your symptoms.
SSRIs are often considered safe and effective options for the treatment of anxiety during pregnancy and have low risks of birth defects. Some examples of SSRIs include:
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Citalopram (Celexa)
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Escitalopram (Lexapro)
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Fluoxetine (Prozac)
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Paroxetine (Paxil)
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Sertraline (Zoloft)
Some examples of SNRIs include:
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Duloxetine (Cymbalta)
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Venlafaxine (Effexor)
Benzodiazepines, on the other hand, such as alprazolam (Xanax) or diazepam (Valium), are generally not recommended during pregnancy due to an increased risk of birth defects, withdrawal symptoms in the newborn, and potential long-term effects on the baby's development.
Reasons to consider staying on your anxiety meds while TTC or pregnant
It’s natural to feel anxious or nervous before major life changes. You may even feel concerned or worried. Infertility, pregnancy, and having a child are some of the biggest life changes you can go through, so it's no surprise that anxiety symptoms can develop or worsen during this time.
According to the Anxiety and Depression Association of America, more than 50% of women experience increased anxiety or depression while pregnant. Women who experience depression and anxiety during their pregnancy are at a higher risk of postpartum depression, which is just one reason why treating your anxiety and depression during pregnancy is so crucial.
Furthermore, anxiety left untreated during pregnancy can increase the risk of low birth weight and/or preterm delivery. In other words, the benefits of taking anxiety medication before or during pregnancy may outweigh any potential risks, so it's important to talk through all of your options with your healthcare provider before making a decision that ultimately feels right to you.
Making a plan with your doctor
Before I tried to get pregnant, I discussed my anxiety medication plan with my therapist, my primary care physician, and my OB/GYN. I wanted to have a plan in place for both my pregnancy and post-pregnancy journey.
As someone prone to anxiety and depression, I was extremely nervous that I would experience postpartum depression. I stayed on my regularly-prescribed dosage of Lexapro throughout the duration of my pregnancy with the understanding that, if I felt I needed more help, we could increase it if need be.
Two weeks after having my son, I felt my old panic disorder tendencies taking hold of my thoughts. I was obsessively thinking of all the bad things, all the what-ifs. After speaking with my supportive team of health professionals around me, I started taking an increased dose of my anxiety medication. Within just a few weeks, I could feel myself escaping the fog of the GAD and panic.
Staying on anxiety medication during my pregnancy and afterward changed the entire experience for me — in the best possible way.
If you are planning to start a family, are actively TTC, or are pregnant, discuss these options and any concerns with your therapist, physician, and OB/GYN. Your medical team can work with you to develop or change your treatment plan. You may also consider a consultation with a psychiatrist, who specializes in treating pregnant and postpartum women!
There are so many resources for women and so many safe and effective anxiety medications to help women get through some of the toughest months and years of their lives. You are not alone.
Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.