Glossary

Term · Postpartum: Mind

SSRI

Also: SSRIs, SSRI medicine

Short for selective serotonin reuptake inhibitor, the most common class of antidepressant medicine. Used for depression and anxiety in and after pregnancy, with its own risks and benefits.

In plain words

An SSRI is a class of antidepressant medicine. It is among the most commonly used treatments for depression and anxiety, both in pregnancy and after birth. Clinicians may prescribe one when symptoms are moderate to severe, or when talking therapy alone is not enough. Mothers who take an SSRI are often asked about it at prenatal and postpartum visits, and breastfeeding questions come up often. Large studies of SSRI use in pregnancy have looked at heart defects, lung pressure problems in newborns, and other outcomes. Many findings show small or no added risk compared with untreated depression, and a few associations are still discussed in the literature. Whether an SSRI is right is a decision made with a prescriber. This entry does not recommend any medicine or dose.

The deeper version

SSRIs inhibit the presynaptic serotonin transporter, raising synaptic serotonin. They are the standard first-line pharmacologic class for moderate to severe and anxiety in ACOG Clinical Practice Guideline No. 5 (2023) and NICE guideline CG192 (2014). Huybrechts and colleagues (New England Journal of Medicine, 2014; about 950,000 pregnancies) found no significant increase in cardiac malformations with first-trimester exposure after adjusting for depression and confounders. Huybrechts and colleagues (JAMA, 2015) found that the link between late-pregnancy exposure and persistent pulmonary hypertension of the newborn was small after adjustment, with a low absolute risk. Interpretation depends on absolute risk and on the risk of untreated maternal illness. Infant exposure through breast milk is generally low and is summarized drug by drug in .

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Sources

  • Huybrechts KF et al. — Antidepressant use in pregnancy and the risk of cardiac defects. New England Journal of Medicine 2014
  • American College of Obstetricians and Gynecologists — Clinical Practice Guideline No. 5: Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum, 2023

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