Pregnancy

The tricyclics have been used in pregnancy and do not carry risk of fetal malformation. For SSRIs and newer antidepressants the situation is less clear as sufficient experience is lacking: they usually carry warnings against use in pregnancy. Accumulating experience suggests that fluoxetine is safe. (87) Mood stabilizers are contraindicated; lithium, carbamazepine, and valproate all have some risk of fetal malformation. Where antidepressants are used at the time of delivery there may be complications of anaesthesia and fetal sedation, and these should be anticipated. Most antidepressants and mood stabilizers appear in breast milk, but in small quantities. Breast feeding should be discussed with the patient.

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