Lexapro is the brand name for the generic drug Escitalopram. It belongs to the category of selective serotonin reuptake inhibitor (SSRI) antidepressant drugs. It is used for treating major depressive disorder (MDD) and generalized anxiety disorder (GAD) (1). Many women, especially those who have the drug already, may wonder about its safety during pregnancy. This post answers whether you can take Lexapro while pregnant, its safe use, risks, and side effects.
Can You Take Lexapro When Pregnant?
The US Food and Drug Administration (FDA) had listed Escitalopram under pregnancy category C. This means that fetal toxicity was shown in animal reproduction studies, while there are no adequate and well-controlled studies in pregnant women. Therefore, Escitalopram might be prescribed during pregnancy only when its benefits outweigh the fetal and maternal risks (1).
How Does Lexapro Work?
Lexapro or Escitalopram acts by increasing the activity of serotonin, a naturally available chemical in the body. Serotonin modulates several human behavioral processes and responses such as mood, perception, memory, anger, aggression, fear, stress, addiction, and sexual interests. Lexapro produces antidepressant activity by working on some parts of the central nervous system. The drug may also affect other body systems, leading to concerns about its use during pregnancy (2).
What Are The Potential Risks Of Taking Lexapro During Pregnancy?
The limited research on Escitalopram use during pregnancy suggests that the drug may not increase the risk of congenital malformations but may slightly increase the risk of low birth weight (3). Other scientific studies suggest certain risks with taking antidepressants, including SSRIs such as Lexapro, during pregnancy.
In 2016, researchers found an increased risk of miscarriage with antidepressants use in the first trimester of pregnancy (4).
A review published in 2019 stated that exposure to antidepressants, such as SSRIs, in the third trimester of pregnancy may be associated with seizures in newborns (5).
An increased risk of severe congenital heart defects (CHD) may be associated with SSRI exposure in early pregnancy (6). Newborns whose mothers took these medications late in the third trimester were found to develop some complications. Conditions indicated serotonin toxicity symptoms or drug discontinuation symptoms such as seizures, respiratory distress, temperature fluctuations, vomiting, hypoglycemia, tremor, irritability, and constant crying (1).
Some studies indicate a higher rate of persistent pulmonary hypertension of the newborn (PPHN) whose mothers took SSRI medication after 20 weeks of pregnancy (7). PPHN occurs when a baby’s lungs cannot function outside the uterus.
Experts have found that the increase in the risk of miscarriages was similar in women who were exposed to SSRIs during early pregnancy and those who discontinued SSRIs before pregnancy (8). Nevertheless, more rigorous human studies are required to confirm all findings (9).
What Are The Side Effects Of Lexapro?
Lexapro or Escitalopram may cause the following side effects (10).
Nausea Diarrhea Constipation Altered sex drive Drowsiness Abdominal pain Heartburn Increased sweating Fatigue Flu-like symptoms, runny nose, or sneezing
Some serious adverse effects that may require immediate medical attention are:
Hyper excitement Hallucination (seeing or hearing things that do not exist) Allergic reactions such as hives, rash, itching, or swelling of face, throat, tongue, lips, or eyes Fever Joint pain Symptoms of serotonin syndrome such as fever, sweating, confusion, irregular heartbeat, muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhea Problem concentrating or with memory Seizures
Discontinuing Lexapro suddenly may precipitate withdrawal symptoms such as:
Mood alterations Irritability Agitation Tingling in hands and feet Anxiety Dizziness Confusion Headache Sleep problems
What Should You Remember When Using Lexapro?
Pregnancy may change the way some medications act inside your body. However, you must not stop Lexapro administration abruptly on conception or detection of pregnancy. It may lead to withdrawal symptoms and exacerbation of depression. Untreated depression during pregnancy may have complications, such as an increased risk of developing suicidal tendencies and postpartum depression (11). Therefore, discuss the use of Lexapro extensively with your doctor, understand its side effects, and use it only as prescribed.
