*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
If you are taking Zoloft during pregnancy, you may have many questions about the potential risks. Zoloft, a commonly prescribed medication for depression and anxiety, is in the selective serotonin reuptake inhibitor (SSRI) drug class.1
It is important to discuss whether Zoloft is the best fit for you while pregnant with a prescriber. If you want to discuss your current prescription with a provider or are considering a prescription for Zoloft, online psychiatry platforms such as Talkiatry and Brightside Health can be good places to start. They offer assessments and can help you determine the best medication options while pregnant or breastfeeding.
Boxed Warning: Sertraline (Zoloft) – Risk of suicidal thoughts and behaviors in certain people
Sertraline, the active ingredient in Zoloft, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Sertraline can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with sertraline and any other medications before starting treatment.
What Is Zoloft (Sertraline)?
Zoloft’s generic name is sertraline. Sertraline belongs to a class of medications called Selective Serotonin Reuptake Inhibitors (SSRIs) Zoloft (sertraline) increases serotonin levels, a neurotransmitter in the brain that helps regulate mood. Zoloft is commonly prescribed to treat various mental health conditions, including depression, anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD)1
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Side Effects of Zoloft
Medication and pregnancy require careful consideration due to the potential risks and effects on the mother and the baby. Medicines like Zoloft can have side effects that vary from person to person. These side effects may occur as the body adjusts to the medication or due to individual sensitivities. While most side effects of Zoloft are mild and temporary, some may require medical attention.1
Common Zoloft side effects include:
- Nausea
- Diarrhea
- Insomnia
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Headache
- Sweating
- Tremor
- Weight changes
- Sexual dysfunction
- Agitation
- Indigestion
When treating depression and anxiety disorders with Zoloft, certain side effects may have a higher prevalence or be more noticeable. For example, sexual dysfunction, weight changes, and fatigue are commonly reported.1 If you experience serious symptoms such as suicidal thoughts, worsening depression, or unusual bleeding, seek immediate medical help. Prompt attention to serious symptoms is crucial for your safety and well-being during treatment with Zoloft.
Serious side effects of Zoloft that require immediate medical attention include*
- Agitation
- Anxiety
- Confusion
- Suicidal thoughts
- Hallucinations
- Irregular heartbeat
- Seizures
- Severe allergic reactions (e.g., rash, itching, swelling)
- Serotonin syndrome
When using Zoloft to treat depression and anxiety disorders, some side effects, such as agitation, anxiety, and confusion, may occur more frequently or be more noticeable. If you experience any serious symptoms or if these side effects significantly affect your daily life, it is crucial to seek immediate medical assistance. These symptoms may require careful monitoring, especially during the initial stages of treatment or dosage adjustments.
*All medications, including Zoloft, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions and understand the potential side effects and benefits of any medication.
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Is Zoloft Safe During Pregnancy?
Taking antidepressants during pregnancy, including Zoloft, requires mindful consideration of safety concerns. Studies suggest a potential risk of birth defects and withdrawal symptoms in newborns exposed to Zoloft. However, the overall risk is relatively low, and the decision should be made with a healthcare provider, weighing benefits and risks, such as whether you have experienced postpartum depression before. The lowest effective dose is recommended, as abruptly stopping it can cause Zoloft withdrawal symptoms and relapse. Refer to the Zoloft prescribing information for more specific guidance on dosage and safety considerations.
Can Zoloft Cause Birth Defects?
Evidence suggests a potential risk of birth defects associated with Zoloft and pregnancy. Particularly, there is a risk when taking it during the first trimester. The probability of harm is generally low, though.1
Can Zoloft Cause Withdrawal Symptoms in Your Baby?
Newborns exposed to Zoloft during pregnancy may experience withdrawal symptoms, known as neonatal adaptation syndrome (NAS) These symptoms include jitteriness, irritability, feeding difficulties, and respiratory distress.2
Can Zoloft Interfere With Fertility?
The use of Zoloft is not typically associated with interference with fertility in either men or women. Depression itself can potentially impact fertility.3 The relationship between depression and fertility is complex, so discussing medication use during pregnancy with your healthcare provider is urgent to ensure the best possible outcomes.
What If You Are Already Taking Zoloft When You Become Pregnant?
If you are already taking Zoloft when you become pregnant, it is important to consult with your healthcare provider. If you abruptly stop taking your medication, Zoloft withdrawal symptoms can occur as well as a relapse of your mental health condition.2
What Zoloft Dosage Is Safe During Pregnancy?
The safe dosage of Zoloft during pregnancy depends on individual circumstances. It is crucial to discuss this with your healthcare provider. The prescribing information for Zoloft recommends using the lowest effective dose, considering the patient’s specific needs, while monitoring for any potential adverse effects.1,4
Does Zoloft Increase the Risk of Miscarriage in the First Trimester?
Research on the risk of miscarriage associated with taking Zoloft during the first trimester is limited. Generally, it suggests that using Zoloft does not significantly increase the risk of miscarriage compared to the general population.1 However, it is important to note that individual circumstances may vary, and factors such as maternal mental health conditions and other medical considerations can influence the overall risk.
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Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Potential Risks of Taking Zoloft During the Third Trimester
Taking Zoloft during the third trimester may pose certain risks. According to the medication product information packet of Zoloft, there have been reports of infants experiencing complications, such as respiratory distress, cyanosis (bluish discoloration of the skin), and jitteriness when exposed to Zoloft in late pregnancy. 1
Zoloft Withdrawal
Zoloft withdrawal, or antidepressant discontinuation syndrome, can occur when abruptly stopping the medication. Prevalence of withdrawal symptoms varies, with some experiencing mild effects while others face more serious ones. During pregnancy, abrupt discontinuation of Zoloft adds risk due to the potential impact on maternal mental health and the developing fetus.5
Common withdrawal symptoms include dizziness, nausea, headache, fatigue, and mood changes. Serious symptoms like agitation and anxiety are rare but possible. If experiencing withdrawal symptoms, communicate with your provider as some may require immediate medical attention. Never stop Zoloft abruptly without consulting your provider to ensure a safe approach to managing mental health during pregnancy.1,5
Preterm Birth & Low Birth Weight
There are potential links between Zoloft and pregnancy, specifically, an increased risk of preterm birth and low birth weight. Studies suggest that Zoloft exposure in late pregnancy may contribute to these outcomes. Additionally, maternal weight changes may occur while taking Zoloft, as some individuals may experience weight gain.6
Can You Breastfeed While on Zoloft?
Breastfeeding while taking Zoloft (sertraline) is a topic that requires careful consideration. Zoloft is known to pass into breast milk, and there have been reports of infants experiencing adverse effects. However, the overall danger to the baby is considered low, and many medical professionals think that breastfeeding may have advantages that surpass any possible hazards brought on by Zoloft exposure.1
Keep in mind that speaking with a medical professional is essential to accurately assess the dangers of taking other antidepressants while pregnant and determine the best course of action for treating maternal mental health.
Do Other Antidepressants Have Similar Risks During Pregnancy?
Other antidepressants, such as Prozac (fluoxetine), Wellbutrin (bupropion), and Lexapro (escitalopram), may also carry similar risks during pregnancy like Zoloft (sertraline) does. SSRIs are a class of drugs linked to risks such birth abnormalities, premature birth, and low birth weight. However, it is crucial to recognize that the specific risks and safety profiles may vary among different antidepressants.7 Each medication should be evaluated individually, considering factors such as the particular drug, dosage, timing of exposure during pregnancy, and maternal health.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Questions to Ask Your Healthcare Provider About Zoloft and Pregnancy
The effects of medication on pregnancy outcomes can vary. When considering Zoloft use during pregnancy, engaging in open discussions with your healthcare team, including a psychiatrist and a therapist, is all-important. Questions should include the need for antidepressant treatment, medication options, and potential effects on the unborn. Additionally, exploring online psychiatry services can be beneficial if you require a change in prescribers or seek specialized guidance.
Questions to ask your care team when considering using Zoloft while pregnant may include the following:
- Do you think I have a depressive disorder based on my symptoms?
- Do my symptoms warrant the use of an antidepressant drug like Zoloft?
- I’m already on an antidepressant. Should I switch to Zoloft or continue with my current medication?
- Which medication do you suggest for me, and how did you reach that conclusion?
- What doses of Zoloft are considered safe during pregnancy?
- Should I take Zoloft throughout my entire pregnancy or only for specific periods?
- How does Zoloft affect the baby? Are there any particular risks or potential complications?
- What happens if I decide to stop taking Zoloft during pregnancy?
- Can I continue taking Zoloft if I choose to breastfeed?
- Will Zoloft help with postpartum depression?
Remember to have an open and detailed discussion with your healthcare provider to address your concerns and make informed decisions regarding Zoloft use during pregnancy.
In My Experience
I have witnessed the importance of open communication and informed decision-making when considering Zoloft and pregnancy. Suppose you are experiencing depression or anxiety during pregnancy. In that case, you should know you are not alone in this journey. Taking the courageous step to seek help is a significant stride towards better mental health for yourself and your baby.
Remember to prioritize self-care, establish a strong support network, and maintain open communication with your healthcare team. Your well-being matters, and by reaching out and seeking the support you deserve, you are actively nurturing your mental health and ensuring the best possible outcome for yourself and your baby.
Combining medication with therapy and support is vital for addressing depression and anxiety during this critical time. I strongly urge you to open up with your healthcare provider about Zoloft and its implications during pregnancy. Trust their expertise, follow their guidance, and embrace the support they offer. By doing so, you can embark on your journey toward motherhood with the necessary support and knowledge to make informed decisions that prioritize your well-being.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.