Escitalopram in Pregnancy — Is It Safe?
Last reviewed: · Source: US FDA drug label database
Escitalopram may be continued in pregnancy when needed — data are broadly reassuring and stopping suddenly is usually the greater risk.
Is it safe to take Escitalopram with Pregnancy?
Escitalopram is the active component of citalopram and shares its pregnancy profile: no consistent evidence of major birth defects, expected temporary neonatal adaptation symptoms with third-trimester use, and a small increase in PPHN risk with late exposure. The decision to continue, adjust, or switch belongs with you and your prescriber — untreated maternal depression and anxiety carry substantial risks of their own.
How do Escitalopram and Pregnancy interact?
Escitalopram is the S-enantiomer of citalopram with the same SERT inhibition mechanism and placental transfer. Neonatal adaptation syndrome and small PPHN risk mirror the SSRI class. Its cleaner pharmacology means fewer drug interactions during pregnancy care.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA escitalopram label — pregnancy section; NICE CG192.
Who should be careful?
Women considering stopping abruptly (relapse risk), those with cardiac rhythm concerns, and anyone whose anxiety or depression is worsening in pregnancy — escalate early to your perinatal team.
What if I've already taken Escitalopram and Pregnancy?
Continue and arrange a routine (not emergency) review with your GP or perinatal mental health service. Flag SSRI use in your birth plan so midwives observe the baby for adaptation symptoms.
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Frequently Asked Questions
Can I stay on escitalopram while pregnant?
Often yes — the data are broadly reassuring and relapse from stopping is usually the bigger danger. Plan it with your prescriber.
Does escitalopram cause birth defects?
Large studies have not shown a consistent increase in major malformations. Small unreplicated signals exist, as with most SSRIs.
What happens to the baby if I take it up to delivery?
Temporary adaptation symptoms (jitteriness, feeding issues) are common and self-limiting. Your midwife team will observe the baby — make sure they know.
Is escitalopram or sertraline better in pregnancy?
Sertraline has the largest reassuring dataset and lowest milk transfer, so it's often first choice — but stability on your current medication counts for a lot. Individual decision.